Abstract
By the nature of their occupation, first responders witness numerous traumatic events. Most of the time, their training and desire to help others allows them to respond professionally and appropriately. However, there are certain events that, for whatever reason, affect first responders in a more dramatic way, leading to emotional and behavioral changes that affect their interpersonal relationships and occupational functioning. Even if they recognize the need, first responders often are hesitant to reveal their distress and/or seek professional help to superiors, believing that they will be perceived as unfit for duty. In this chapter, the need for administrators to understand and accept the severe impact of traumatic events is discussed. Consistent with the individualized nature of traumatic responses, a tiered strategy of intervention is proposed. Finally, drawing from an occupational health perspective, a model that conceptualizes and responds to exposure to traumatic events as an occupational hazard is discussed.
TopIntroduction
As you read this chapter, thousands of first responders are handling calls, hoping to positively impact the lives of perfect strangers who have called for help. Some of those calls will be life changing for the responder due to the intense nature of the event.
The occupation of a first responder is first and foremost to protect the community. This is a multifaceted occupation, with physical requirements and cognitive demands, and often needing to work in challenging environmental conditions. Throughout this book, there has been significant attention to the challenges that first responders face as they go about their jobs:
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A job that most people cannot do.
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A job that requires individuals to tolerate what is intolerable to others.
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A job that provides a front row seat for some of life’s ugliest moments (i.e., overexposure to violence, death, extreme physical injury and life or death decision making).
Although, for the most part, first responders cope with their jobs well, there should never be any underestimation of the emotional toll that this constant exposure to traumatic events can take on someone. The effects of this cumulative stress can create a breaking point. Then, there are those events from which no one should just be able to walk away: The mass shootings that result in dozens of lives lost, the child who drowns in the family swimming pool, the horrific car accident where one of the victims is a first responder’s family member or friend. As one first responder shared, “I’m retiring. I’ve seen one too many homicides, one too many suicides, one too many car wrecks.”
TopBackground
First responders are exposed to traumatic events and stressors on a regular basis (Substance Abuse and Mental Health Services Administration, 2018). Not every event produces traumatic stress, and it is often not possible to predict which event will be “the one.” Among 215 first responders requesting treatment at a University of Central Florida Posttraumatic Stress Disorder treatment clinic (UCF RESTORES), the traumatic events that precipitated the request for treatment are presented in Table 1.
Table 1. Types of traumatic event that precipitated a request for treatment
| Traumatic Event | Percentage |
| Pediatric call | 22% |
| Mass shooting | 16% |
| Multiple events | 13% |
| Death of family member or friend | 11% |
| Motor vehicle accident with death | 10% |
| Gory/graphic/dramatic death | 8% |
| Near death experience | 7% |
| Shooting | 6% |
| Suicide calls | 4% |
| Trauma not related to work | 4% |
| Trauma during military service | 3% |
| Sexual assault | 1% |
Key Terms in this Chapter
Behavioral Health: A field of study that examines how emotions and behavior affect psychological and physical well-being.
Standard of Care: A process, procedure, or course of treatment that clinicians follow and that is accepted as an appropriate approach by their professional community.
Cultural Competence: In healthcare, it is the ability to deliver care to someone with an understanding of their unique perspective, values, and needs.
Peer Support: The use of specially trained individuals to provide emotional and behavioral support to their colleagues.
First Responder: An individual uniquely trained and responsible for going to a place where there is a need for emergency assistance.
Trauma: An experience that creates deep emotional distress for an individual.
Occupational Health Assessment: An examination conducted by a professional to determine environmental adjustments that might be made to promote a healthy working environment.