First responders ensure that someone is there for you in a disaster. EMTs, lifeguards, firefighters, police officers — the title of a first responder covers many jobs. Since they are first on the scene, it takes a toll on their mental health.

Here is a comprehensive guide to first responders and mental health issues they face.

The Components of First Responder Mental Health Issues

There are three major components in first responder mental health issues:

  1. Depression. In a case study, almost 7 percent of EMS professionals had depression. That number may rise depending on the circumstances. For instance, first responders to the 2011 Japan earthquake had over 21 percent depression rates.
  2. Stress and Posttraumatic Stress Disorder. Ranging from mild stress to PTSD, the numbers are higher in first responders than in the general population.
  3. Suicidal Ideation. The numbers aren’t a full representation of the scope of suicidal ideation in first responders. Yet, preliminary figures show that thinking of suicide, past attempts, and current thoughts of suicide are higher in first responders. This is especially relevant after major trauma or disaster. And trauma is commonplace among first responders.

Statistics on First Responders and Mental Health

According to the U.S. Department of Health in a supplemental by the Substance Abuse and Mental Health Administration:

It is estimated that 30 percent of first responders develop behavioral health conditions including, but not limited to, depression and posttraumatic stress disorder (PTSD), as compared with 20 percent in the general population (Abbot et al., 2015). In a study about suicidality, firefighters were reported to have higher attempt and ideation rates than the general population (Stanley et al., 2016). In law enforcement, the estimates suggest between 125 and 300 police officers commit suicide every year (Badge of Life, 2016).

Why are these numbers so high? Well, imagine what a first responder does on a daily basis.

First responders are the first to arrive at the place of accidents, disasters, and more. The very definition of what they do is in their title. Police officers, search and rescue, firefighters, and other first responders see things that affect their mental health. Whether it is the death of a child or the enormity of a natural disaster, it’s not a one-time thing. Their job means that they encounter death and mentally challenging events every single day.

This constant barrage of depressing events continues to chip away at the fabric of their mental health.

The Stigma of Seeking Mental Health Options

One of the problems that first responders face is the stigma behind mental health. Often, first responders suffer in silence and don’t seek outside health. As stated by Psychology Today, there is a fear of ostracism. Fear of labels and discrimination prevails, and prejudice and ridicule are part of this fear. It can be ongoing and all-encompassing.

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What Kind of Treatment is Available?

Posttraumatic stress disorder, depression, and anxiety encompass some of the symptoms that first responders face. One of the most successful treatments for these mental health problems is CBT — cognitive behavioral therapy.

What this type of therapy does is to try to aim the focus away from negative behaviors and thoughts. There are many ways to achieve this. For instance:

Stress Inoculation Therapy. This incorporates ways to manage stress. Within this therapy, there is a variety of options. These include role-playing, biofeedback, meditation, breathing exercises, and more.

Prolonged Exposure Therapy. This therapy allows patients to face past triggers and trauma in a safe environment. Prolonged exposure therapy may incorporate virtual reality or imaginal exposure.

Eye-Movement Desensitization and Reprocessing (EMDR). This therapy uses stimulation in the brain triggered by eye movements and simultaneous recollection of memories. This may help minimize traumatic memory’s intensity. It also works to reduce the emotions associated with trauma.

Cognitive Processing Therapy. This therapy helps patients learn to think positively. It’s not simply a “think positive” course. Instead, the therapist teaches patients to re-frame negative feelings.

Alternative Therapies

Those mentioned above are not the only therapies that help first responders. Here are a few alternative therapies. These are sometimes used in conjunction with the above therapies or on their own.

Experiential treatment like art therapy, music therapy, therapy with psychedelic drugs, and animal therapy all fall under alternatives that help. Also, there is evidence that psychedelic drugs could be effective in reducing anxiety. Patients receive drugs like MDMA and psilocybin within a controlled environment under the watchful eye of a trained therapist.

Group therapy and family support options help as well.

How Employers Help

While therapy and awareness remain important elements in first responder mental health, employers help, too.

For example, some places provide monthly mental health and wellness check-ins for employees. This allows the first responders to discuss their problems with a licensed psychologist.

Critical incident stress debriefings help first responders process trauma or crisis events. While these debriefings aren’t the same as seeking a therapist, they help by facilitating conversation. This changes the way a first responder thinks and deals with what happened.

For first responders needing help, there is treatment available. The First Responder Program at Transformations Treatment Center is a specialized treatment program that has been very successful in helping first responders overcome the underlying issues that lead to addiction. It is designed to treat co-occurring diagnoses including posttraumatic stress disorder (PTSD), anxiety disorders, and depression.