Description and Importance of the Topic
First responders (FRs) are usually susceptible to potentially traumatic events (PTEs). They are also susceptible to occupational stressors. According to Garner et al. (2018), FRs is a broadly inclusive group of “medical and military personnel, firefighters, police officers, paramedics, rescue disaster volunteers, and others.” FRs are particularly susceptible to “acute stress disorder (ASD), PTSD (posttraumatic stress disorder, and depression” (Garner et al., 2018). Experiences from PTEs and occupational stressors can cause deleterious effects on the mental health and wellbeing of FRs. Bearing in mind the nature of their jobs, it comes as no surprise that most FRs believe mental health and wellness is important. However, FRs are rarely inclined to pursue mental health treatment due to the stigma associated with mental health counselling or due to a barrage of real or perceived barriers to care (Pittaro, 2019). Many FRs delay treatment, fail to stick to treatment plans, or receive inadequate care from inexperienced health care professionals who lack specialized training. More likely, the FR may not fully understand the treatment options available to them in pursuing treatment.
This topic is important because it focusses on one of the main issues faced by FRs, a broadly inclusive group of people that provide essential services in the community. Specifically, the topic focusses on the mental health of FRs and treatment options available to them. FRs are usually the first on the scene. FRs typically respond promptly to situations that are very challenging, dangerous, and draining. In addition, FRs are the first to reach out to disaster survivors and provide support to them, both emotional support and physical support. Although the services that FRs provide are essential, their duties are strenuous and often put them at an increased risk of PTSD, ASD, and depression. This paper delves into discussing the mental health challenges encountered by FRs and treatment options available to them.
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The reason this Topic was Chosen
Although FRs are frequently regaled as “heroes” during and after responding to disasters, they usually lack mental health support. Every year, the United States experiences many record-breaking disasters. During and after these events, FRs are heavily relied on by the affected communities to help them recover. But who can FRs rely on to ensure that they can recover too? FRs respond to strenuous situations, most of which put them at risk for secondary or vicarious traumatization. Yet as a profession, FRs are rarely inclined to pursue treatment (Pittaro, 2019). According to Pittaro (2019), many FRs delay treatment or fail to fully to treatment plans. This topic was chosen to not only address the mental health challenges faced by FRs but also highlight some of the treatment options available to them. This will help FRs understand what treatment options they can rely on to ensure that they can recover too.
Learning of Goals of the Researcher
The learning goals include:
To identify the mental health problems faced by FRs, and
To identify the treatment options available to treat the mental health problems faced by FRs.
Background Literature
Garner et al. (2016) carried out a study to determine the traumas experienced by FRs. According to the authors, FRs, who also happen to be the survivors of natural and human-caused disasters, are not given much consideration as a survivor. The author acknowledges that, just like traditional survivors, FRs also deeply affected by trauma. According to Garner et al. (2016), FRs suffer particularly from ASD, PTSD, and depression during and after responding to critical incidents, like natural disasters, fires, and accidents. Garner and his colleague employ a case study methodology in their study. From their case study, the authors found that there is a link between FRs and mental health issues.
In another study, Lanza et al. (2018) conducted a study to critique systematic resources for FR, and a needs assessment for FR resilience that was carried out by one of the authors. According to the authors, FRs are susceptible to traumatic events, which can cause deleterious effects on their mental health and wellbeing. Using “evidence-based practice” knowledge about FRs, Lanza and his colleagues present the challenges FR usually face when responding to disasters, and recommend interventions. Some of the challenges highlighted by the authors include ASD, PTSD, and depression. The interventions recommended by the authors include prevention education, postvention, and treatment.
In another study, Johnson et al. (2019) carried out a systematic review to determine the prevalence of mental health problems among FRs and to explore treatment engagement strategies in FRs. According to the authors, FRs (i.e., firefighters) are often exposed to PTEs and occupational stressors. This makes them susceptible to a variety of psychological disorders and suicidality. In order to address the mental health concerns of these FRs, the authors state that it is vital first to understand fire culture and treatment barriers, which depend on a number of factors, including subpopulation and geographical factors. From their systematic study, the authors found that FRs are rarely inclined to seek treatment due to stigma, structural barriers, and anticipating negative outcomes from treatment. Failure to seek treatments makes these FRs susceptible to developing mental problems with time. The authors outline some treatment engagement strategies. According to the authors, some of the strategies that can be used to addressed treatment barriers include “peer support, informal support, telehealth approaches (e.g., digital storytelling), work-recovery strategies, mindfulness, and critical incident stress management.”
In another study, Flannery (2015) carried out a study to present a multi-modal treatment paradigm based on the available data on FRs. According to the author, 5.9 to 22 percent of FRs develop psychological trauma and PTSD. These experiences can cause physical, mental, and/or behavioral issues. Since disasters happen daily, FRs remain at risk. According to the author, current treatments have included single and double interventions, which are effective but not in all cases. Due to the ineffectiveness of single/double treatment interventions, Flannery proposes a paradigmatic shift to multi-modal treatment intervention.
In another study, Kehl et al. (2014) carried out a study to investigate how stressful in-service incidents impact FRs. The authors focused their study on firefighters. To investigate this relationship, the author used a sample of 927 firefighters. The participants had taken part in another study called BeSeCu (Behavior, Security, and Culture) study. According to the study, these participants had all gone through disturbing work-related events in the past. The study was conducted between 2008 and 2011 in 8 predominantly European nations. The authors used three tools to establish the relationship they were investigating. The first tool is the BeSeCu-FR assessment tool. The second tool is the “Impact of Event Scale-Revised” (IES-R), while the third one was “Posttraumatic Growth Inventory –Short Form” (PTGI –SF). The participants completed the BeSeCu-FR, IES-R, and PTGI-SF. From the findings of the study, the participants reported experiencing distressing work-related incidents. In addition, the participants reported postvalent distress and PTSD. However, the authors found that there was no relationship between the time since the firefighter experienced the incident and the PTGI-SF total score.
Methodologies Found
The scholarly sources reviewed in this paper used different methodologies to collect their data. Garner et al. (2016) used a case study methodology to collect data. The case study involved a real career firefighter. The authors also systematically reviewed prior research studies. With regard to the study conducted by Lanza et al. (2018), the authors systematically reviewed prior studies related to the topic covered in this paper. The search was limited to literature done between 2002 and 2017. All of the sources reviewed are peer-reviewed journals or scholarly articles.
With regard to the study carried out by Johnson et al. (2019), the authors systematically reviewed prior literature. The search was limited to studies done between 1998 and 2018. All of the sources reviewed are either peer-reviewed journals or scholarly sources. With regard to the study carried out by Flannery (2014), systematically reviewed prior literature related to treating psychological trauma in FRs. The author used information available in prior literature to develop a multi-modal paradigm. All of the literature used by the author are peer-reviewed journal articles or scholarly sources. Lastly, Kehl et al. (2014) used qualitative and quantitative research design in their study. The authors used a sample of 927 participants and employed three tools, namely, BeSeCu-FR, IES-R, and PTGI-SF, to collect data. The data obtained were then analyzed by performing multivariate regression analysis.
Results Found
FRs are routinely exposed to a wide array of PTEs and occupational stressors. These PTEs and occupational stressors expose FRs to many disorders, such as PTSD, ASD, and depression (Garner et al., 2018; Lanza et al., 2018). Different studies have proposed different strategies to address the mental health problems that FRs face. Some of these strategies include “peer support, informal support, telehealth approaches (e.g., digital storytelling), work-recovery strategies, mindfulness, and critical incident stress management” (Johnson et al., 2019); a paradigmatic shift to a multi-modal approach ( Flannery, 2015). This is because, according to the author, single/double treatment interventions are not effective. By implementing these strategies, one can efficiently and effectively address the mental health issues that FRs face during and after disaster events.
References
Flannery, R. B. (2015). Treating psychological trauma in first responders: A multi-modal paradigm. Psychiatric quarterly , 86 (2), 261-267.
Garner, N., Baker, J., & Hagelgans, D. (2016). The private traumas of first responders. The Journal of Individual Psychology , 72 (3), 168-185.
Johnson, C. C., Vega, L., Kohalmi, A. L., Roth, J. C., Howell, B. R., & Van Hasselt, V. B. (2019). Enhancing mental health treatment for the firefighter population: Understanding fire culture, treatment barriers, practice implications, and research directions. Professional Psychology: Research and Practice .
Kehl, D., Knuth, D., Holubová, M., Hulse, L., & Schmidt, S. (2014). Relationships between firefighters’ postevent distress and growth at different times after distressing incidents. Traumatology , 20 (4), 253.
Lanza, A., Roysircar, G., & Rodgers, S. (2018). First responder mental healthcare: Evidence-based prevention, postvention, and treatment. Professional Psychology: Research and Practice , 49 (3), 193-204. http://dx.doi.org/10.1037/pro0000192 .
Pittaro, M. (2019). Mental health care for first responders. [Online]. Retrieved April 12, 2020, from https://www.psychologytoday.com/us/blog/the-crime-and-justice-doctor/201907/mental-health-care-first-responders
