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'Giving Help and Not Asking for It': Inside the Mental Health of First Responders

Human tragedy comes with the badge -- but help dealing with it often doesn't.

New Orleans firefighters getting emotional in church
New Orleans firefighters at the first post-Hurricane Katrina Mass at the historic St. Louis Cathedral.
(AP/Kevork Djansezian)
Teaching cops, firefighters and prison workers to recognize and know how to handle people with mental illness is a big part of the efforts to reduce suffering and death at the hands of law enforcement. Less talked about is the mental health of the cops, firefighters and prison workers themselves.

In the last two years, the number of suicides among firefighters exceeded the number of deaths in the line-of-duty, according to Jeff Dill, a retired firefighter who is chief executive officer and founder of the Firefighter Behavioral Health Alliance.

The stats are just as sobering among corrections officers. Preliminary results of a survey for the California Correctional Officer Health and Wellness Project reveal that 65 percent of correctional officers in that state have at least one symptom of post-traumatic stress disorder and one in nine of the 8,600 respondents acknowledged having suicidal thoughts. These survey results confirm what the California Correctional Peace Officers Association found in 2013: The suicide rate for its members was about 50 percent higher than for the general population.

In these kind of jobs, human tragedy comes with the badge. For the most part, though, departments are doing too little to help their public protectors deal with the stress and trauma of it all.

“We see people die in our daily life,” says Andrew Shannon, public information officer for the Code Green Campaign, which offers peer counseling and other support services to firefighters and emergency medical personnel nationwide. 

Stress levels are also heightened by lack of sleep. For workers in his field, Shannon says 48-hour shifts are not uncommon.

“We get sleep time, but it’s interrupted,” he says. 

Mass shootings and natural disasters have become more common, likely worsening the emotional impact on police, firefighters and paramedics. Dill initially founded the Firefighter Behavioral Health Alliance, a counseling service for firefighters, in 2008, after seeing the impact that Hurricane Katrina had on the emergency response workers.

“When they came back, they talked about seeing a lot of horrific things,” he says. 

But even when departments reach out to their stressed employees, Dill says they don’t always reach back. There can be a reluctance, for several reasons, to take advantage of the help that’s offered. 

“If someone is diagnosed with post-traumatic stress disorder, their job may be threatened,” says Dill.

The federal Americans with Disabilities Act (ADA) provides some protections for someone who is fired due to a PTSD diagnosis, but the ADA only protects people who can perform "essential job functions with or without a reasonable accommodation." In practice, this clause leads many cases to be contested legally, and each case requires its own assessment -- even if individuals are in the same department, says Alisa Arnoff, a partner at Scalambrino & Arnoff, LLP, a labor and employment firm, which has represented both firefighters and fire departments.

Admitting that you have mental health problems also runs counter to long embedded cultures in fire departments, police departments and prisons that frown on showing personal weakness. When you put on a first responder uniform, you’re expected to be “brave, strong and courageous -- giving help and not asking for help,” says Dill.

Regardless, some places are starting to focus more attention on the mental health of people hired to protect the public.

In Stockton, Calif., police learn to talk about their feelings and are encouraged to seek peer support or see therapists as part of the department's wellness program. Phoenix is often cited for its “Friends Helping Friends” program, which offers firefighters counseling and resources to deal with issues like drug and alcohol abuse, depression, family problems and stress. Oregon has established a project to support correctional officer mental health, and New York is undertaking a survey similar to the one that was just completed in California. 

*CORRECTION: A previous version of this misquoted Amy Lerman, a lead researcher for the California Correctional Officer Health and Wellness Project.

Caroline Cournoyer is GOVERNING's senior web editor.
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