Dr. Asa Don Brown, Ph.D., C.C.C., D.N.C.C.M., F.A.A.E.T.S.

first responder holding head

As a first responder and psychologist, I have been in the midst of some of the most horrific and unimaginable scenes. All the training in the world can never prepare your visual mind or your sense of smell associated with fire related events. Whether you are on the scene of a motor vehicle accident or involved with battling a raging inferno; the mind of a first responder is put to the test on a daily basis. Whether you are a paramedic, firefighter, police officer, 911 dispatcher, or some other form of first response; the life of a first responder is heavy-laden with tragedy and sorrow.

It is well known that first responders are first on the scene, but little is discussed about their lack of mental health care. Thus, the trouble begins for many first responders. Alone late at night with their mind toiling through images of the past; the first responder may be challenged with a barrage of images associated with tragedy and sorrow. Unfortunately, there are too few first responders who are willing to reach out for help, and more that deny having any mental health concerns at all. The burdens on a first responder are not always associated with being a first responder, but, the egregious nature of the job sometimes takes its toll on the life of the first responder.

First responders have a macho persona. After all, you are a real-life superhero and rightfully so. First responders are not always climbing up trees to rescue cats, nor are they battling a raging inferno, but they are frequently interacting with the community. First responders are known to visit schools; be involved in a variety of community projects; to receive calls involving domestic violence; learn of hostile activities before they occur; and they are privy to a wide range of domestic and international threats. Given all of this, they are often informed that they must conceal a bushel of information. Naturally, first responders have a tendency to be selfless, but in their selfless acts, they are often guilty of avoiding their own personal self-care. Balancing life, career, and family can sometimes be a juggling act, so much so, that some may turn to alcohol and other substances to manage conditions like post-traumatic stress disorder (PTSD).

Stanley et al. found that career firefighters reported higher levels of problematic alcohol use and PTSD as compared to the volunteer firefighters, while the volunteers reported higher levels of depression and suicide attempts and ideations (Stanley et al., 2017). Recent (past month) heavy or binge alcohol drinking was reported in approximately 50 percent of male firefighters, and driving while intoxicated was reported in 9 percent of male firefighters (Haddock, Poston, Jahnke, & Jitnarin, 2017).

Due to the nature of the career, first responders have a higher probability of developing PTSD and other mental health conditions. The repeated exposure to disasters, accidents, violence, loss of life and trauma can pose a significant risk to the health and well-being of an individual. Moreover, these experiences not only have an effect upon the first responders themselves, but it most certainly has a vicarious effect upon the first responder’s network of friends and family.

Additionally, first responders have become victims of stigmas, threats, and hostile acts. Sadly, mental health has taken a bad rap amongst first responders. This undeserved reputation is not only communicated amongst first responders, but therapists are often portrayed in movies and television as wacky, neurotic and unhinged (e.g. Analyze This; Good Will Hunting; What About Bob?). If this was not enough, a staggering 70% of United States firefighters are volunteer. As volunteers, very few departments offer EAPs / EFAPs (employee assistance or employee family assistance programs), nor do they offer compensation for issues of mental health.

First responders have a legitimate concern with being outed. If a first responder is known to be using alcohol or other substances while on the job, the legal and career consequences could be severe. Moreover, if a first responder is known to be struggling with a mental health condition, they may be placed on a desk job or on leave. Therefore, the fears of a first responder may be compounded by the perception of mental health and the struggle to manage a mental health condition.

As first responders, we spend our days providing care for others. Balancing a career as a first responder and having a mental health condition can be difficult. Add an addiction to the equation, then the first responder’s perceptions become altered and their ability to serve: null. Encouraging a first responder to seek help can be like pulling a camel through your front door. While it’s not impossible, it may be a bit challenging to say the least.

First responders need to be encouraged to ask for help. They need to understand that asking for help is not a sign of weakness, nor a question of their masculinity, but rather, it is a courageous step towards living a full and productive life.

It is not uncommon for first responders to avoid asking for help. When it relates to substance and alcohol abuse, asking for help may prevent you from losing your job or being found guilty in a court of law. First responders are held to a higher standard while serving on the job. If a first responder is using a substance or alcohol while performing a task related to his or her job; they could be tried for such conduct. Moreover, a first responder may never dream of using while on the job, but addictive issues have a way of spilling over into other aspects of one’s life. An addict may present as irritable, agitated, or even hostile while performing duties assigned. It’s important that you recognize any inconsistencies or mood changes in your fellow first responder.

Being a first responder is about being a part of a family. As a member of this family, I encourage my fellow brothers and sisters to address their issues. I beg you to consider asking for help. It’s not too late to request help or to find someone that you can lean upon. After all, it’s a family and we should look out for one another.

Reference Provided Upon Request

Dr. Asa Don Brown, Ph.D., C.C.C., D.N.C.C.M., F.A.A.E.T.S. Website: