It’s a strange one, isn’t it? When you think of your role as a First Responder, it’s physical health that probably springs to mind as whether you’re a firefighter, police officer or EMT, these are the calls that get you kitted-out and blue lighting your way through the busy streets of America. Yet take a step back and think about the very real – very serious effects – the nature of the job takes on your own mental health.
First Responder Mental Health Statistics and Causes
So, what exactly is going on?
It doesn’t help that the image – quite rightly – appropriated to First Responders is that of stoic public servants, embodying the popular hashtag #notallheroeswearcapes.
But it certainly comes at a cost. For even the bravest of those willing to jump into fires, get in the line of gunshot or deal with the bloodiest of wounds is not infallible, and being repeatedly exposed to such traumatic conditions (be they earthquakes, hurricanes or terrorist attacks) leaves a heavy mark on the mind – especially when a life is not saved. Throw into the mix a lack of sleep (read more about that here), a separation from family and a macho culture – leading to a misplaced notion of stigma through a fear of ridicule, prejudice and discrimination - and you have a whole family of First Responders who are responding to the needs of others but letting their own needs fall by the waste side.
It’s difficult to know where to begin when reporting First Responder mental health statistics as it seems new data is being released each day. But here are a few stand-out statistics:
First Responder depression is real, with 13% suffering in some way. Twenty-six percent display signs of PTSD and 25% are at high risk for suicide (figures by Professor Sarah Jones at the University of Arkansas for Medical Sciences)
70% of firefighters have trouble sleeping, while over 50% of firefighter deaths are due to stress and exhaustion, according to a 2012 literature review
37% of emergency medical service providers have contemplated suicide and 6.6% have made an actual attempt (figures by JEMS - the Journal of Emergency Medical Services) – nearly 10 times the rate of American civilians. Sixty-nine percent feel as if they have never had enough time to recover between traumatic events (Bentley et al., 2013)
Around 75% of police officers have reported experiencing a traumatic event but less than half of them told their agency about it (Fleischmann et al., 2016), while an estimated 125 and 300 police officers commit suicide every year (Badge of Life, 2016 – a police suicide prevention program)
What’s even more concerning is that all these figures could be much higher since there is no official database tracking these incidents.
First Responder Mental Health Symptoms
So, what are the signs to look out for to determine whether you – or a loved one – are suffering from a breakdown in mental health?
Where it all begins, First Responders may experience physical, cognitive, emotional or behavioral symptoms of stress. Some may occur immediately, while others might only present themselves much later (PTSD).
Physical symptoms that of stress that may be affecting you:
- Chest pain
- Difficulty breathing
- Dilated pupils and problems with eyesight
- Extreme fatigue
- Headaches and other pains
Cognitive symptoms of stress can include the following:
- Confusion and disorientation
- Poor problem solving
- Memory problems
Emotional symptoms of a Mental Health breakdown include:
Feeling of failure
Behavioral symptoms include:
- Loss or increase of appetite
- Substance abuse, such as alcohol or drugs
- Poor self-care
Strategies for keeping a healthy mental attitude as a First Responder
Looking at it like this, it can seem completely overwhelming. Fortunately, there are many coping mechanisms available:
The first step in accepting the mental health ramifications attached to your role as a First Responder is to ensure you are properly informed and educated to all the facts. Learn what happens, why it happens and how to deal with it when it does happen.
The better prepared you are – both in your job and personal life - the less overwhelming it will seem. Make sure you ask as many questions as possible about what is to be expected of you at any given time. Inform your loved ones of known shifts and periods of time in which you might be unavailable, making sure their expectations of you are realistic, and be involved in any plans involving household and childcare so that you feel more in control of what you’re leaving behind.
Make sure you take regular breaks, eat a healthy diet and exercise – and resist the temptation to self-medicate with drugs and alcohol! Keep a journal where you can write down thoughts and feelings and talk to others about your experiences. Practice breathing and relaxation techniques and start using the word ‘no’! Read more about the importance of lifestyle on First Responder health here.
In an ideal world, all First Responders would have access to mental health resources such as Employee Assistance Programs, but sadly this isn’t the case, with a 2016 survey from the National Association of Emergency Medical Technicians finding that 37% of respondents said their agency did not provide mental health services. And even those lucky enough to work in an agency thatdoesprovide these things will often not utilize the resources for fear that others will find out – coming back full circle to the misplaced macho culture we spoke about earlier. But it is certainly worthwhile to give it a go, as the JEMS survey found that of those who participated in a critical incident stress management program, 63% rated the experience very or extremely helpful.
Even if your workplace doesn’t have any official First Responder mental health resources, nothing is stopping you from reaching out to your employer and telling them you’re suffering. You may even want to develop a buddy system of sorts, allowing you to partner up with a colleague in which you help monitor each other’s stress, workload and coping mechanisms. Check-in with each other regularly and offer to both share and listen to experiences, as well as encouraging each other to take breaks. Someone should take accountability for you, and you should take accountability for them in return. Mental health must no longer be a taboo subject, meaning you must accept it both internally and externally.
No matter where it comes from, however - your employer, colleagues or a professional counselor - get help wherever you can. Studies have, however, found that therapists must fully understand where their patients are coming from, to really make a breakthrough. That’s why we support such important organizations, such as Next Rung and Blue H.E.L.P.
There are always people who will be willing to help – but you must first be willing to ask for it, breaking down the stigma surrounding First Responder mental health one step at a time.