Why First Responders Face Increased Risk for PTSD, Suicide

For most Americans, a typical day at the office comes with the usual ups and downs, some stress, difficult clients, perhaps some inner-office politics. For first responders, on the other hand, a typical shift might very well include a mass casualty event, a horrible crime scene, or even a risk to one’s own personal health and safety.

And while one could argue that first responders “knew what they were getting into” when they decided to pursue this career, it doesn’t lessen the very real effects that repeated exposure to trauma can have on an individual’s mental health.

PTSD: Real and Deadly

While awareness in today’s society of Post Traumatic Stress Disorder (PTSD) is growing – especially when it comes to active military members and veterans– a lesser-known but still-deadly PTSD epidemic is silently spreading through U.S. firehouses and ambulance companies. Today’s research shows that first responders are disproportionately at risk for PTSD, with an estimated 30% of first responders developing behavioral health conditions including depression and PTSD, compared with 20% in the general population. Other studies show that 85% of first responders have experienced symptoms related to mental health issues.

With symptoms like anxiety, depression, isolation, hyper-vigilance, and flashbacks, PTSD can cause serious, life-disrupting issues, leading to divorce, addiction, and even suicide. Individuals struggling with PTSD and related mental health issues often turn to self-medication through abuse of drugs, food, and alcohol.

More intensive studies have also been recently focused on first responder suicide rates, which are growing at an alarming pace. According to the Firefighter Behavioral Health Alliance, more than 115 firefighters and emergency medical service workers in the U.S. died by suicide in 2017, surpassing the number of LOD deaths for the same timeframe. Sadly, the statistics also suggested that only around 40 percent of firefighter suicides are actually reported, suggesting that the epidemic is far more serious and far reaching.

Changing the Culture

While the nature of the work – being exposed daily to someone’s worst possible experience in life – seems to be the underlying cause of the first responder stress, the culture of the firehouse may hinder reaching out for help. Unfortunately, there remains a stigma around PTSD, depression, and similar conditions. Mental health professionals would argue that if someone received a broken leg or physical injury on the job, they would of course seek and receive treatment to return them to full health. However, recognizing and gaining access to treatment for mental health injuries is still considered somewhat taboo, and possibly seen as a sign of weakness and unreliability.

Many firehouses and EMS agencies are now actively working to combat the PTSD epidemic on several fronts. Studies have shown that PTSD and depression can be systematically managed with the increased availability of coping therapies, counseling sessions, and other clinical tools. For example, more open conversations and information sessions, informal one-on-ones, post-incident check-ins, and the availability of chaplains or specialized counselors help reduce stigma and open the channels of communication.

How Data Can Help

Additionally, some of today’s incident reporting software tools can help track individual crew member’s exposure to critical events, in the same way his or her training and vaccinations are tracked. The system can then alert officers when a certain threshold of traumatic event exposure has been passed within a set time frame, triggering a protocol of proactively reaching out to the crew member. This removes the barrier of the crew member, who may already be struggling with stress or mental health issues, having to begin the conversation with officers themselves.

Tips for First Responders

In a recent article, Psychology Today offered a list of helpful things that first responders specifically can remember as they face a unique and increased exposure to trauma, including:

• Know that you aren’t alone. About one in five people experiences a mental health issue in any given year, and the extraordinary stressors that first responders face boost that risk.
• Trauma is a normal human response to an abnormal situation. It would be strange if you had no negative reaction to putting your life at risk or seeing terrible things happen to people. Understanding this allows you to move from a mindset of “What’s wrong with me?” to a more empowering, “This is what’s going on with me.”
• Trauma is better understood as an injury to the brain rather than an illness. Left unaddressed, however, that injury can lead to illnesses such as depression and anxiety.
• You can help build resilience to trauma exposure by working on your connections with others. The more supportive, caring, trustworthy people you have in your life, the more able you are to cope with the experiences that can lead to trauma. Also learning coping mechanisms and skills in managing feelings, improving communication and self-expression, and addressing stress can be extremely helpful.

Get More Information for Your Agency

ESO recently hosted a webinar titled, Addressing PTSD and Creating a Culture of Courage, conducted by Brett Ellis, Assistant Chief of Operations for Harris County ESD No. 48 Fire Department. Ellis discussed findings from his study of firefighter behavioral health in relation to suicide ideation. Out of 4,022 first responders, 6.6% had attempted suicide, more than 10x the rate of the general population. The session also covered how physical and mental health are pivotal to keeping first responders safe, and how you can help bring safety and awareness into your department. Watch the on-demand webinar now.

Get Help for Yourself

If you are a firefighter or EMT struggling with PTSD or suicidal thoughts, you can take this confidential online quiz, created by the FBHA.

You can also call the National Suicide Prevention Lifeline 1-800-273-8255 or the Share the Load Program 1-888-731-3473. Once you have reached one of the above, call a trusted family member, friend, chaplain, or counselor. If you need assistance in finding a counselor in your area, contact FBHA for further information at 847-209-8208.