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Navigating the Impact of Being a First Responder

A Journey of Strength and Resilience

Being a first responder is a calling that requires a heart that beats for service and a spirit that thrives on courage. It’s about running toward chaos when others instinctively step back, about embodying strength in moments of vulnerability, and about writing stories of heroism in the pages of everyday life. A first responder is a beacon of hope, a steadfast guardian of safety, and a symbol of unwavering dedication to the well-being of others. However, this noble path comes with profound and complex effects that evolve over time, both on a personal and professional level.

The physical demands of the job, such as lifting heavy equipment, navigating challenging terrain, and responding to emergencies in all weather conditions, can take a toll on a first responder’s body over time. Long hours and irregular shifts can disrupt sleep patterns, leading to fatigue and potential health issues. But even as the body weathers the challenges, the emotional toll can be equally impactful. First responders frequently encounter distressing and emotionally charged situations, and the cumulative effect of witnessing accidents, injuries, and tragic events can lead to emotional exhaustion, compassion fatigue, and burnout. The emotional strain may manifest as a sense of desensitization, detachment, or increased irritability.

Over time, exposure to traumatic incidents can impact a first responder’s mental health and resilience. Conditions like post-traumatic stress disorder (PTSD), anxiety, and depression may develop or worsen. Coping mechanisms may evolve, and some individuals may struggle to find healthy ways to process their emotions. The demands of the job can also affect personal relationships. Irregular schedules, long hours, and the emotional toll of their work can strain relationships with family, friends, and partners. Communication challenges and difficulties in sharing their experiences can lead to feelings of isolation.

Despite the challenges, the job provides a strong sense of purpose and fulfillment. Many first responders find deep satisfaction in helping others during their most vulnerable moments. However, this sense of purpose can sometimes become entangled with personal identity, making it challenging to transition away from the role. As time passes, some first responders may choose to leave the profession due to the cumulative effects of the job on their physical and mental well-being. Others may find ways to adapt, seeking support through peer networks, counseling, or stress management techniques to sustain their careers and overall well-being.

Understanding the evolving impact of being a first responder is crucial for promoting the well-being and resilience of these dedicated individuals. By providing adequate mental health support, access to counseling services, and opportunities for debriefing, we can ensure that our heroes continue to navigate their journey with strength, courage, and the unwavering spirit that defines their noble path.

First Responder Suicide Prevention: What We Need to Know!

Suicide Prevention

By Dr. Lisa Grossman

It’s a painfully difficult topic, yet, the reality of this line of work that we have to talk about. It’s the topic that seems to have touched everyone in some way, shape, or form.  It’s suicide, and it’s on the rise among first responders. 

The Numbers

Over the years, we have seen a steady increase in the number of suicides across this country among our first responders. BLUE H.E.L.P. is an organization that brings awareness to suicide and mental health issues, and has been recording law enforcement suicides, including corrections and federal officers, since January 2016. In 2019, 238 law enforcement officers were lost to suicide, 171 in 2020, and there have been 35 to date in 2021. In addition to their efforts with the law enforcement community, they have now expanded to include firefighters through RED H.E.L.P. with the same mission of education, support, and acknowledgment. Although they just began their efforts, they have reported two firefighters lost to suicide to date for 2021.

While numbers vary among sources, according to the Firefighter Behavioral Health Alliance, 82 firefighters and 21 EMTs/paramedics were lost to suicide in 2018, and 119 firefighters and 20 EMTs/paramedics in 2019. In addition to those disciplines, the veteran suicide rate continues to rise along with active-duty service members. Although there is a two-year lag in reporting data, the VA has reported the rate has gone from 17.5 veterans a day in 2017 to 17.6 in 2018, with concerns that the number may tick higher as we work our way through the impact of the coronavirus. 

How Does Someone Get to That Point?

One of the most common questions I get asked is, “how does someone get to that point,” the place where they see no other option. Sadly, it’s often a combination of things. The brain is not wired to see and do the things that these men and women have to see and do on a daily basis. But, they do it and do it proudly. They respond to the horrific calls, the tragic scenes, and hug the family members left in despair, all while navigating their own struggles and challenges. Sadly, the burden of it all becomes too heavy to continue to carry and some can’t pull themselves from the darkest of places. The intention is not to hurt their loved ones, colleagues, or friends, but the pain becomes too great, and they are unable to see through it.

Many risk factors have been linked to first responder suicides, including Post Traumatic Stress (and other mental health challenges such as depression and anxiety), health concerns, marital problems, substance abuse, and financial challenges. The combination of these with the trauma they are exposed to on a regular basis can have a lasting and devastating impact on one’s psyche over time if they don’t get the help and resources they need. 

What to Watch For

While most people who struggle with depression don’t die by suicide, depression can increase the risk of suicide. It is important to know the signs of depression and other mental health-related conditions that could potentially lead someone down that path. Some of the big indicators someone is dealing with depression are not being able to get out of bed and having difficulties sleeping, struggling with feelings of hopelessness or worthlessness, shutting down, loss of appetite, and drastic changes in mood. In addition, it is also helpful to know the signs and symptoms of Post Traumatic Stress Disorder as it can co-occur with depression and is quite common among first responders. Nightmares, flashbacks, and hypervigilance are all common characteristics of PTSD, but it is important to point out that just because someone has experienced these symptoms doesn’t mean they have Post Traumatic Stress Disorder. It is important to see a mental health professional for a proper diagnosis. 

In addition to the signs and symptoms of related mental health conditions, there are also indicators that someone may be contemplating suicide. Talking about going away or making statements like “you’d be better off without me” or “I’m a burden to our family,” saying goodbye, increasing the use of alcohol or drugs, having a sudden change in behavior such as improved mood or happiness quickly after signs of depression or sadness, engaging in reckless behavior, becoming withdrawn, and having a history of previous attempts, can be experienced by those who are thinking about suicide. 

What Can You Do?

Though some of the signs may be there, sometimes it’s difficult to catch these in those closest to us. It is for this reason that I stress to people to listen to their gut. If ‘something’ is telling you there may be a problem and you’re concerned, it is imperative to take action! If you see warning signs or get that feeling, ask the difficult questions and explore invitations. The statement I use when teaching suicide prevention and intervention is to be comfortable being uncomfortable. It may be hard to ask someone you work with, love, or care about if they are thinking about suicide, but those tough questions need to be asked.

If you think or feel someone may be contemplating suicide, directly ask them, “are you thinking about suicide.” If they say yes, ask them, “do you have a plan” and “when was the last time you thought about it.” If they are responding with a yes, be there to support and listen and connect them to the right resources; you can call the National Suicide Hotline (800-273-8255) with them or one of the other numbers provided below, reach out to their mental health professional if they are working with one, or take them to the nearest hospital. Some facilities now have policies and procedures in place to assist a first responder in crisis, including a separate area to wait while getting evaluated. The important thing is to get help, and don’t try to handle the situation alone! Encourage and support the appropriate help and give reassurance. 

Sadly, the stigma around mental health and suicide is the top reason first responders don’t get the help they need. They are worried they will lose their job or position, be labeled, or may be be afraid others will view them as weak. It takes strength to ask for help, and getting help does not equal mental illness. It is imperative that we change the conversation around mental health and talk about topics like suicide more openly. At the end of the day, it’s ok not to be ok! 

If you or someone you know is struggling with thoughts of suicide, PLEASE reach out!
National Suicide Hotline 800-273-8255
Copline: 800-267-5463
Fire/EMS Helpline: 888-731-3473
Crisis Text Line: Text “Blue” to 741741
Veterans Crisis Line: 800-273-8255; press 1 for Veterans Crisis Line or Text 838255

The Strength of Vulnerability

The Strength of Vulnerability

By Susie Kroll

I am so sorry for your loss. | Yes, we found your son; he wandered about a mile away. | I’m sorry that they stole $20,000.00 from your retirement accounts. | Your daughter is being placed in protective custody due to severe child neglect. Yes, we will make sure to check on your wife since she has been expressing being suicidal.| Radio, he is unresponsive; start aid; the suspect stabbed him in the abdomen. Last seen running southbound.| I’m sorry, honey. Mommy won’t be home for the holidays this year; I have to work. I know, son; I am sorry I keep missing your baseball games.| You can’t come within 1,000 feet of the residence for three years. You’re under arrest for the perpetration of domestic violence; you can’t punch her until she is unconscious.| We recovered your car, but it’s been stripped of everything of value. | Look, this isn’t working out between us.| You don’t get it; it’s just a few drinks. Get off my back. | I forgot our anniversary again; there’s just too much going on. Sweetie, I am going to be home late again. I know. I’m sorry; it’s been like this for weeks now.| My partner didn’t survive the gunshot wound; it’s been ten years, but it feels like yesterday in my mind. I should have gotten there faster.|  Honey, I gotta go. There’s a call out for a barricaded and suicidal subject with hostages.  

Honey, how was your day?  Fine.

We have all heard stories, seen headlines, and watched shows related to police work.  Images are conjured in our minds from books, media, and our imaginations.  Yet, there are people who live it daily, see it daily, and carry the memories and experiences with them forever.  Often, the impacts of these experiences are not immediately felt but erosive in nature over the course of a career as a first responder.  Messaging to first responders has evolved over the last few decades.  Initially, an emphasis was placed on being a warrior, a keeper of the peace, and being the one who would, above all, serve and protect the community without weakness.  Recently, emphasis has been placed on being a guardian of communities, safety, and holistic policing.  With this evolution must come the expectation that vulnerability is not weakness but rather the ultimate expression of strength.

Compassion and humanity in first responders should be a pillar of cognition and integration in how first responders care-take themselves.  After all, we cannot hope to be the calm and safety on the worst day of someone else’s life if we cannot first make sure that we are healthy and resilient in our own care.  

As a model for the advancement in the principles of self-care and resiliency for first responders, offered for consideration are a couple of stories from those that have paved the way to thriving in the strength of vulnerability.

Officer Drake* is an incredible police officer and a 20-year veteran of the work.  He has seen his fair share of danger, tragedy, crime, loss, and community engagement throughout his career.  Officer Drake is a family man, a devoted husband, and engaged readily in ancillary duties in police work in addition to his regular patrol duties.  He is someone that his peers have sought out because of his steadfast compassion and fierce loyalty to his family and work.  Officer Drake found himself faced with a cluster of life stressors all happening at once.  His wife was suffering from complications of a brain tumor that was inoperable but not terminal in nature.  Without warning, she served him with divorce papers.

Community, global perspectives, internal department changes, and politics surrounding police were becoming increasingly volatile.  And he was having to face the reactions of his family, friends, and children as they reacted to the impending divorce. To say he was blind-sided is an understatement.  He was a committed husband now facing the onset of a mental illness in his wife of almost two decades.

Officer Drake had reached his limit to care for himself, and his capacity was being challenged minute-to-minute.  His wife refused to speak about the divorce and accused him of many things to which he was not guilty.  Due to her mental health diagnoses, she could not be reasoned with or counseled to participate in couples or individual therapy.  Officer Drake reached out to a local Mental Health Professional (MHP) whom he had heard about through other officers.  For weeks, he would talk with her about feeling helpless, powerless, and utterly confused by the circumstances of the divorce.

He was having to balance the procedural aspects of divorce while reconciling the emotional loss and pain he was feeling at the same time.  It was clear that these two paths of events did not respect the needs of the other and took on a life of their own.  They were further complicated by the fact that he had to continue to work to support his children, the mounting medical bills, and now the impending separation and divorce from the love of his life.  Officer Drake resigned himself to her demands and requests.  While he disagreed with her recollections and choices, for the sake of his children and out of his continued love for his wife, he agreed to the divorce.  This challenged his faith, his memories of their relationship, and his utter rejection of the idea of divorcing the only woman he ever truly loved and still does.

After working with the MHP for several months, he was able to mourn the loss of his marriage.  He found strength in laying his feelings on the table, being honest with himself, feeling the pain in a safe environment, and challenging himself to see love differently.  He learned he still loved his wife; he grieved the marriage but could love her still by taking care of himself and his children.  He never anticipated having to become this strong emotionally, but he met the burden with honesty and vulnerability, which evolved into the resiliency of and for himself and strength he didn’t know he possessed.   

Officer Sykes* is a 15-year veteran of law enforcement.  She has held many positions during her career.  She worked successfully with a hostage negotiation team, trained police officers on how to drive patrol cars safely, running lights and sirens, and in all manner of weather conditions.  She thinks outside of the box and tries to keep her community as safe as possible while still getting people the resources they need.  In one particular instance, she was faced with a young adult male that brandished a firearm while experiencing a psychotic episode.  She knew he needed help, but she also had a duty to maintain public safety and arrest this individual for the brandishing of the firearm.

Officer Sykes was able to reach out to a department MHP and a prosecutor to help the young man. She was able to ensure public safety by petitioning for an extreme risk protection order.  During the proceedings to have the male’s gun rights revoked, she also requested of the prosecutor that he be provided with a mental health assessment and services for his mental health concerns. She was able to foster both public safety and resource connection for the young male.

Officer Sykes is no stranger to hostile and stressful policing. During her time on a hostage negotiation team, she saw many suspects perpetrate domestic violence on their partners; she saw many suicides that could have been prevented; she witnessed the anguish of family members when they learned their loved ones had died due to gang violence.  One day, she was the subject of a call–her husband experienced a catastrophic medical event resulting in his death in their living room.  She tried desperately to render aid while she waited for emergency medical services to arrive. She described, to a counselor, watching his life leave his body and the resulting irreversible heartbreak she experienced.  She sought comfort in counseling and the affection provided to her by three incredible dogs. She speaks openly about how therapy keeps her whole and keeps her smiling and carrying on with hopeful eyes toward the future.  She continues to be a fixture in her job of resiliency by leading as an example.  

Seeking peer support or counseling is the most vulnerable thing most first responders can do.  Admitting that the stressors, life circumstances, and pain are too much to handle alone takes courage.  It would be unfathomable for a first responder to tell a 911 caller they were weak for asking for help.  In turn, these officers exemplify bravery in realizing that asking for help is ,in fact. the most courageous act they could endeavor to do. 

In vulnerability, we all find strength.

  

*names have been changed

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