First responders are an essential part of a community. They play an important role helping and keeping people safe in the event of an emergency. The Department of Homeland Security estimates that more than 25 million people hold first responder roles in the United States. This includes any professional or volunteer performing duties like firefighting, law enforcement, any emergency medical professionals, and others.
Daily life on the job in any of these professions can include long hours away from family and prolonged stress from dangerous situations. Even a relatively normal shift can be stressful, due to the uncertainty it holds. Because of the high-stakes environment of first responder work, professionals in the field are more likely to develop mental health issues or attempt suicide.
To perform at the top of their capability in caring for others, first responders must also take care of their own mental health.
Unfortunately, many first responders neglect their own mental health due to a perceived stigma. Frequent encounters with mental illness and substance abuse can create a bias or desensitization that causes first responders to avoid labeling themselves and seeking the treatment they need.
Identifying burnout and traumatic incident stress
In addition to the initial impact of a traumatic incident, constant exposure to high-pressure, potentially life-threatening situations can take a toll on a person’s mental health.
Understanding burnout
Although a burnout diagnosis is often mistaken with other mental health conditions such as depression, burnout is different because it tends to result from a specific situation. A stressful work environment or unhealthy work-life balance are two common attributes of first responder jobs that can lead to burnout.
A 2022 study of first and second responders found that first responders were more likely to meet the requirements of burnout. This study examined these workers specifically during the COVID-19 pandemic, but the evidence still illustrates the high capacity for burnout in traumatic work environments. Burnout symptoms can begin subtly, and become more pronounced if the trigger remains. Common signs of burnout include:
- Fatigue;
- Apathy or displeasure with work;
- Headaches;
- Changes to diet or sleep schedule.
Identifying these signs early can help to take measures to address burnout before it becomes a major issue.
Understanding traumatic incident stress
Over the past two decades, research on work-related exposure to traumatic events has allowed researchers to estimate the effects of traumatic incidents on workers. These estimates find as many as 32% of first responders may develop PTSD at some point. This is nearly triple the potential rate of 12% for general adults in the United States. While general work stress can share similar symptoms with traumatic incident stress, the symptoms are often more severe and can be attributed to emotionally and physically traumatizing events. Some symptoms may indicate immediate professional care, so it’s important to familiarize yourself with them:
- Serious physical symptoms: If a stressful or traumatic event results in shock, shallow breathing, chest pain or other severe pain, seek medical help immediately. These could be signs of the onset of a serious health episode.
- Minor physical symptoms: Traumatic incidents can also cause physical responses such as fatigue, dizziness, sweating, and general aches. These reactions may be less severe than some of the immediately life-threatening reactions, but should still be considered seriously.
- Emotional symptoms: Often, a traumatic incident will result in some emotional responses such as anxiety, guilt, fear, irritability and loss of emotional control.
- Cognitive symptoms: A traumatic event can sometimes affect an individual’s ability to perceive or process information; resulting in confusion, disorientation, nightmares and issues with memory recall.
- Behavioral symptoms: Stress response after a traumatic incident can alter a person’s behavior. Anger, loss of appetite, substance use and restless activity can all be reactions to a traumatic incident.
Many of these symptoms may be temporary, but if they continue or become worse, medical help may be required.
How to prevent and manage stress
Stress is often an unavoidable part of life. Short-term stress can be relatively harmless. After all, stress is needed to motivate us to do difficult tasks. In the long term, however, consistent stress can lead to health issues including heart disease, depression and obesity. Managing stress in a healthy way can help to reduce these dangers, which is particularly important if stressors stem from a recurrent aspect of life, such as first-responder work.
To prevent and manage your stress related to work, you must first recognize your stressors before taking efforts to avoid or reduce exposure to them when possible. It’s also important to be able to work through stress and anxiety that is unavoidable. Several techniques can help in these areas.
Psychological First Aid (PFA)
Just as physical injuries can be lessened by the immediate application of first aid, psychological trauma benefits from taking measures to reduce a traumatic incident’s impact. Psychological first aid is all about recognizing common stress reactions and understanding appropriate coping strategies.
People react to stressful situations differently in terms of severity, timeframe, and physical or emotional response. PFA offers a way to recognize and address these reactions, which makes it a valuable companion to counseling and other traditional therapy.
Develop a buddy system
It’s practically impossible to navigate through stress alone, especially as a first responder. You must establish a support network to help cope with stressful situations and environments. Engaging with a peer can be a mutually beneficial exercise that is also convenient since both individuals are teammates or coworkers.
Due to the similarity of shared experiences, it’s also a great way to ensure sympathy, which can help the support be more specific and personal. A coworker support group can also help in ways other support can not since buddies can help each other with stressful work tasks or other job-specific responsibilities.
Establish self-care practices
Regular mental health upkeep through self-care practices can be paramount to managing stress. Incorporating new habits, such as those listed below, or making small adjustments to behavior can help you look at stress in a new way, and better understand your own needs.
- Journaling: It can be easy or even instinctive to dismiss a stressful event or situation and try not to dwell on it. However, journaling can be an introspective way to process the stress and understand better how it has specifically affected you and made you feel.
- Breathing exercises: Practicing gentle breathing exercises can help reduce stress and bring perspective when anxiety begins to build.
- Exercise: Regular exercise can benefit all facets of your health — including your physical and mental health. Exercise reduces stress hormones, and increases other neurochemicals like endorphins, which help a person feel more relaxed and rejuvenated, ultimately reducing feelings of stress.
- Talk to family and friends: Talking through stressors with family and friends can help release any burdens you may be holding on to from a stressful situation. It can also help cultivate mutual understanding, allowing all parties to recognize the value and result of different coping mechanisms.
- Prioritize sleep: Many of the body’s functions rely on sleep. Getting a good night’s rest can be essential to ensuring good overall health, and it is also a key component in mental health.
Keeping these factors in mind can help to address mental health concerns as they come up. However, they’re not an entire replacement for professional help. If you find that any of these practices are a small band-aid to the problem, professional help may be necessary.
Seek help from a professional
When seeking out professional help for any trauma from your first responder work, enlist the services of a therapist or counselor. Although it takes some vulnerability to do this, you can only provide help to others in your work if you are in peak mental and physical condition.
Moreover, if you’ve recently experienced a traumatic event, professional therapists can help to work through specific trauma. However, it is also a good idea to be proactive and seek ongoing counseling. By pursuing continued care, you can reduce the opportunities for stress to build up over time.
Mental health resources by profession
While some of the stressors faced by first responders may be similar in nature, many are unique to different roles. As such, organizations exist to help out specific groups of first responders. These groups seek to offer various types of mental health support catered to different first responder groups and roles.
Firefighters
Firefighters often have to rush into burning buildings and other dangerous situations, putting their lives on the line to save others. This can involve rescuing people who have been severely injured, or trapped as a result of an accident. Responding to emergencies can be traumatic, and so can the mental toll of interacting with victims and the families of those affected. Organizations dedicated to helping firefighters include:
- Firefighter Behavioral Health Alliance: The FBHA provides workshops and information that help firefighters prepare for and respond to the stressful realities of their job. These programs and educational resources are developed under the supervision of a retired firefighter looking to support others in the field.
- Firefighter’s Support Alliance: This organization serves as an advocacy group for mental health issues surrounding firefighters. The group seeks to bring attention to mental health concerns through education and legislative discussions.
- National Volunteer Fire Council First Responder Helpline: This call center focuses on providing immediate support to firefighters and their families. The line is staffed by degreed counselors who offer their services.
EMS
Workers in EMS are often the first to arrive at a traumatic scene. EMS workers such as EMTs and paramedics provide immediate medical assistance for patients before they are transported to the hospital. This means they often have to interact with people who are injured and/or panicked. Repeatedly responding to situations of disturbing conditions can be upsetting, and have an impact on mental health. Some organizations that help support EMS workers include:
- PeerConnect: This platform provides peer support to first responders. The service puts peers in contact with one another so that they can offer each other support.
- Code Green Campaign: This organization offers education and advocacy for first responders. The group also provides resources, including a list of licensed therapists listed by state.
- Reviving Responders: This group seeks to prevent suicide among first responders. They help to provide access to resources and cultivate support among the EMS and first responder community.
Search and rescue
Search and rescue workers are dedicated to locating and providing assistance to victims, often following a disaster. These efforts include the cooperation of several disciplines. Support groups that focus on search and rescue include:
- ResponderStrong: This organization focuses on intervention and prevention to address mental health concerns among search and rescue workers. The site offers links to resources, including educational materials and tools for first responders and their families.
- Responder Alliance: This organization offers online courses and seeks to spread awareness of mental health issues affecting first responders. This includes providing a community, as well as resources and training materials.
Police
Law enforcement officers can deal with danger and adversity daily. Upholding the law and responding to intense situations, police officers face numerous stressors. Organizations dedicated to offering mental health resources to police include:
- Copline: This hotline is staffed by volunteers who provide support to police officers. The line is dedicated to providing confidential services to officers dealing with work and general life stressors.
- CODE-4 Counseling: This group offers individual and couples counseling for first responders and their families. They also focus on training, and helping organizations develop their own wellness initiatives.
- Badge of Life: This organization is focused on educating and preparing law enforcement officers to deal with mental health issues. They also provide resources for suicide prevention among officers.
Additional resources for first responders
These organizations and pages offer various support and resources for first responders and other public safety workers:
- Safe Call Now: This helpline connects first responders and their families with mental health resources. They also educate and inform first responders and connect them with mental health professionals.
- Building Warriors: This organization offers training, counseling, and peer support for first responders and their families. The page provides a calendar detailing upcoming classes and training sessions.
- Disaster Distress Helpline: This 24/7 helpline provides resources for those experiencing issues with mental health or substance abuse to help them recover and cope.
- FORTITUDE: This organization focuses on offering mental health and substance abuse assistance for veterans and first responders.
- 2nd Alarm Project: This nonprofit organization provides a variety of mental health resources to first responders. This includes peer support initiatives, mental health education resources, and leadership resources.