Protecting and Serving the Mental Health of First Responders: PTSD

Written By: Jennifer Voorhaar, LCSW-C

Our first responders are often the ones we most overlook. Sounds a little strange, doesn’t it? Well, it is true. We have thousands, maybe millions, of men and women in first responder positions serving as police officers, firefighters, EMTs, and paramedics as well as dispatchers. Some say, “that’s what they signed up for.” Some say, ”it’s just a part of the job.” Some say, “they’re fine.”

Well, I say, hogwash! I say, that is nonsense. I say, they deserve more.

According to the National Council on Mental Wellbeing, 70% of adults in the U.S. have experienced some type of traumatic event at least once in their lives. I’d offer that since COVID, that is likely 100% of us. I mean, “surviving a natural disaster” is a criterion for trauma, and certainly a global pandemic fits the bill. Of those 70-100% of the population, about 6% of those individuals will develop Post Traumatic Stress Disorder. The Institutes of Health reports that 80% of first responders experience traumatic events on the job. I’m not sure how that number isn’t 100% given the nature of the job, but I’ll go with the research for now. Furthermore, the Substance Abuse and Mental Health Services Administration reports that roughly 1 in 3 first responders develop PTSD.

Let’s think about this. 6% of the general population may develop PTSD but 33% of first responders will develop PTSD. This is where I say again….hogwash! Nonsense! They deserve more.

Now might be about the time you’re asking yourself, “so what is PTSD anyway?” I’m so glad you asked. In general, or basic terms, it is the experience or collection of symptoms present after a person experiences or witnesses a traumatic event. Their symptoms often impact their day-to-day functioning and are characteristically different from their baseline functioning. Symptoms might include nightmares, flashbacks, avoidance of people, places and things, hyper-vigilance, anxiety, and depression to name a few.

Why might first responders be more likely to experience PTSD? It is likely due to the cumulative nature of their careers. A non-first responder might experience one traumatic event in their lifetime. First responders likely experience more than one every working day. Our brains and our bodies remember the stress and the trauma. Just like a sink or a bucket, there’s a limit, and things start to overflow. The other thing that happens is that our first responders are expected to be like Dory in “Finding Nemo” and just keeping swimming. They go from call to call with no debrief, no down time, no opportunity to breathe, and no chance to process what they’ve seen, heard, and experienced.

Just as with so many other populations of people, there is huge stigma around seeking mental health care. Because their line of work “expects” them to “deal with it” they hesitate to seek mental health support early. Often its not until there are issues in relationships, job performance, health concerns or overall decline in well-being that treatment and support is sought. Let’s say again….hogwash!

Its time for us as a community to make mental health treatment as universally accepted as dental cleanings and eye exams. I may not be having trouble with my teeth but I still go to those cleanings every 6 months. I may not have trouble with my eyes but I’ll still get them checked. Our brains, minds, hearts, and bodies deserve the same care and concern.

If you’re a first responder or you know a first responder, consider these things:

1. Know that you don’t have to just “suck it up” because it’s “what you signed up for.”

2. Find a trusted peer or professional provider to process your experiences with on a regular basis.

3. The more we brush under the proverbial rug, the worse things will become. So, don’t be afraid to acknowledge those calls that stick with you. Talk about the ones that leave you feeling something a little more or different than the one before. Don’t ignore it just because history says you have to keep on going.

4. Take care of yourself, and consider 4 Pillars of Health:

a. Stress

b. Food/Nutrition

c. Movement

d. Sleep

Yes, I know that you are super stressed, eat on the fly, and are too tired to exercise because you don’t sleep (thanks to shift work) but maybe, just maybe, you could consider one tiny tweak in your schedule, habits or routines to allow for:

a. Coping skills to manage stress

b. Partnering with a family member to help with some planning and preparation of healthy meals to feed and fuel your body

c. Walk. Not just on the job. Not sure from the car to the station. Take 10, 15, 20 maybe even 30 minutes and walk. Start there and then see what comes next. Maybe a jog. Maybe some weights. What about some yoga (see where coping skills fit in here too?)

d. Make sleeping a priority. Even with shift work. Even with crazy schedules. Even with spouses and kids and pets in the house. Figure out a way to make sleep a priority. (I know someone who used to make a cozy bed in the master bedroom closet to ensure good sleep after a midnight shift).

The work that our first responders do is heroic. From the dispatcher who answers the call, to the police who secures the scene, to the EMT who transports to the hospital, each and every one is heroic. Let’s work together as a community to ensure they… YOU… have what is needed to be the best they can while they protect, care for, and serve our community.