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As a profession, first responders are at a far greater risk of developing stress-related symptoms. These symptoms, if left untreated or unresolved, may contribute to a number of debilitating physical and mental impairments of varying degrees, including post-traumatic stress disorder (PTSD)—especially when compared to professions outside of the public safety arena.
The term "first responders," when used in the context of this article, encompasses paramedics, emergency medical technicians, police officers, firefighters, corrections officers, search and rescue personnel, and others who possess specialized training in responding to emergency situations.
The demands of their specialized training requires that they repeatedly and routinely encounter and be exposed to traumatic—and often horrific—incidents, many of which can have a profound, and at times, debilitating influence on their psychological and physical wellbeing. Despite extensive preparation in the form of ongoing trainings, nothing can truly prepare someone for what will occur when responding to a real-life emergency situation.
There is no denying that first responders are commonly regaled as, “brave, courageous heroes,” and rightfully so; however, even the supposedly bravest and most courageous of heroes can be psychologically scarred by what they routinely witness. Yet as a profession, first responders are rarely inclined to pursue mental health treatment due to a barrage of real or perceived barriers to care. Many first responders delay treatment, fail to fully adhere to treatment regimens, or receive inadequate care from inexperienced clinicians who lack specialized training.
These so-called barriers can include the perception that treatment is unnecessary, or the harboring of cynicism and disdain or distrust of mental health professionals. More likely, the first responder may not fully understand the options available to them in pursuing treatment. Additional barriers of particular concern include retaliatory actions from employers such as negative evaluations by supervisors, unwanted changes in job duties and shiftwork, along with other unethical and potentially, illegal retaliatory measures. Retaliation in any way is unethical and in some cases illegal, yet it does exist, and it can be concealed by administrators as something other than retaliation.
Intervention and Prevention Strategies: Resilience
One key component to creating effective intervention and prevention strategies is to develop and hone the first responders’ resilience to, and coping defense mechanisms for, dealing with traumatic incidents.
The emphasis must be on how an individual processes thoughts, behaviors, and actions when confronted with stressful, traumatic events or situations. In short, resilience entails embodying a sense of self-care and wellness in which steps to recovery, understanding, insight, and awareness can be accepted and subsequently, passed on to others in need, according to a Psychology Today article. Peer-to-peer approaches are widely accepted because it is much easier to identify and trust someone who understands what you are experiencing because they have also witnessed or experienced firsthand those same challenges.
Other than a peer support system, one of the primary ways to build resilience is having a trusted support system consisting of family and friends.
This support system must be built on traits such as compassion and trust, and it must provide individuals with unconditional encouragement and reassurance, which will create a strong foundation built on positive self-image along with self-confidence in order to overcome low and challenging moments.
The American Psychological Association’s Road to Resilience outlines 10 strategies designed to build resilience.
- Make connections. First responders need to build positive relationships with family members, friends, and others who can provide the necessary support that they require.
- Avoid seeing crises as insurmountable. Exposure to highly stressful events are inevitable for first responders, but what is vitally important is how one interprets and responds to those events. Try looking beyond the present to how future circumstances may be better.
- Accept that change is a part of living. As you get older, certain goals may no longer be attainable as a result of adverse situations. When you accept that some circumstances cannot be changed, it allows you to focus on other circumstances that you can influence.
- Move toward your goals. Develop some realistic goals. Do something regularly—even if it seems like a small accomplishment—that enables you to move toward those positive goals / accomplishments.
- Take decisive actions. Rather than trying to detach completely from our problems and stressors or wish they would just go away, take decisive actions to improve the situation as best you can. Avoidance is not the answer.
- Look for opportunities for self-discovery. Individuals often learn something about themselves and grow in some respect as a result of struggling with loss, rejection, or disappointment. Many who have experienced tragedies and hardship report later they have stronger relationships, a greater sense of strength even while feeling vulnerable, an increased sense of self-worth, a more developed spirituality, and a heightened appreciation for life.
- Nurture a positive view of yourself. Have confidence in your ability to solve problems and trust in your instincts.
- Keep things in perspective. Even when faced with very painful events, try to consider the stressful situation in a broader context and keep a long-term perspective.
- Maintain a hopeful outlook. An optimistic outlook enables you to expect that good things will happen in your life. Try visualizing what you want, rather than worrying about what you fear.
- Take care of yourself. Pay attention to your thoughts and feelings. Engage in activities that you enjoy and find relaxing. Exercise regularly. Taking care of yourself to keep your mind and body primed to deal with situations that require resilience.
While there is admittedly no simple solution to a complex problem, applying these strategies can help build resiliency so that when confronted with stressful, traumatic situations, you will have the ability to cope with the event in the most positive and beneficial way possible. The more equipped first responders are in coping with stress and adversity, the more likely they can ward off depressive, self-destructive thoughts and behaviors.
