First Responder Mental Health During the Holidays 


The end of the year brings holidays celebrated across many faiths, yet for some, this is a difficult time of year. As first-responders we recognize that many of the patients we encounter struggle with holidays, but what about ourselves? Responder mental health is a serious issue and over the past few years we, as a community have started to acknowledge this and offer prevention and treatment. The NREMT now requires this as continuing education for Paramedic refresher and EMT refresher and should be a daily conversation while on duty.

The first step in any problem is acknowledging the issue and who is affected. For the past 5 years, firefighter suicides have exceeded line-of-duty deaths. Let that sink in for a minute, more firefighters are dying by their own hands than the incredibly dangerous job they perform daily. These statistics are likely underreported as well, as the reporting data is voluntary to Firefighter Behavioral Health Alliance. So why are so many of us suffering in silence?

The culture of EMS, Fire and Law enforcement revolves around the hero persona and machismo.  We strive to be the hero in every possible situation, work, home, out with friends/family and or on vacation. We always see ourselves as being “on-duty” and we rarely allow ourselves the space to decompress or process the events we see, hear and touch. Agencies often fail to support a culture of mental health awareness and individuals are looked down upon if they have a mental health issue. Comments such as “just suck it up” and “let’s get a drink and forget about that call” promote degradation of the mental health of individuals and agencies. The mental health of an individual on shift is directly linked to the mental health of others, he or she works with for extended periods of time.

The second step is prevention, change the culture within the agency/department. This requires leadership that recognizes and understands mental issues. Often front line first-responders are afraid to talk to superiors in fear of removal from duty. The fear is valid and has been demonstrated across departments nationwide, employees have been fired or removed from duty without cause. Peer paramedic/firefighter support groups have opened the door for individuals with a need to talk to someone, without fear of retribution. Outside professionals and agencies provide the same service, with increased comfort of the individual. Think of this as mental health mutual aid.

Treatment is the final step and often the most difficult for individuals and agencies. Where do I send people for support? How do I know when to pull someone off the truck? How can I ask about their treatment without violating their privacy? When can they return to active duty? Should I ask about firearms in their house? Can I keep an eye on this person without overstepping? These are all common questions and difficult to answer. Having a mental health plan for both individuals and MCI’s is necessary for first-responder agencies. This should detail the process of line employees receiving help, being removed from duty, returning to duty and everything in between.

While we celebrate the holidays, on duty or off, remember that your brothers and sisters may be suffering in silence. Take the time to listen, make yourself available and let them know you care about them. Here are a few things you can say to help anyone who is struggling with mental health, especially over the holidays.

I am here for you.

How can I help you today? Do you need a trade for a day off or do you feel better when you’re on duty?

It is ok not be ok.

You are important to me.