First Responders: Being a Hero Carries a Heavy Cost – There is Support Available Just for Them


The definition of a first responder is a person trained to respond to emergencies. Policewomen and men, firefighters, emergency-room nurses and doctors, lifeguards, and many other professions fall into this category. However, rushing into disasters, job-related or not, can come with a heavy psychological toll that many emergency-response organizations are only now starting to address.

  • First responders continuously see human suffering, life and death decisions, personal harm, and intense workloads that can lead to a sense of exhaustion and hopelessness and other symptoms of post-traumatic stress disorder (PTSD).
  • It should come as no surprise then that 85 percent of first responders report symptoms related to mental health issues, according to a 2017 study.
  • The same research found professionals in emergency medical services (EMS) suffer roughly ten times the rate of PTSD than the general population.

Consider just a few of the disasters emergency-responders dealt with in 2018 alone:

  • 340 mass shootings
  • 8,527 wildfires in California alone, causing 98 civilian and six firefighter fatalities
  • Two major hurricanes – Michael and Florence – in the southeastern United States.

These types of events leave a psychological mark on first responders.

“When we have national disasters or have a guy take a truck and run people over…those are added stressors,” Jeff Dill, a former firefighter and licensed counselor, told Health Leaders.

  • Repeated exposure to dangerous or high-stress situations affects everyone’s mental health, no matter how prepared or trained for it a person is.

Some experts prefer to think of this type of trauma as a brain injury, which removes some of the mental health-related stigmas. Still, left untreated, full-blown PTSD can develop, bringing on some of the following symptoms:

  • Anxiety and depression
  • Feelings of guilt, anger, and hopelessness
  • Nightmares, flashbacks, and recurring thoughts about particular events
  • Constantly on edge, anxious and easily triggered by reminders of past trauma
  • Insomnia
  • Self-medicating with drugs and or alcohol

“To take care of others, responders must be feeling well and thinking clearly,” reports the Centers for Disease Control and Prevention (CDC).

The federal agency offers educational tools and tips on how first responders can combat burnout and recognize secondary traumatic stress signs. Some of these include the following:

  • Develop a “buddy system” for first responders in a disaster situation, which provides for monitoring each other’s anxiety and safety
  • Limit working hours to 12-hour shifts or less
  • Practice breathing and relaxation techniques
  • Get an adequate amount of sleep
  • Avoid or limit caffeine and use of alcohol
  • Take breaks and realize that the needs of survivors are not more important than taking care of your wellbeing

Though some emergency-response organizations are developing tools and methods to train their employees on trauma ahead of time, most institutional support for emergency workers comes after a mass disaster. In addition, because there’s something of a stoic culture among first responders, it is more difficult for many to reach out for the help they need.

  • Another reason some first responders might not self-report is, perhaps, a legitimate fear that they will be stigmatized and not be allowed to return to the field if they report mental health issues.

There are some signs that this social dam is breaking, though. Several states, including Idaho, Oregon, and Oklahoma, have passed or are working to push legislation to make it easier for first responders to cover PTSD and other mental health-related issues.

  • “We depend on our police, fire, dispatchers, and emergency workers every day,” said Idaho House Minority Leader Mat Erpelding. “This is going to improve their health and everyone’s safety. This legislation is long overdue.”

Without the good health and wellbeing of emergency workers, society will be much worse off. They are making sure that first responders feel supported and understand that resources for any mental health issues they might experience should be front and center of the nation’s public discourse.

List of support resources for first responders.