Let’s Change the Culture That Ignores First Responders’ Mental Health

Every day, America’s first responders walk — or run — into someone else’s worst day. They process, react, save lives and move on to the next emergency call, the next tragic scene, the next heartbreaking moment. These traumatic experiences accumulate over the life of a public safety career.

But that’s what you sign up for; that’s the job, right? We hear this all too often — and maybe it is true to some degree. But it does not mean first responders aren’t hurting. They are not immune to trauma. Sometimes the helpers need help.

Studies estimate that more than one-third of our nation’s first responders deal with job-based mental health struggles. First responders experience higher rates of anxiety, burnout, depression, post-traumatic stress and more. Suicide remains a significant risk for emergency responders, emphasized during September’s Suicide Prevention Awareness Month.

These factors can contribute to diminishing morale, erosion of trust in leaders, and trouble with retention and recruitment.

While the severity of this crisis expands, public-private collaborations like the FirstNet Health and Wellness Coalition (FNHWC) are seeking to make an impact.

Composed of more than two dozen national public safety organizations, representing every discipline and all chain of command levels, the FNHWC recently completed an analysis of America’s public safety and public health landscape, identifying needs, obstacles and solutions regarding first responder mental health. Our multi-year effort, summarized in a new white paper released this month, included data analysis, literature review, input from experts, and a survey of almost 400 first responders.

What we found was surging enthusiasm among first responders to address their mental health and wellness. One-third of survey respondents wanted their departments to amplify awareness of programs and training opportunities. The helpers know they need help.

Better stress management, physical fitness opportunities, life coaching, resilience training, and ways to deal with anxiety were all areas of need identified by responders. The barriers they face — cost, lack of awareness, no time or work-life balance — are familiar to anyone, first responder or not. The difference is the ongoing and compounding exposure to potentially traumatic events, paired with a public safety culture that typically stigmatizes and ignores mental health.

The coalition’s collective work resulted in five key recommendations, aimed at helping communities, departments and individuals implement healthy behaviors and cultural change.

First, engaging public safety leadership is necessary. First responders want their supervisors to demonstrate and model behaviors of mental health and wellness practices, rather than just talk about them. 

Second, wellness must be integrated into training throughout a public safety career, and beyond. This means starting pre-academy, continuing through in-service training and education, and extending to retirees.

Third, broader, more equitable funding should be allocated at the local and national level. While grants are available and important, they are not always sustainable or equal across all public safety professions. Many municipalities need to better understand the value of funding resources for public safety wellness.

Fourth, health and wellness standards and more technical assistance centers need to be established. Implementation will increase if services are accessible, affordable, confidential (when necessary), part of the public safety organizational culture, and do not endanger careers.

Fifth, wellness must be part of the broader discussion nationally and locally, within associations and their local chapters, departments, agencies, hospitals, firehouses, 911 call centers, the halls of government – everywhere. Further examination and dialogue will help us learn more about the complex dynamic between emergency response and mental health.

Fully implementing these recommendations requires more than what a single department, union or individual can do alone.

Elected officials and public safety leaders should work together to establish state-level standards for first responder health and wellness programs and integrate them throughout the career life cycle. Expanded and more equitable funding — both grants and legislative budgetary allocations — will ensure health and wellness resources get where they are needed.

We owe it to every public safety hero to help them grow from trauma, erase the stigmas, change the culture, and be the strongest first responders they can be.

Anna Courie, DNP, is an expert on first responder health and wellness, a former nurse, and director of Responder Wellness for the FirstNet Program at AT&T.

Ed Davis is former commissioner of the Boston Police Department.

Editor’s Note: If you or someone you know are contemplating suicide or struggling with suicidal thoughts, help is available 24 hours a day through the Suicide and Crisis Lifeline at 988. You are not alone.