From fires to active shooters, first responders must react quickly to life-threatening situations. Adrenaline and training may take over in the heat of the moment to help them survive, but afterward brave people can be left alone to deal with the emotional trauma of these events.

Talking leads to coping
The radical circumstances in which first responders find themselves often leave their mark after the fact. Emergency Management notes that as many as 37 percent of all firefighters meet the criteria to be diagnosed with post-traumatic stress disorder (PTSD), and even more agents may show symptoms after a large crisis.

The healthiest way to work through these issues is to discuss them with professionals. If stress is left undiagnosed and untreated, it could lead to mental health conditions such as depression or anxiety. In the past, officers were not encouraged to talk about the experience of a traumatic day.

“Back in the old days, it was not OK to talk,” Onslow County EMS Division Chief Beth Himes told The Daily News. “You weren’t allowed to tell people how you feel, but we’ve seen a change in that over the past 15 years. People need to have a vent, they need to have a person they know they can talk to.”

Today, officers are frequently pushed to discuss issues with colleagues and superiors, keeping the lines of communication open to better work through shock.

Debriefs are part of broader crisis support 
Agencies need to address the emotional needs of their employees, and many choose to do so through debriefs. A Critical Incident Stress Debriefing (CISD) is a seven-step program that offers support to first responders. Throughout the course of the program, participants are given “psychological first aid” where they are invited to discuss their feelings and understand how to deal with their reactions to an incident. Debriefs are used when traditional coping mechanisms are not enough to handle the stress of an event.

To work properly, however, CISD requires an investment in necessary resources and tools, incorporating the group discussions into a broader crisis support system. Agencies must have an intervention plan in place for after the debrief. As Emergency Management explains, building networks with schools, hospitals and religious centers establishes a long-term support system.

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An effective debrief provides first responders with a team of trained experts who work with the agency to provide ongoing support for struggling personnel. Teams include mental health professionals—who can diagnose severe problems—and peer professionals capable of understanding the stress of being a first responder. Other team members cultivate relationships with the participating agents. Through a sustained connection with others, traumatized people are better able to recognize changes and seek later treatment, when necessary.

Managers are trained to look for signs of stress
The effects of trauma do not surface immediately or at the same time for all people. Agency managers and supervisors must be trained to recognize the signs of stress, even weeks after an incident. These peers are well-positioned to provide insight into the mental health of a traumatized co-worker, and they can keep an eye on personnel long after the initial debriefs have ended.

“There is a tendency for everyone and everything to show up in the first couple of days, which often comes from too much self-dispatching,” Dave Neal, a member of the fire and emergency management program at Oklahoma State University, told Emergency Management. “They may be really good people, but maybe it makes more sense for them to wait two or three days after that first wave, when the mental and emotional stress starts to take place. That means emergency coordinators need to have a system in place.”

Stress is an implicit part of the work of being a first responder. Ignoring the emotional and psychological issues brought on by traumatic events may only lead to more obstacles later on. Beginning the process early—even before these incidents occur, to brace officers for what might come and where to get help when tragedy strikes—results in a comprehensive system of support for those who need it.

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