In his 1983 book entitled Mister Rogers Talks with Parents, Fred Rogers recounted how when he was a child and would see scary things on the news, his mother would tell him, “Look for the helpers. You will always find people who are helping.” In many cases, those “helpers” are the EMTs and paramedics who are first to arrive at a scene after a trauma has occurred. While this line of work is profoundly rewarding and provides invaluable services to communities, it also comes with high exposure to danger and trauma.
The challenges that first responders face are unavoidable and can have a significant impact on their mental health. Recognizing what steps they can take and where to find help can enable those serving on the frontlines to safeguard their mental health and continue to be effective in their jobs.
The Unique Mental Health Challenges Faced by EMTs and Paramedics
EMTs and paramedics face many job-related stressors unique to their professions. One study that assesses EMS mental health statistics shows that first responders report significantly higher rates of depression, post-traumatic stress disorder, anxiety, sleep disorders, fatigue, and suicide.
These stressors stem from routine exposure to suffering and death, the unpredictable nature of the job, and being in situations that jeopardize their own health and safety. The work is mentally taxing, requiring a high degree of focus and composure in high-stress situations. On top of this, the shift-work pattern can disrupt their bodies’ circadian rhythm and cause sleep difficulties, further exacerbating mental health issues. Paramedics may also experience guilt and self-doubt when a situation has a disappointing outcome.
Unfortunately, even though this line of work is inherently disruptive to workers’ mental health, paramedics and EMTs receive very little training on how to protect and care for their mental wellbeing. Many workers have difficulty recognizing the signs of mental illness or knowing where to turn when they need help. In some cases, the stigma surrounding mental illness in some workplaces could discourage discussions about paramedics’ mental health.
Coping with Stress and Trauma on the Frontlines
Because this work can be physically and emotionally exhausting, it is important to find ways to cope with regular exposure to stress and trauma. While there isn’t a one-size-fits-all approach for supporting mental health, there are several strategies workers can try to decrease their stress levels.
Talk About It
For many first responders, being able to talk about their on-the-job experiences is therapeutic and important for mentally digesting difficult days. Connecting with others who are in similar lines of work and sharing the emotional aftermath of a particularly challenging trauma can be a lifeline for those trying to cope with job-related stress.
Maintain a Balanced Lifestyle
Traumatic events and dangerous situations take up a lot of headspace, so first responders have to make an effort to maintain balance so negative thoughts don’t take over. Developing hobbies, finding constructive ways to unwind at the end of a shift, and serving their communities through low-stress volunteer work can help EMTs and paramedics keep their work in perspective—seeing it as part of their life rather than their entire life.
Focus on Physical Health
For those living with chronic stress, it’s easy to underestimate the importance of maintaining physical health. Eating a balanced diet, focusing on getting adequate sleep, and exercising regularly requires extra effort and planning. For someone who’s experiencing burnout, putting in extra effort toward anything can feel overwhelming and unsustainable. However, supporting physical health is an effective strategy for managing mental health and reducing the effects stress has on the body.
Keep a Journal
Recording thoughts on paper can help first responders process traumas and tragedies, particularly when talking through particularly troubling events feels too difficult. It can also support a balanced perspective when individuals are able to look at past entries and see how they did everything they could in a given circumstance, even when they didn’t see a good outcome.
Breaking the Stigma: Encouraging Mental Health Support for First Responders
First responders may experience secondary trauma resulting from caring for people in crisis, putting their own mental health at risk. To support them, there are several steps employers can take to minimize the damage this trauma has on workers. Some ways employers can support mental health include:
- Conducting debriefing sessions after particularly traumatic events; this allows first responders to process the experience with others who were involved
- Start a peer-to-peer support program; providing additional training to help first responders help their coworkers during a mental health crisis can make it easier to talk about job-related mental illness
- Have a flexible return-to-work process; create a process that helps workers transition back to work after taking time off for their mental health.
- Provide access to literature on mental health as well as contact information for local mental health care providers who serve first responders
- Each workplace has its own culture, and each worker has unique preferences on how they deal with traumatic events. Employers may consider conducting an anonymous survey for insight into how workers want to be supported after exposure to trauma and danger.
Available Resources and Mental Health Programs for EMTs and Paramedics
There are several resources available to support first responders experiencing job-related mental illnesses. Providing resources to first responders can support their mental health while building a stronger workforce.
Employee Assistance Programs
EAPs focus on employees’ mental health by providing counseling, follow-up services and referrals for resources in the community. These programs may also provide financial planning and legal support.
Peer Support Programs
Peer support programs allow first responders who’ve developed effective coping strategies to assist others with their mental health challenges. Peer mentors can model ways for handling anger, fear and sadness after a difficult day, as well as teach skills and offer ongoing emotional support.
Critical Incident Stress Management Teams
Some organizations, such as Maryland Institute for Emergency Medical Services Systems, use critical incident stress management teams to assist first responders with navigating the psychological and emotional impacts of stressful situations. These teams may be comprised of mental health care professionals and peer mentors who’ve completed special training.
Mental Health Hotlines
There are several mental health hotlines that first responders can call for immediate help, including:
- American Foundation for Suicide Prevention: (800) 273-8255 or text TALK to 741741
- National Alliance on Mental Illness: (800) 950-6264
- National Suicide Prevention Hotline: (800) 273-8255
- Safe Call Now: (206) 459-3020
Some mental health facilities, such as FHE, provide specialized services and support specifically for EMS personnel, law enforcement officers and paramedics. Through these programs, first responders can connect with peer communities and obtain treatment for mental illnesses or substance abuse.
Self-Care Strategies for Maintaining Wellbeing in High-Stress Environments
Stress is unavoidable for EMTs and paramedics, but there are constructive ways first responders can manage this stress and maintain optimal effectiveness at work. Incorporating self-care strategies can help them avoid burnout and ongoing mental health challenges.
Include Self-Care Practices in Daily Routines
Set aside time for self-care practices every day. This may include enjoying a relaxing bath, reading a few chapters of a book, or enjoying a sunset.
Engage in Regular Physical Activity
Taking a brisk walk, going for a jog, or setting off in a kayak can be effective for getting rid of excessive stress.
Limit Time Spent on Doomscrolling
The internet provides a constant stream of depressing or worrying content. For someone already handling regular stress and trauma, regularly consuming this content can have a serious negative impact on mental health. Resist the urge to doomscroll through troubling articles on news sites and social media.
Building Resilience and Emotional Strength in the Emergency Medical Field
Building resilience for those in the emergency medical field is possible with a combination of external support and personal coping strategies. Employers can support emotional strength by fostering a strong social support system, providing access to mental health resources, and having a return-to-work program for those who’ve taken time off for their mental health. Likewise, first responders can build resilience by setting work-life boundaries, taking care of their physical health, and making an effort to decompress at the end of every workday.