Depression and PTSD:  Help for First Responders

Depression and PTSD:  Help for First Responders

It is estimated that 30 percent of first responders develop behavioral health conditions including, but not limited to, depression and posttraumatic stress disorder (PTSD), as compared with 20 percent in the general population (Abbot et al., 2015).

First responders are usually the first on the scene to face challenging, dangerous, and draining situations. They are also the first to reach out to disaster survivors and provide emotional and physical support to them. These duties, although essential to the entire community, are strenuous to first responders and with time put them at an increased risk of trauma.


The purpose of this blog are to discuss the challenges encountered by first responders, specifically Emergency Medical Services Personnel, during regular duty as well as following disasters; shed more light on the risks and behavioral health consequences (such as PTSD, stress, and depression) of serving as a first responder; and present steps that can be taken to reduce these risks either on the individual or institutional levels.


Behavioral Health Conditions

One of the core risk factors for first responders is the pace of their work. First responders are always on the front line facing highly stressful and risky calls. This tempo can lead to an inability to integrate work experiences. For instance, according to a study, 69 percent of EMS professionals have never had enough time to recover between traumatic events (Bentley et al., 2013). As a result, depression, stress and posttraumatic stress symptoms, suicidal ideation, and a host of other functional and relational conditions have been reported.



Depression is commonly reported in first responders, and rates of depression as well as severity vary across studies. For instance, in a case-control study of certified EMS professionals, depression was reported in 6.8 percent, with mild depression the most common type (3.5 percent) (Bentley et al., 2013).


Among medical team workers responding to the great East Japan earthquake (2011), 21.4 percent were diagnosed with clinical depression (Garbern, Ebbeling, & Bartels, 2016). In a study in Germany, 3.1 percent of emergency physicians had clinical depression (Pajonk, Cransac, Muller, Teichmann, & Meyer, 2012).



Stress symptoms and posttraumatic stress symptoms in EMS personnel have been reported in a number of studies. For instance, in a review of published literature, EMS/paramedics reported higher peritraumatic dissociation at the time of the Loma Prieta Bay Area earthquake (1989) compared with the police (Marmar et al., 2006). In a study in Germany, 16.8 percent of emergency physicians had probable PTSD (Pajonk, Cransac, Muller, Teichmann, & Meyer, 2012). In a case-control study among certified EMS professionals, stress was reported in 5.9 percent, with mild stress the most common type (3.1 percent) (Bentley et al.,


Suicidal ideation has been reported in first responders in a number of studies, but there is still a question as to the rates given the way data has been collected in samples of convenience versus the use of random samples. However, existing research suggests that EMS personnel may be more likely than the general population to think about and attempt suicide. For instance, in a literature review, suicidal thoughts and ideations in EMS/paramedics were evaluated as compared to the general population (Stanley, Hom, & Joiner, 2016).


Based on findings from a study included in the review—only two studies of suicidality in EMS personnel met the criteria for the review—authors found a lifetime prevalence rate of 28 percent for feeling life is not worth living, 10.4 percent for serious suicidal ideation, and 3.1 percent for a past suicide attempt (Stanley, Hom, & Joiner, 2016). In another study in the same review, it was found that having both EMS and firefighting duties was associated with a sixfold increase in the likelihood of reporting a suicide attempt as compared to firefighting alone (Stanley et al., 2016).


In a separate study, Abbot et al. reported that 37 percent of fire and EMS professionals have contemplated suicide, nearly 10 times the rate of American adults (2015). In addition, 6.6 percent of fire and EMS professionals reported having attempted suicide as compared with just 0.5 percent of civilians.



Below are two links to the same 3 minute mental health assessment.  One link is to the phone app for your phone and the website so you can monitor how your mental health is changing over time. 


They both provide an M3 Score - a number to help you and your doctor understand if you have a treatable mood disorder. M3 Information, LLC ( “M3”) grew out of a collaboration of National Institute of Mental Health ( “NIMH”) alumnus and other academic researchers, clinicians, information technology and business people committed to reengineering the detection of mental health disease and streamlining its integration into Primary Care, the point of first contact for a majority (over 70%) of all mood disorder cases. The M3 Checklist research was validated in the Annals of Family Medicine.



Benjamin Franklin wrote, "If you fail to plan, you are planning to fail!"  Plan ahead for traumatic incident recovery and follow the link below to USFRA endorsed insurance that provides comprehensive treatment for PTSD, addiction and much more http://traumacoverage/usfra


Jan 28th 2020 Society for Trauma Education and Empowered Recovery