INTRODUCTION
When something terrible happens the first thing that most people do is call 911 and they send first responders, which include police, EMTs, paramedics and firefighters, to face the brunt of a car accident, a fire, or all too often in the modern era, mass shootings and possible explosions. That said these first responders very often face serious psychological impacts from the kind of scenarios that they find themselves, from a gunshot wounds to the dismembered bodies of accident victims they see it all, raw and unavoidable. The risk factors for first responders is severe and has lasting effects that may affect them throughout their career and the length of their life. If unaddressed and untreated in can significantly impact the quality of life of many first responders. After reviewing many sources it becomes clear that first responders are often under-appreciated and their mental health under-addressed. The kinds of difficult, emotionally draining, traumatic and sometimes downright dangerous situations that innately accompanies their chosen career path it can and does have drastic effects and meaningful research into finding means to improve the negative statistics relating to resiliency and first responders is imperative and highly worthwhile.
BACKGROUND
What exactly does resilience mean when applied to the psychology of individuals, like first responders? In the simplest of terms, resilience refers to the ability of an individual’s to adapt, adjust and cope in stressful and adverse situations (Southwick, Bonanno & et. al. 2014). In fairness some people are better at that than others. Some people have a knack for being able to deal with stressful situations and even thrive under pressure of any kind. Other people, however, do not adapt or adjust as quickly as others regarding the sights they see, the things that they feel, the things that they hear and the panic and anxiety that comes with what can be overwhelming, especially unaddressed and improperly dealt with (Nauert, 2015).The kinds of injuries that first responders often experience, the kind of scenarios they are placed in and the emotional toll they face on a daily basis is it really any wonder that first responders are at risk of extreme mental illness and psychological instability? That said finding ways to improve these negative statistics is recommended and a great deal of study has been dedicated to determining the best approaches.
DISCUSSION
Police may respond to an accident where the body of a child has been thrown from the vehicle. EMT’s and paramedics deal with blood, broken bones and people that cannot be saved and Firefighters see the damage around them and the effects that fire can have, especially when there are casualties. The research identifies a number of specific mental health risks and potential consequences most commonly experienced by first responders and are signals, as well, that the first responder may want to taking steps to address their feelings and anxieties (Reagan, 2015).
Hyper-arousal: This includes symptoms of sleeplessness, anxiety and mood swings, often anger, irritability and fear. These effects can manifest in physical health side effects as well (Reagan, 2015).
Intrusions: This includes symptoms like nightmares, flashbacks and over-focus on the events that they are struggling with. First responders often see the horrors they witness long after the event has taken place (Reagan, 2015).
Avoidance: Literally, avoidance is self explanatory. Many first responders will avoid the situation and the symptoms they are experiencing . They may also avoid contact with the people and places involved. Sometimes this manifest so severely that people become anti-social and self-isolating are a larger scale (Reagan, 2015).
Psychic Numbing: Many may develop an emotional numbness to their feelings, they may “space out” and, often, turn to self-medicating, the use of drugs and alcohol, to take themselves out of their “reality” (Reagan, 2015).
Post Traumatic Stress Disorder: PTSD is a serious psychological conditions where a person has been so severely traumatized by an event or experience, which is when all of the aforementioned symptoms are now having a distinct and detrimental effect on their quality of life. PTSD is often seen among the military, but it is also a risk for all first responders (Bonanno, Westphal & Mancini, 2011).
Self-Harm and Suicide: Again, when first responders do not recognize their own risks or are reluctant to seek help for mental health issues that can become extreme and manifest as PTSD, severe depression and many physical health effects that are contributed to by the presence of mental health conditions, like heart trouble, digestive issues and high blood pressure. Again, many may turn to drugs and alcohol to cope, others may turn to self harm. In the worst cases many first responders have chosen to end their own lives (Gunderson, Grill, & et. al. 2014).
There are a lot of theories that have been developed and studied how to explain, recognize, approach and address the mental health issues that are effecting first responders all across the country and around the globe.
Stress Response Theory: There are two main parts to Stress Response Theory, first what is the initial emotional reaction to a trauma event and, secondly, the necessary efforts to adopt the new traumatic information into their understanding of the world; trauma can challenge an individual’s core beliefs and world outlooks. When they cannot accomplish this then the likelihood of developing more serious problems, like PTSD, becomes common (Weber, 2008). Such a situation for first responders could include the kinds of crimes that are too often seen against children. Having to see what kinds of sadistic and cruel ways that children are often treated could be completely shocking and horrifying that it may be impossible for some to ever accept, which, of course, can make doing their job all the more difficult.
Information Processing Theory: This is a popular theory in psychology. It argues that traumatic events are processed in different parts of the brain than other experiences. If that process is not completed then the negative memories can become unbearable. Not only will people suffering from trauma avoid thinking or talking about the topic that is haunting them, they will also avoid any kinds of cues that may remind them of those memories (Weber, 2008). Experiencing those cues can lead to anxiety, fear and an inability to do their job effectively.
Trauma Theory: Trauma Theory was first introduced in the 1970s as a means of explaining the psychological states of Vietnam veterans, Holocaust survivors and victims of sexual assault. In this theory the perspective was changed regarding people suffering from trauma and unable to gain the level of resilience needed to function healthfully. This theory offers that these people are not “sick” or in some way defective, but are injured and in need of therapeutic aid (Center for Nonviolence & Social Justice, 2014).
Society will always be filled with accidents, crimes and natural disasters. There will always be injured people, casualties and horrifying conditions. More than ever, in the modern, era with the increasing likelihood of domestics and international acts of violence. First responders are living in an era of gang violence where it is dangerous to respond to emergencies. First responders are living in an era where there are mass shootings at business and on school campuses and their terrorist’s acts being committed without warning. All of these events only create more and more traumatic experiences and imagery that can have a long and lasting affect on first responders here in the United States and all over the world (Nauert, 2015).
There is nothing that can be done about the scenarios that first responders may find themselves in, but what can be done is the development of greater means understanding of the effects these jobs has on first responders, how first responders can address their feelings and how policies can be more proactive in making beneficial procedures more present in the fields that employ first responders. It has been suggested by a number of experts that their need for resiliency programs developed and enforced for all first responders to participate in that will lessen their burden, lower anxiety and limit any long term effects (Southwick, Bonanno & et. al., 2014). Such curriculums should address a number of points that are imperative to coping with trauma successfully and lead to a path of beneficial resilience.
Goal Setting: There is nothing more important than helping people who are attempting to cope with experiences and their side effects; so they can focus on what is most important and achieve realistic goals, whatever they may be (Gunderson, Grill, & et. al., 2014).
Exercise: When one is overcome with anxiety or depression they often become less active, even sedentary, but encouraging therapeutic exercise helps stave off the negative effects of dealing with necessary resilience (Gunderson, Grill, & et. al., 2014).
Self-Defeating Thoughts: Many first responders who are struggling with the needed resilience that their jobs often require can be difficult when the individual takes out their emotional issues on themselves. For example, negative thinking is contributory to why many first responders opt to self medicate or self harm. That said part of any resiliency program must include an available outlet where individuals can talk openly and help them to avoid such self-defeating thoughts (Gunderson, Grill, & et. al., 2014).
Proactive Outreach: It does not benefit anyone to have programs available if many first responders are reluctant to take advantage of them. By incorporating such counseling outlets mandatory on a regular basis, then first responders will no longer feel stigmatized; dealing with trauma in jobs with high traumatic risks would become part of common practices (Gunderson, Grill, & et. al., 2014).
It should be made clear that there is no “universal” cure-all for the different individual’s that experience low resiliency of first responders. Every individual will interpret, process, and cope with stressful situations and traumatic events differently. Some people may struggle but with the right interventions and coping mechanisms may overcome their issues more easily, while another may continue to struggle for some time and require more in-depth and continuous aid. That is why many experts are arguing that prior to incorporating resiliency programs within fire departments in different locations the percentile of negative mental health issues among many firefighters and extremely high instances of alcoholism. After the implementation of resiliency programs the statistics of anxiety, trauma and self medication among many firefighters decreased (Deppa, 2015). That said it validates that such programs are highly beneficial and should be implemented in all departments and agencies made of up of first responders.
CONCLUSION
First responders see things that average people on a day-to-day basis simply do not. The average worker does not see blood, body parts and dead bodies. However, first responders see these things all the time, sometimes many times a day. These people place themselves at physical, but very often, psychological danger dealing with highly stressful situations. The abundance of research makes it clear that the psychological issues of first responders is being experienced and witnessed among firefighters, EMT’s, paramedics and police every single day and there are needs for measures to be taken to benefit those first responders to cope and successfully work through the emotional and mental risk factors they are facing. Fortunately, there are outlets available and there are examples of resiliency programs that are making great strides in benefitting first responders. The logical solution to the problem is making resiliency programs a mandatory aspect in the workplace for all first responders and, therefore, making proactive paths to resiliency will improve how first responders deal with the stress, trauma and anxieties of their job experiences.
REFERENCES
Bonanno, G.A., Westphal, M. and Mancini, A.D. (2011). Resilience to Loss and Potential
Trauma. Annual Review of Clinical Psychology. 7(1). 1-25.
Deppa, K.F. (2015). Resilience Training for Fire Fighters: A Proposed Approach. University of
Pennsylvania. 1-84.
Gunderson, J., Grill, M. and et. al. (2014). Responder Resilience: Evidence-based program
improves & sustains first-responder behavioral health. Journal of Emergency Medical Services. 2014. 57-61.
Nauert, R. (2015).Trauma can up risk of mental disorders in first responders. Psych-Central. 1.
Retrieved June 12, 2016, from http://psychcentral.com/news/2013/02/27/trauma-can-up-risk-of-mental-disorders-in-first-responders/51995.html.
Reagan, L. (2015). When helping hurts:Trauma’s effects on first responders. Good Therapy
Organization. 1. Retrieved June 12, 2016, from http://www.goodtherapy.org/blog/when-helping-hurts-traumas-effects-on-first-responders-0212154.
Southwick, S.M., Bonanno, G.A. and et. al. (2014).Resilience definitions, theory, and challenges:
interdisciplinary perspectives. European Journal of Psychotraumatology. 5. 1-14. Weber, Weber, D.L. (2008). Information processing bias in post-traumatic stress disorder. The Open
Neuroimaging Journal. 2. 29-51.
Center for Nonviolence & Social Justice. (2014). What is Trauma? Center for Nonviolence &
Social Justice. 1. Retrieved June 12, 2016, from http://www.nonviolenceandsocialjustice.org/FAQs/What-is-Trauma/41/
