The Conversation We Need to Have About First Responder Mental Health

Oct 8

4 min read

October has become an important month for conversations about mental health, and I have found myself reflecting on how mental health is viewed within the law enforcement and first responder community.

I recognize I have a different perspective on this subject. I am a law enforcement officer, but I am also a practicing mental health clinician. I have spent years experiencing this culture from the inside while also sitting on the other side of the table, listening to people talk about the things they carry. Those two roles have given me a perspective that is sometimes difficult to reconcile.

Over the last decade of my career, I have attended countless training courses focused on officer wellness. We talk about resilience, stress management, sleep, exercise, nutrition, peer support, and finding healthy ways to cope with stress. All of these things have value, but somewhere along the way, I noticed something missing. We talk about wellness, but we don't always talk about mental health. We talk about how to be resilient, but what happens when resilience isn't enough?

Why?

Is it because we are helpers, and somewhere along the way we decided that helpers don't need help?

We are the people who show up in someone's life when they are at their lowest and most vulnerable. We walk into homes when everyone else is walking out. We deal with trauma, violence, addiction, loss, and crisis. We are trained to assess risk in other people, but how often are we willing to assess our own?

Research continues to show law enforcement officers and other first responders face significant risks to their mental health. Anxiety, depression, substance use, relationship difficulties, post-traumatic stress, burnout, and suicidal thoughts are realities within this profession. Yet we don't always talk about them. The more I learned about the research, the more frustrated I became. Why aren't we talking about this more openly?

Then I started thinking about my peers.

I thought about the pride they have in their work. Their integrity. Their commitment to doing the right thing, even when doing the right thing, is difficult. I thought about the people I know who would run toward danger without hesitation in helping a stranger yet might hesitate to admit that they themselves are struggling.

I can imagine how difficult it can be to reach out when you feel as though you are carrying the weight of the world on your shoulders.

So many of us entered this profession because we wanted to help. We wanted to protect people, make a difference, and leave our communities better than we found them. That desire to serve is one of the things that makes this profession so meaningful. But the job does not make us immune to stress, trauma, or the challenges that come with it.

In fact, the very qualities that make someone good at this work, (strength, independence, resilience, loyalty, and the ability to keep going), can sometimes make it difficult to recognize when we need help ourselves. Having a “this is just part of the job” attitude can be more damaging than we realize.

First responders can experience not only burnout but also compassion fatigue. Compassion fatigue can develop through prolonged exposure to the trauma and suffering of others. Over time, it can leave a person emotionally and physically exhausted and can affect their ability to experience empathy, hope, and connection. It may look like emotional numbness, withdrawal, irritability, hopelessness, difficulty concentrating, intrusive thoughts, apathy, exhaustion, sleep disturbances, or other physical symptoms.

And then there is moral injury.

Although the concept was initially recognized and studied extensively within the military, moral injury is also relevant to first responders. It can develop when a person experiences events that deeply conflict with their core moral beliefs or values, particularly when they believe they have violated those values, failed to uphold them, or were unable to prevent something they believe should never have happened.

Moral injury can leave people struggling with guilt, shame, self-blame, loss of self-trust, and questions that can be incredibly difficult to silence:

“I should have…”

“What if I had…”

“I could have done more…”

These experiences can become wounds that aren't visible to anyone else. The word trauma comes from the Greek word for wound. And perhaps that is an important way to think about what happens to first responders. Some of the wounds we sustain on the job cannot be seen.

“Resulting in trauma” is certainly not language we see in a job description for law enforcement officers, firefighters, EMTs, dispatchers, or other first responders. Yet exposure to traumatic events is an inherent part of these professions. To believe first responders are somehow immune to the psychological impact of what we experience is unrealistic. Still, there is an entrenched belief within our culture that admitting we need help is a sign of weakness. If something bothers us, we aren't tough enough. If we struggle, maybe we aren't capable or fit to do the job.

That belief has to change.

And change starts with us.

Being vulnerable is scary. Asking for help can be uncomfortable.

But vulnerability is not weakness.

HERE IS THE TRUTH:

You are not less capable because you are struggling.

You are not weak because something affects you.

You are not failing because you need help.

And seeking support does not erase your strength, your service, or everything you have accomplished.

We have to stop treating mental health as something that only becomes important when someone reaches a breaking point. We need to recognize the warning signs earlier. We need to check on our people, not just after a critical incident, but throughout their careers. We need to create cultures where asking for help is met with support rather than judgment.

If you notice a change in someone, don't be afraid to say something. If you're not feeling like yourself, ask for help. If someone you care about seems different, check in.

There are resources available. There are people who understand the unique culture within the first responder community.

You should not have to choose between your well-being and your career.

You do hard things all the time.

Do something hard for yourself.

Get honest.

Be vulnerable.

Have the conversation.

Go to the meeting.

See the therapist.

Whatever it is, take the first step.

Because you are not alone.

And asking for help isn't a sign that you can't handle the job.