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First Responders Come Last

Today, as hurricane Dorian leaves the islands of the Bahamas in complete devastation, with the death toll rising as the eye of the storm moves towards the US East Coast, first responders are task with the role of trying to develop a safety net for those who have survived and continue the count of those who have died.  The role of the first responder is both important and emotionally draining. These police, firefighters, search and rescue personnel, emergency and paramedical teams witness the worst of times during and after an emergent situation occurs, which takes an emotional toll on these men and women. At a scene of an accident, first responders are expected to immediately push their feelings aside and provide physical and emotional support to survivors. At the end of the day, they are expected to leave their jobs at the scene of the crime and go home to live healthy normal lives. Unfortunately, that is often not the case for many first responders. Current research has shown that the lives of many of these first responders is neither healthy nor normal.

SAMHSA (Substance Abuse Mental Health Services Administration) has recently put out a supplementary research bulletin titled,  “First Responders: Behavioral Health Concerns, Emergency Response, and Trauma" (May 2018), which estimated that 30 percent of first responders develop mental and behavioral health conditions including, but not limited to, depression and post-traumatic stress disorder (PTSD).

First responders are often left alone to unsuccessfully try and balance the traumatic memories of witnessed devastation and the day-to-day expectations that comes with wanting to have a personal life. This uneven balancing act frequently leads to high rates of substance use disorders and mental health issues. It is estimated that approximately 25% of all first responders are currently struggling with addiction to drugs, alcohol, gambling, sex, etc (SAMHSA, 2018). Too often, these ignored substance use and mental health issues have led many first responders to feel as though they had no other choice but to take their own lives.

In research done on the act of suicide and how it impacts firefighters and police, it was reported that firefighters have higher attempts and thoughts of suicide rates than the general population (Stanley et al., 2016). For police officers research has suggested that around 125 to 300 police officers commit suicide every year (Badge of Life, 2016).

For first responders, there is an age-old culture of being tough; a “real man” where no emotion is allowed to be expressed under fire, a robot of sorts. This fearless individual would never dare to ask for help with the PTSD that they experience daily. This tough identity is often perpetuated throughout 

society, making it difficult for one to recognize that a mental health or substance use issue exist, leaving them to suffer in silence while living a life full of personal disasters.

Police, firefighters, search and rescue personnel, emergency and paramedical teams are at the frontlines of every natural or manmade disaster, tasked with the job of risking their lives for the sake of others. These first responders, who experience the scariest of situations, deserve not only gratitude, but validation of the truly difficult and emotionally draining job that they have. Mental health and/or substance use programs focused on the needs of these first responders are overdue. Education on the prevalence of mental health and substance abuse issues and the permission to ask for help should be made available in all first responder training programs. 

Hurricane Dorian has taken 7 lives so far. As the winds die down and the wreckage left by the storm is revealed, first responders will be there digging through the piles of debris in search of those who have been missing. The sights and sounds coming from all the devastation will be difficult to experience and police, firefighters, search and rescue personnel, and emergency and paramedical teams will again be asked to put themselves aside to offer emotional and physical support to survivors. What about them? Who will be there for them?

Alejandra Luna LCSW, Mental Health Therapist/LGBTQ+ Specialist

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