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How employers can help first responders stay mentally and emotionally strong

Firefighter smiling behind his mask

Many mental health conditions, including depression, substance use disorder, post-traumatic stress disorder (PTSD), and even suicidal ideation, are more common among first responders. First responders undergo intensive training to prepare for their physically demanding and potentially dangerous jobs — but are they prepared mentally and emotionally? Employers have an opportunity, and an obligation, to take a proactive approach to protecting the mental health of their teams working on the front lines.

The unique challenges of first responders

Constant exposure to traumatic events and life-threatening situations — and the stress of working long hours away from family members and under high-stakes conditions — can easily build up and take an enormous toll on mental health.

  • Police officers and firefighters are more likely to die by suicide than in the line of duty.1
  • 85% of first responders have experienced symptoms related to mental health conditions.2
  • Depression and PTSD are up to 5 times more common in first responders.3

The current situation around COVID-19 has only compounded the stressors first responders cope with daily. Employers must address these issues head-on — and provide their teams with robust mental health support.

Who are our first responders? The term “first responder” can refer to anyone trained to respond in an emergency. In this article, we focus on law enforcement, firefighters, and emergency medical responders (EMRs).

Supporting first responder mental health starts with fighting stigma

The role of a first responder is to help others. Strength, bravery, and grit are highly valued — and employees often take on a “whatever it takes” mentality. This perpetuates stigma around mental health conditions — based on the misconception that they’re a sign of weakness. Conversations about mental health are often swept under the rug or never stated. But the high rates of depression, PTSD, substance use disorder, and suicide make it clear that first responder mental health needs to be addressed early and often.

Speaking up about mental health creates pathways to recovery

If talking about mental health could become embedded in first responder work culture, the stigma around mental health conditions could be lifted. More than 7 in 10 first responders say they’d be more likely to seek professional counseling if a leader in their organization spoke openly about their own experience.4 And peers have an even greater positive influence — 8 in 10 say that if a close colleague spoke up, they would be encouraged to seek help for themselves.5

Consider this: First responders believe treatment is effective — but professionally risky

Most first responders believe that treatment works for conditions like PTSD, depression, and substance use disorders — and they’re right. But many also believe that people who seek help for these conditions will face negative repercussions at work. Unfortunately, it’s perceptions like these that make many first responders reluctant to take advantage of the mental health services available to them.

Why don’t first responders ask for help? 57% fear negative repercussions for seeking help, and 40% fear being demoted or fired.

The power of prevention for first responder mental health

Depression, PTSD, substance use disorders, and other mental health conditions can be prevented or successfully treated when first responders get the right support. Employers can play an important role in making that happen.

Promote the practice of self-care

Working as a first responder comes with intense physical and mental demands — taking time to recover and replenish is essential. As an employer, it’s important to encourage, model, and help facilitate healthy behaviors, such as:

  • Adequate sleep
  • Balanced nutrition
  • Regular exercise
  • Taking time off to engage with family, social support, and valued activities

Recognize the role of resilience

Resilience is the ability to cope with adversity and trauma. But the job of a first responder is to jump in and support others who are experiencing trauma. First responders need specific —

and continuous — training and support to cope with the stress they experience on the job. Investing in resilience training can help your team with several vital skills:

  • Guarding against burnout
  • Managing stress under pressure
  • Recovering after traumatic experiences

There are many available resources specifically designed to help first responders practice self-care and build resilience. For example, myStrength. external link is a digital self-care app that now offers 17 interactive tools designed to reduce stigma, address burnout, build skills, and open lines of communication.6

Cultivate mindfulness

Practicing mindfulness is a skill that can help first responders manage stress in the moment and become more resilient in the future. In one study, first responders who participated in online mindfulness training for just 5 to 10 minutes a day for 30 days experienced less stress, greater resilience, and increased engagement at work.7

First responders respond well to mindfulness training. 9 in 10 say it helped them manage stress, improve focus, and resolve conflict.

Taking action: Simple ways employers can support first responders

First responder mental health is a complex and evolving subject — and additional stressors have been brought on by COVID-19.
There’s no one-size-fits-all solution, but you can help guide your organization in a positive direction:

  • Prioritize mental health. Incorporate mental health and wellness, suicide prevention, and anti-stigma efforts into your workforce wellness strategy. Share information about available resources. external link through regular outreach and promotional materials posted around the workplace. Share information about available resources, such as these flyers (PDF). external link promoting myStrength’s First Responder content.
  • Emphasize the parity of mental and physical wellness. Leaders should speak directly about mental health, the same way they do about physical safety. They should be champions for fighting stigma and creating a culture of acceptance and support.
  • Examine shift schedules to help employees prioritize sleep. Sleep deprivation leads to unsafe working conditions and health risks — so encourage shift schedules that maximize off-duty time to allow for recovery. Develop educational programs concerning sleep quality and quantity, and provide annual screenings for sleep disorders.
  • Encourage employees to be physically active. Creating a voluntary, incentive-based program is a great way to encourage employees to get more exercise. For example, employees can opt in to take a fitness assessment once a year and receive a one-time payment. This benefits everyone — employees are rewarded for their healthy behaviors, and healthier employees tend to have lower health care costs.
  • Invest in mental health awareness and stress management training. Create ongoing learning opportunities to help employees build resilience and develop positive coping skills. These trainings should be mandatory and on-the-clock — not voluntary and on employees’ own time.
  • Train employees to recognize warning signs. Programs like Mental Health First Aid. external link can teach them to spot the signs of chronic stress and mental health conditions in themselves and their peers — and what to do if they think someone might be at risk. Training developed or delivered by other first responders can also be particularly effective.
  • Establish peer support programs. Sometimes first responders feel more comfortable talking to someone who has been through and survived what they’re experiencing. Try to involve team members from different ranks, positions, and backgrounds.
  • Offer regular resiliency check-ins. Make sure it’s clear that these are not fitness-for-duty assessments — just discussions about how employees are feeling and what they’re doing to practice self-care and manage stress. It’s also a connection point where they can talk about any additional support they might need.

Helping the helpers

We depend on first responders to keep ourselves, our families, and our communities safe. That’s a tremendous responsibility. It’s not easy to run into the proverbial burning building — day after day — while everyone else runs out of it. Collectively, we need to show up for first responders the way they show up for us, and employers can play a vital role in making that happen. Asking for help should be celebrated as a sign of strength, not weakness. Employees should have access to the tools they need to thrive in mind, body, and spirit. And there should be an ongoing dialogue about mental health that fosters a culture of awareness, acceptance, and support.

About our expert

Dr. Holly Kennedy-Hansen

Dr. Holly Kennedy-Hansen works as an integrated care psychologist for Kaiser Permanente in Aurora, Colorado. She received her doctoral degree in clinical psychology in 2009 from the Arizona School of Professional Psychology and completed her residency and postdoctoral work at Princeton House Behavioral Health. Prior to her work with Kaiser Permanente, she contracted with the United States Air Force Academy and Buckley Air Force Base treating active duty soldiers, cadets, and veterans. While working on base, Dr. Kennedy-Hansen completed special duty evaluations and treated patients assigned to military police, fire, and medical units. She has also gone on to complete specialized training in working with perinatal mood, trauma, and substance use disorders. Dr. Kennedy-Hansen remains passionate in working with first responders and helping to bring increased awareness and training to other professionals regarding their treatment needs.

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  • 1

    Miriam Heyman, et al., “The Ruderman White Paper on Mental Health and Suicide of First Responders,” Ruderman Family Foundation, April 2018.

  • 2

    “University of Phoenix Survey Finds Majority of First Responders Have Experienced Symptoms Related to Mental Health Issues,” University of Phoenix press release, April 20, 2017.

  • 3

    See note 1.

  • 4

    “University of Phoenix Survey Finds More Than Half of First Responders Feel There Are Job Repercussions For Seeking Professional Mental Health Counseling,” University of Phoenix press release, September 11, 2019.

  • 5

    See note 4.

  • 6

    myStrength® is a wholly owned subsidiary of Livongo Health, Inc.

  • 7

    “First Responders Respond to Mindfulness,” Mindwell-U press release, April 27, 2017.