When a tragedy occurs, they’re the first ones on the scene. They witness traumatic events and intense situations, sometimes on a daily basis. First responders put themselves on the line time and again, which can take a toll and eventually require access to first responder mental health resources.
Rates of substance use disorder, post-traumatic stress disorder (PTDS), depression, domestic violence, and suicidal ideation are all higher among first responders than other demographics. For example, research indicates that more than half of firefighters may be at risk for anxiety, PTSD, depression, and/or alcohol use disorder.2
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First Responder Mental Health Statistics
3 out of 10 first responders develop mental health issues like depression.1
More than 1/3 of police officers, approximately 35%, experience PTSD.1
Roughly 20% of dispatchers and 911 operators experience PTSD.1
PTSD and depression are 5 times more common among first responders.1
The rate of PTSD among first responders is 13% higher than the general population.1
85% of first responders have experienced mental health issues.1
Substance Abuse and First Responders
Approximately 1 out of every 10 firefighters abuse drugs.1
Approximately 3 out of every 10 firefighters abuse alcohol.1
Approximately 40% of EMTs engage in high-risk use of drugs or alcohol.1
First Responder Suicide Statistics
As many as 300 police officers commit suicide every year.7
More than a third of fire and EMS first responders have considered suicide, which is 10 times the rate of the national average.7
Domestic Violence Among First Responders
Among all occupations, police officers have the highest rate of domestic violence in their families.3
The rate of domestic violence for families of police officers is 4x higher than that of the general population.3
Early Signs of First Responder Mental Health Problems
To protect first responder mental health, it’s crucial to recognize early signs of problems. Following are common red flags to watch for that indicate a first responder is suffering from mental health challenges and could use first responder mental health resources.
Depression/anxiety/constant sadness: Do the bad days outweigh the good? Are you finding it hard to feel pleasure or joy? If this is the case, it’s time to reach out for mental health support.
Irritability/anger: Do little things bother you that never used to get under your skin? Are you snapping at loved ones more often than usual? This irritability is a sign of mental health problems.
Increased or new substance use: Have you started using substances you never used in the past? Are you using drugs or alcohol more often than in the past? These are signs that you are experiencing mental health challenges and are attempting to self-medicate them with substances. This pattern can lead to severe consequences and substance use disorders.
Reliving traumatic events: Are you replaying traumatic events again and again in your mind? Do you have sudden flash-backs to troubling events? These are symptoms of PTSD, which are treatable.
Burnout: Are you experiencing nightmares, fatigue, headaches, muscle tension, or digestive issues? These are symptoms of burnout, which can lead to substance abuse and other mental and physical health issues.6
Making the Workplace a Mentally Healthy Environment for First Responders
Follow the Asher model: Employers can adopt this seven-point model to develop a culture of mental health awareness in first responder settings.5
Awareness – Be open and honest and make sure everyone knows it’s ok to not be ok.
Solution-focused approach – Rather than focus on the problems, keep the focus on solutions.
Peer support – Establish a trained peer-support team that takes a proactive approach to offering support and accountability.
Resiliency – Educate and train employees on methods that build resiliency, such as deep breathing exercises and mindfulness.
Healthy habits – Offer only healthy options for lunch menus and vending machines and provide a fitness facility to encourage physical health.
Spirituality – Establish a chaplain program to offer support for first responders and provide outreach programming, such as “Pray with the Police.”
Family – Offer relationship support and involve first responders’ families throughout their career.
Establish policies that are mental-health friendly: Offer sick leave for mental health reasons. Allow employees to use leave time for therapy appointments. Provide breaks based on individual needs rather than a fixed schedule. Allow beverages and food at work in case employees need to mitigate the side effects of medications.
Offer trainings on mental health awareness: These trainings equip first responders to recognize when someone needs mental health support. Train them to respond appropriately and be proactive in getting help for others or themselves.
Establish employee assistance programs: These offer support for first responder mental health and physical health. Incorporate stress management training, yearly wellness checks, incentivized fitness programs, anti-stigma campaigns, and work environments that offer natural light to connect with the outside world.
Provide peer-support programs: These programs should include employees with a variety of backgrounds and ranks. Often, peer programs encourage first responders to seek help, because they are more comfortable speaking with someone who has been through what they are currently going through.
Schedule resiliency check-ins: These discussions allow employees to share how they’re doing with self-care and stress levels. The check-ins also provide opportunities for employees to discuss any other supports they may need.
Prioritize rest: Establish shift schedules that encourage first responders to get ample sleep. Educate employees about proper rest, and complete annual sleep-disorder screenings.
Treatment Barriers to First Responder Mental Health Resources?
Despite the clear need for first responder mental health support, many of these professionals don’t get the help they need. Fewer than 50% of first responders who need mental health care seek treatment.4
Why? It’s not because treatment isn’t available. Resources are there, but several barriers prevent first responders from tapping into these supports. Common barriers include:
Time constraints due to on-call duties and shift work make services hard to access.
The first responder culture stresses self-reliance and self-sufficiency.
First responders may not realize the mental health risks and long-term consequences involved with the stress of their careers.
First responders don’t know how or where to access services for mental health.
Professionals fear that getting treatment will have a negative impact on their career.
40% fear being fired or demoted.1
More than half of first responders fear negative repercussions for seeking help.1
Many of these barriers can be removed with proper education about first responder mental health and the resources available. If first responders and their families have a better understanding of the prevalence, cause, and treatment of mental health issues, this can help remove the stigma associated with first responder mental health treatment.
Additionally, first responder employers can offer more flexible hours and shorter shifts to allow first responders easier access to mental health services. Lastly, offering resources – like the list of resources below – can help make first responders more aware of the many supports available.
List of Substance Abuse and First Responder Mental Health Resources
There are a wealth of foundations, non-profits, and professional organizations offering support resources for the first responder community. Following are 60 of the top resources available for first responders who are at risk, including resources for loved ones looking for ways to help them.
Counseling and Therapy Programs for First Responders
Intensive outpatient programs: IOPs allow first responders to get treatment while maintaining family obligations. The programs provide aggressive intervention that addresses first responder mental health as well as issues with substance abuse and first responders.
12-step Groups/Peer Support for First Responders: These groups provide treatment that creates a sense of community and accountability. The setting gives first responders the opportunity to share their struggles with their peers, who have experienced similar challenges.
Trauma-informed therapy: Evidence-based methods include Cognitive Behavioral Therapy (CBT), narrative therapy, and eye movement desensitization and reprocessing (EMDR). These treatments can be effective in addressing symptoms of PTSD.
Alternative therapies: These therapies allow first responders to manage and heal from mental health problems by tapping into their physical or creative sides. Methods may include equine therapy, yoga, adventure therapy, tai chi, or art therapy.
First Responder Mental Health Resources
911 At Ease International: Offers free trauma-informed counseling for first responders and their families.
Bulletproof: Provides confidential resources for addiction, mental health, and treatment for law enforcement professionals and their families.
For the Frontlines: First responders can text 741741 for help with fear, stress, isolation, and other issues. Counseling is free and is available 24/7.
Livengrin Foundation: This nonprofit offers a FRAT program (First Responders Addiction Treatment), which specializes in recovery services for first responders and their families.
Firefighter Behavioral Health Alliance: Focuses on suicide prevention and behavioral health awareness. Provides workshops for EMS, dispatch, and fire departments.
Fire Hero Families: Connects firefighters and their families throughout the country to virtual support groups.
First Responder Support Network: A group of professionals who volunteer their time to provide treatment and aftercare for first responders and their families.
ResponderStrong: Offers a help line, self-help tools, articles, educational resources, and professional assistance for first responder mental health.
Reviving Responders: A nonprofit organization that is dedicated to suicide prevention and promotion of mental health among EMS workers.
Share the Load Program: Helps fire and rescue departments establish behavioral health programs and offers resources for those seeking support for mental health and addiction issues.
Survive First: Provides mental health resources for first responders and their families who are seeking support.
The Code Green Campaign: Also called Code Green, serves all types of first responders with advocacy and education on mental health.
Wings of Change: In-person and virtual peer support groups, offered for first responders and led by first responders.
Crisis Lines for First Responders
Access EAP: 800-248-1688. Free, confidential hotline available 24/7. Offers support for mental health and substance abuse problems.
Copline: 800-267-5463. Answered by retired officers trained in providing mental health support. Available 24/7.
Crisis Text Line: Counseling support for mental health crises. Available 24/7 by texting BADGE to 741741.
Frontline Helpline: 866-676-7500. First responders and family members struggling with trauma can get support from former first responders.
Hero’s Warm Line: 844-833-HERO. Provides resources and confidential peer-support services. Designed for first responders and their friends and family.
I Love a Fire Fighter – What the Family Needs to Know: Psychologist Kirschman shares strategies for firefighters and their families who are facing occupational hazards such as trauma and substance abuse issues. By Ellen Kirschman.
Wright, H. M., Fuessel-Hermann, D., Pazdera, M., Lee, S., Ridge, B., Kim, J. U., Konopacki, K., Hilton, L., Greensides, M., Langenecker, S. A., & Smith, A. J. (2022). Preventative care in first responder mental health: Focusing on access and utilization via stepped telehealth care. Frontiers in Health Services, 2, 848138. https://doi.org/10.3389/frhs.2022.848138
Wright, H. M., Fuessel-Hermann, D., Pazdera, M., Lee, S., Ridge, B., Kim, J. U., Konopacki, K., Hilton, L., Greensides, M., Langenecker, S. A., & Smith, A. J. (2022). Preventative care in first responder mental health: Focusing on access and utilization via stepped telehealth care. Frontiers in Health Services, 2, 848138. https://doi.org/10.3389/frhs.2022.848138
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