Addressing the mental health needs of first responders

First responders are often the first to aid someone who needs help, but where do they turn when they need support? Their responsibilities are strenuous and can significantly impact their mental, physical, and emotional well-being. Despite the challenges, they are prepared to make significant sacrifices in the service of others.

No matter how well-trained they are, any first responder can be affected by the incidents they witness or experience. They often face high-pressure situations that demand quick decisions to save lives. Recurring, or even a single exposure to, traumatic events can adversely affect their mental health. The Centers for Disease Control and Prevention have found that the occupational stress experienced by first responders is linked to an increased risk of various mental health issues. These can include feelings of hopelessness, anxiety, depression, post-traumatic stress, and suicidal behaviors, such as suicidal ideation and attempts.

Factors the lead to poor mental health and substance use among first responders

While everyone may have their own unique stress response, various factors can affect a first responder’s mental health. These factors include the intensity and frequency of exposure to traumatic events, the availability of support systems, personal coping mechanisms, and pre-existing mental health conditions. Additionally, the demanding nature of first responder work, characterized by long hours, high stakes, and emotional strain, can exacerbate feelings of anxiety and depression. Understanding these influences is essential for developing effective strategies to support the mental well-being or first responders.

Little time to relax

When it comes to answering a call for help, there is no set schedule.  Because of the unpredictability, first responders are given little time to decompress after a call. Because they are often hypervigilant, their heightened awareness can be mentally and physically exhausting and make it difficult for them to unwind and be a source of chronic stress.

Isolation

First responders frequently encounter difficulties when trying to connect with individuals outside their immediate team or those who have not shared similar traumatic experiences. Their job demands, which often include irregular hours and high-stress situations, can severely limit their opportunities for social interaction. As a result, they may find it challenging to nurture friendships and maintain a fulfilling social life. These relationships could play a vital role in helping to lessen the impact of the trauma that first responders encounter.

Exposure to traumatic events 

First responders may frequently experience emotional challenges that can significantly affect their mental health and overall well-being. Common problems include post-traumatic stress disorder (PTSD), anxiety, and depression. PTSD specifically can develop after experiencing or witnessing traumatic events, such as serious accidents, violent confrontations, or natural disasters. Symptoms of PTSD may include persistent and distressing thoughts about the trauma, recurring nightmares, and heightened emotional responses, such as anger or anxiety.

Challenging work environments 

Unpredictability is a common challenge for first responders working in demanding environments. The unpredictable nature of their work makes it challenging to maintain adequate rest, which can negatively impact mental health and lead to difficulties in decision-making and concentration. High-stress situations with little time to de-stress can further impact job performance and mental health.

Signs and symptoms of concern

First responders may struggle to identify mental health symptoms related to their work. These symptoms can manifest in various forms, such as heightened anxiety, irritability or fatigue, yet they might dismiss them as temporary or something they can simply “work through.”  Unfortunately, ignoring these indicators can exacerbate their condition, leading to more pronounced symptoms and significant decline in overall mental health.

When a first responder starts to feel overwhelmed by these mounting pressures, such as persistent nightmares or difficulty concentrating, it’s crucial to acknowledge these feelings as signals that support may be needed. Seeking help—whether through counseling, peer support, or mental health resources—can be an essential step in navigating the challenges of their demanding roles and preserving their well-being.

It is essential to pay close attention to:

• Irritability and moodiness
• Insomnia or poor sleep
• Difficult concentrating
• Excessive worry or feat that something bas has or will happen
• Recurring dreams, nightmares, or intrusive thoughts
• Constantly feeling on high alert
• Prolonger or severe symptoms of stress (increased heart rate, sweating, clenched jaw)
• Increased substance or alcohol use
• An increase in family or relationship issues
• A change in eating habits
• Physical ailments such as constant headaches or stomachaches

Maintaining healthy coping skills in a high-stress profession

When it comes to work that is challenging even for the strongest person, it would be beneficial to employ healthy coping mechanisms to maintain good mental wellness and be more aware if their mental health begins to become challenging.

Talk about it. Finding a trustworthy person to share thoughts and feelings with can be beneficial. Even if they are just there to listen, having a supportive and trustworthy person to talk to can provide comfort and emotional relief.

Think about physical health. Being mindful of what we put into our bodies can significantly affect our overall health and well-being. It’s important to pay attention to caffeine and alcohol consumption, as excessive intake can lead to adverse health effects. A balanced and nutritious diet is essential, along with getting enough sleep. Sufficient sleep and regular physical activity are crucial for maintaining good health. Additionally, staying hydrated is vital for optimal physical and mental functioning.

Embrace setting boundaries. It is important to learn to confidently say no to additional responsibilities when already overwhelmed. Moreover, acknowledging that taking time off—whether for mental health, relaxation, or personal matters—is not only acceptable but is also an essential component of maintaining long-term productivity and effectiveness as a team member. Taking breaks and ensuring a healthy work-life balance ultimately enables individuals to return to their tasks with renewed energy and focus, benefiting themselves and their teams.

Aim for a daily routine.  As a first responder, sticking to a consistent routine can be quite difficult due to the unpredictable nature of the job. However, making an effort to integrate regular daily activities into the workday can be incredibly beneficial. Simple practices such as taking short breaks to stretch, enjoying a healthy snack, or engaging in brief moments of mindfulness can provide essential mental respite. These small but meaningful activities allow responders to momentarily step away from the pressures of their demanding roles and help to alleviate stress.

Resilience Program: Mental health treatment for first responders 

Rosecrance offers comprehensive programs specifically designed for first responders, recognizing the unique challenges they face through the Resilience Program. Treatment options at Rosecrance encompass residential and outpatient care, ensuring flexibility and accessibility to meet individual needs. Participants can benefit from peer support programs, which provide a valuable network of understanding and encouragement. Treatment through our cohesive continuum of care supports lifelong recovery with medically managed detox, residential treatment, intensive outpatient programming, and individual and family therapy.

Rosecrance staff are trained to understand and address the cultural and environmental factors of the Resilience program’s populations to better serve clients’ needs.

Key therapies of the program may include and support:

• Psychiatric services
• Dialectical behavioral therapy (DBT)
• Seeking Safety
• Acceptance commitment therapy
• Exposure therapy
• Transcranial magnetic stimulation (TMS)
• Building Recovery by Improving Goals, Habits, and Thoughts (BRIGHT)
• Vicarious trauma
• Grief & loss
• Peer support: Rosecrance actively recruits peers from the key populations of the program to serve as an additional source of support and encouragement to our clients in the Rosecrance Resilience Program.