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Writer's pictureDr. Robert Smith

Stress Reading for Responders

Updated: Aug 11


IFD Lieutenant (Ret). Psychotherapist-Private Practice Clinical Director, Indianapolis Fire Dept., Local 416, Hamilton County, Boone County and Hendricks County Peer Support Teams


As firefighters, we are trained to read smoke and other fire conditions. As EMT’s and

paramedics we are trained to read or recognize symptoms that might endanger our patients. In

contrast, firefighters and other responders often have serious limitations in determining high

stress levels, anxiety and mood problems in themselves. Several variables contribute to

problems in recognizing behavioral wellness issues which include negative stigma (toward

mental health assistance), a limited behavioral heath system, fear of weakness and the way we

are programmed (trained) as responders. We worry more about taking care of others, than

ourselves.


Why is this an important issue to address? We have an increasing level of suicide due to

chronic stress and exposure to potentially traumatic incidents. Firefighters and EMS are much

more likely to die from suicide than line of duty deaths. Responders are exposed to many

situations or job stress….things we cannot “unsee”. The years of exposure are a big reason why

responders are at least twice as likely to experience Post Traumatic Stress or diagnosed PTSD

than the general population. Stressors in our occupations can lead to problems which include

depression, anxiety, alcohol/ addictions, PTSD, suicide, relationship and financial problems to

name a few.


Entering the behavioral health system can be difficult for Firefighters and EMS as noted above.

It is crucial for departments to implement an effective behavioral health and wellness program

for our responders. Two words are key, implement and effective. The fire service has

embraced the Peer Support movement with good results. This message has been successfully

promoted by organizations such as the International Association of Firefighters (IAFF) and the

International Association of Fire Chiefs (IAFC). Many Peer Support teams have been

developed as a result. Sometimes these teams respond to potentially traumatic events (PTE’s)

or critical incidents well. But they may be lacking in the educational or outreach portions of the

peer support model.


Examples of education would be sending a steady stream of behavioral health education

materials to the company firefighters and EMS crews. This education can be initiated by simply

visiting crews to discuss behavioral wellness issues in an informal setting (e.g., stress,

addictions, suicide, PTSD, depression/anxiety). This type of educational outreach needs to

happen on a regular basis. Examples of outreach can consist of peer support team members

visiting each crew or fire station with literature about behavioral wellness topics and staying

around to talk with crew members and company officers. In addition, company officers or

supervisors can lead these discussions with their crews. Hopefully, we as a fire service culture

can put these practices in place without much difficulty.


Firefighters, EMS and all responders are trained to look after each other. For example, scene

safety is such a concept. As a young firefighter/medic I was trained to look out for my brothers

and sisters because “we don’t need more victims”. Watching out for each other is what we are trained to do. You might ask, “How do we do this, we are not trained therapist? How should

we watch out for each other?"


Pay attention to each other, watch stress levels of others in your crew. Is someone on your

crew acting different? Are they or their habits different? Has their attitude changed? We live

together in these jobs and know each other better than typical coworkers. Often, a coworker will

share these things with another person. Is someone working too hard or has the crew had

some bad calls lately? Has someone disclosed financial or family problems? Is someone

drinking too much or using “too much prescription medication? Has someone’s mood moved

away from baseline (more down than usual)? These are all questions that might suggest that

we should keep a closer eye on each other. Specifically, supporting each other more and

encouraging self care is important. Self care such as engaging in hobbies and leisure activities

are a portion of resilience. Resilience activity is the “medicine” for this and all types of stress.

Resilience is simply self care and unplugging from our daily routine for as much time as

possible. The bigger the dose, the likelihood of therapeutic result. You should ask each other,

“What makes you happy?” or “What brings you joy?" Simply put, this is resilience.

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