Last month’s terrible shooting at Pulse, a gay nightclub in Orlando, shook the nation to it’s core. However, as the news of this terrifying event was breaking, there were immediate examples of heroic actions taken by the people in the club, emergency workers, police, bystanders, and locals; men and women who were at the scene of the event or who interacted with victims in the immediate aftermath who rushed in to help the victims and their families. In the days following this horrific event, in addition to the expressions of outrage, horror, and incredible sadness, there was generated an enormous outpouring of support for the victims of the shooting and their families. Social media feeds and news reports were filled with messages from people across America united in their solidarity and expressions of their desire for the families of the victims and survivors to heal from this tragedy. Due to the extremely traumatic nature of the event that occurred that terrible June night, mental health services will definitely be a component of that healing process.
When an event like this takes place, the focus is understandably on the immediate victims of the tragedy, their families and survivors and they are the ones to whom support is most readily offered as their wounds are the most obvious and cut the deepest. However, there is another group of people who are also affected, whose wounds are not as immediately evident or obvious, but who also need healing. Fred Rogers of Mr. Roger’s Neighborhood used to say, "When I was a boy and I would see scary things in the news, my mother would say to me, "Look for the helpers. You will always find people who are helping." While thankfully that is true, being exposed to a situation as frightening as events of June 12th can also be traumatizing for the helping individuals, regardless if they are a bystander on the street or someone who is on duty and trained as a first-responder.
Unfortunately, trauma suffered by the helpers in a situation is not typically as readily supported and often goes unacknowledged and untreated. Multiple studies have shown that first-responders such as Police, Firefighters, Paramedics, EMTs, nurses, and ER doctors can suffer from symptoms such as elevated stress levels, depression, anxiety, PTSD, and decline in work performance after being exposed to traumatic events in the line of duty. Elevated levels of stress and unaddressed trauma can have a deleterious effect on the mental health of someone in the helping field, particularly those in the first-responder role who may be involved at the most extreme stages of trauma. Over time, the accumulated effects of this repeated exposure can lead to distress in the person’s work and/or personal life, and can result in negative interactive patterns with co-workers, relational partners, or even children. Some studies have even shown that first-responders are at a higher risk for suicide and addictive behaviors than those who are not exposed to repeated traumatic events. Sadly, there is still a stigma against seeking mental health services and, particularly for those who have been trained to deal with extreme situations, acknowledging trauma can feel like an admission of weakness.
In the last few months the landscape that first-responders, particularly policemen and women, have found themselves in has increasingly become contentious, dangerous, and highly stressful. In the deadliest attack on our police community since 9/11, last week’s shooting in Dallas put the men and women of the first responder community there in the crossfires of a literal war zone in which the lives of five of our community service members were lost and eight more injured. The work of a first-responder has always been a dangerous one, but to be targeted and picked off like prey simply because of your uniform brings a whole new level of threat into the current environment that the first responder community faces. The feelings of vulnerability and helplessness that first responders may face when in a situation like the one that occurred in Dallas can have tremendously destructive effects on their emotional and mental well-being if not addressed and treated. That scenario in which a first responder is trying to do his or her job while enduring intense emotional and physical stress and fearing for their lives is very similar to the combat situations faced by the men and women of our military while on the front lines of war. Post-traumatic stress disorder is a very real mental health issue in our veteran community, and any severely stressful and traumatic situation can trigger PTSD in an individual regardless of their experience or how well trained they may be.
Awareness of the need for mental health services for members of our military has slowly risen over the past few years due to the increasing evidence of the detrimental effect the trauma of war can have on a person’s mental health. These findings, as well as increased advocacy efforts, have thankfully increased and improved the mental health resources available for our veterans who suffer from trauma related exposure. Now, the next step is to expand the circle of mental health care to include all those who have suffered trauma in the line of duty protecting the public, whether that be at home or abroad. The goal is to offer an avenue for any individual who has suffered “helper’s trauma” to have the support of their workplace, encouragement of the community, and the provision of a safe place to process their experiences. Through a supportive mental health network and increased awareness of the stresses that our first-responders face, we can work towards providing these services so that these men and women may return to their extremely important duty of protecting and serving the public.
One of the ways in which we as mental health service providers can begin the conversation about mental health in the first responder community is to be proactive and immersive in our approach. There are often a variety of opportunities to volunteer with the first responder community through participating in walks, runs, drives and community awareness days. These can provide some wonderful opportunities to begin to build rapport with the men and women who are the first responders in your community and their families. Often there are internal community resources in place for the first responders and their families that you can approach and offer your services to, either as a volunteer, or by asking to be listed as an additional resource for the community. You could also contact your local Police, Fire, or Paramedic agencies and organizations and offer workshops or presentations to raise awareness of the need for self-care in these fields, as well as the local resources available. Many of the members of your local first responder units may be aware of the dangers of stress and PTSD in their line of duty, and it may be a required course when going through the Police or Fire Academy, and Paramedic training, but possibly is something that has not been brought up since. They may no longer be aware of the warning signs of burnout, the tell-tale signs of trauma, or where to turn for help if they do recognize these signs in themselves or a co-worker. By becoming aware of the need for these services in our own first responder communities and offering the knowledge and support that we as mental health professionals have in this area is where we can step in to bridge the gap and begin to help the helpers.
References:
Enrich, John (November, 2014). Earlier Than Too Late: Stopping Stress and Suicide Among Emergency Personnel. http://www.emsworld.com/article/12009260/suicide-stress-and-ptsd-among-emergency-personnel
Newland, C., Barber, E., Rose, M., Young, A. (September, 2015). Survey Reveals Alarming Rates of EMS Provider Stress and Thoughts of Suicide. http://www.jems.com/articles/print/volume-40/issue-10/features/survey-reveals-alarming-rates-of-ems-provider-stress-and-thoughts-of-suicide.html
Kristal DeSantis is a Pre-Clinical Fellow, LMFT-A, wife of a first-responder, and founder of Austin STRONG: Relationship Building Center in Austin, TX
