Response Ready: Destigmatizing First Responder Mental Health

“9-1-1, what’s your emergency?”

We’ve all seen the medical drama shows.

The larger than life emergencies, the immaculate last minute life saving procedures, the just-in-the-nick-of-time timing. It’s entertaining to watch, but it pales in comparison to the real life careers of first responders.

First responders, including firefighters, law enforcement, emergency medical technicians, paramedics, and dispatchers, are called to respond to unique, and often traumatic calls, which require extensive knowledge, training, and skills to assess a situation and mitigate harm as much as possible.

When first responders report for their shift, they have to be “fit for duty” from the moment they walk in the door, but this extends beyond physical expectations and includes the mental and emotional requirements that are needed for this caliber of work.

Culture and Stigmas

For decades, first responder culture has adopted a “suck it up, buttercup” mentality, neglecting psychological well-being resulting in the failure to recognize the immediacy of care that is needed.

They suffer in silence.

This mentality of “I’ll deal with it later on my own time” creates a pattern of compartmentalization. As repeated exposure to critical incidents continues through the life of their career, first responders become more at risk of suffering from mental health issues.

Critical Incidents

Critical incidents are defined as “any event that overwhelms a person’s usual ability to cope”.

These can include:

The death, injury, or suicide of a co-worker,
Officer involved shootings,
Mass casualties,
Incidents involving children,
Exposure to infectious diseases,
Personal injury,
Victim known to responder

It’s also common that these critical incidents can involve a large influence from the media, adding to the stress of processing and working these emergencies.

This immense amount of stress can lead to many mental health concerns ranging from anxiety and depression, to substance abuse and suicidal ideations.

1 in 3 first responders develop PTSD compared to 1 in 5 among their civilian counterparts.

Data also shows that more first responders die by suicide, than in the line of duty, every day.

So where do we start, and how can we support the mental wellbeing of our first responders?

PPE for Mental Health

First responders ensure scene safety and acquire appropriate personal protective equipment (PPE) based on call type and routine protocols. This equipment can include gloves, eyewear, helmets, SCBA, bullet-proof vests, etc.

Without these tools, they cannot carry out the necessary tasks needed to perform their jobs safely.

Mental health should be held in the same regard and is vital in becoming self-aware of emotions, behavior changes, body sensations, triggers, and coping skills that cover a broad spectrum of needs.

Trauma-Informed Coping Skills for First Responders:

Prioritize Healthy Boundaries: Learn when to say “no” when you need time to yourself, and say “yes” to more of what you need. Start by asking yourself, “what is the healthiest thing for me right now?”
Physical Activities: Mild to moderate exercise or other physical activities can boost your serotonin levels.
Consider Nutrition: Be intentional about what you are putting in your body because what we consume impacts our physical and mental well-being. So next time, maybe skip the energy drinks and grab some water.
Talking to Someone You Trust: Lean on the support of colleagues, family, and friends. You can choose to share all the details of a call to a fellow firefighter or police officer, but may opt not to share details from a call or scale the details to a “Disney version” with your spouse/partner.
Limit Social Media: It may be easy to sit in the common room with your crew and mindlessly scroll through social media, but you need to know your limits. When you experience a traumatic call, limiting access to social media can decrease symptoms of depression, anxiety, and PTSD.
Mindfulness Matters: Incorporating mindful exercises, such as deep breathing or grounding techniques can help create separation between on-duty vs off-duty.

No matter your struggle, remember that what you are experiencing is a normal reaction to an abnormal situation.

Give yourself some grace.

Support from Peers

Peer support has been found to be one of the biggest contributions to destigmatizing first responder mental health and seeking help.

Official peer support programs train colleagues to recognize the signs and symptoms of a first responder who may be struggling so they can provide a space for empathy, understanding, and guidance in a safe and confidential way.

The benefits of peer support and these program initiatives also provides an opportunity for connectedness, and resource sharing, which in turn, decreases isolation.

If your department or agency does not have a peer support program and you are interested in creating one, use the resources below to gather information and research to help your department develop a proposal for integrating this type of program.

Local and State Resources for Peer Support

North Carolina First Responder Peer Support Team: https://www.ncffps.org
North Carolina Law Enforcement Assistance Program (NCLEAP): https://www.nc-leap.org/
North Carolina Responder Assistance Initiative (NCRAI): https://www.ncdps.gov/RAI

Family & Friends Supporting First Responders

As a spouse, friend, or family member, you may hear a lot about the calls they respond to, but you also may not.

Sometimes this “radio silence” is a way to protect you, and doesn’t necessarily mean you are being shut out. It does make support a little trickier, but there are still things you can look out for and ways that you can still be an effective supporter.

If you notice a shift in behavior, irritability, or anger becoming prominent, understand that you aren’t the problem. What first responders experience in a 12-24 hour shift can be more than we experience in our lifetime.

Note your concerns, take a breath, and communicate with them when the time is appropriate. Provide a space to allow them to talk about work-related stress or critical incidents. In this space, all you need to do is listen, not provide solutions.

During any conversation with a first responder, be mindful of your body language, eye contact, the time and place, and minimize reactions to expressed details of critical incidents if they are shared.

Remember, you don’t need to search for words to say, sometimes silent, but present empathy is all that is needed.

Conversations in the Workplace

Destigmatizing mental health in any capacity starts with normalizing conversation. Not only does this promote a safe workplace environment, it also creates psychological safety and fosters a culture that supports mental wellbeing within first responder departments and agencies.

This starts with leadership.

Providing a top-down approach, not only sets the tone for the department/agency, but demonstrates that being “fit for duty” is about the whole responder.

These cultural shifts along with continued education, training, and the provision of community resources will lead to better employee satisfaction and long-term retention.

Local Resources and Services

Knowing what is available to you makes the path to mental wellbeing easier. Here are a few mental health resources to get you started:

Employee Assistance Programs (EAPs): short-term counseling, referrals, and follow-up resources for employees. Ask for department/agency specific details.
First Responder Crisis Text Line: 24/7 support for first responders in a mental health crisis. Text “BADGE” to 741741
Frontline Helpline: Support for first responders and their family members affected by traumatic experiences, staffed by former first responders. Call 866-676-7500.
National Crisis & Suicide Prevention Lifeline: A network of crisis centers that provide emotional 24/7 support to anyone experiencing emotional distress or in a suicidal crisis. Text or call 988.
HopeWay: a nonprofit behavioral health and mental health treatment facility in Charlotte, NC that offers Residential treatment, PHP, and IOP for adults. https://hopeway.org/

Counseling Beyond the Station

You aren’t meant to handle traumatic experiences alone and sometimes need more guided support to sort through the complexities that come with those experiences.

Here at Calming Waters Counseling Services, we can provide individual, couples, and family counseling. We also have clinicians that are specially trained in therapeutic modalities such as Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) or Eye Movement Desensitization and Reprocessing Therapy (EMDR) that are evidenced-based interventions successful among first responders.

All of our providers are listed by the location they see clients at along with a detailed bio of their experience and expertise with certain mental health conditions. If you aren’t sure which provider may be right for you, we offer a free 15 minute phone consultation that helps pair you with a clinician best suited for your needs.

Your dedication to serve and protect our communities makes you an everyday hero, and we thank you for your continued service.