The term ‘first responder’ refers to the men and women of the emergency services – police, ambulance, fire and rescue and State Emergency Services employees and volunteers – who support public health and safety by responding to, and preventing, emergency situations. When a first responder takes their own life there is a profound impact for family, friends and colleagues. Feelings of shock and distress may be mixed up with anger and blame, or guilt. For team mates and colleagues there may be a feeling of surprise that they had failed to recognise the distress of their colleague. ¹

In the course of their work, first responders routinely witness or experience traumatic events resulting in the death of others and significant human suffering. These will include situations where their own life or that of one of their team mates is in real danger. They may experience abuse or assaults ² and the public nature of their work means they may undergo stressful investigations or inquiries about events or decisions they have made. For most first responders, the challenging nature of their role is experienced as stressful and demanding, but also as meaningful and rewarding. With strong workplace and social supports, they are able to face the emotional and physical demands of their role and maintain a sense of wellbeing and resilience throughout their careers. However, for too many first responders, there can be significant mental health consequences of ongoing exposure to trauma, particularly if there are other stressors present in work or other areas of life. Among these first responders, the cumulative effect of repeated exposure to distressing events can cause increasingly severe reactions including depression, anxiety and physical complaints. ^{2, 3} Under-resourced workplaces in which first responders are required to work long shifts or overtime, without an opportunity to recover between traumatic events may make their trauma worse. ² Although there are differences between agencies and between paid employees and volunteers, research has found that many first responders face serious and ongoing mental health issues. In a study of over 21,000 first responders, ² one in three experienced high or very high levels of psychological distress, while one in ten experienced the severe and persistent reactions of post-traumatic stress disorder (PTSD), although they may not have recognised this themselves. Rates of psychological distress increased with years of service, and one in four ex-employees experienced persistent symptoms of PTSD, often co-existing with other disorders including anxiety, sleep disturbance and alcohol or other substance abuse. These symptoms will impact on the family as well. ² These mental health challenges mean that many first responders are at increased risk of suicide and self- harm. Employees and volunteers within the police and emergency services have been found to report suicidal thoughts at some time in their lives at twice the rate of the general population, and are more than three times more likely to have a suicide plan. ²

For first responders who value their strength and resilience, and for whom mental illness carries a self- perceived stigma, acknowledging they are struggling can be a big step. For many too it would appear that they do not actually recognise what they are experiencing as a mental health issue that can be treated. ² Workplace culture can play an important role in reducing the impact of trauma and mental distress, and lessening suicide risk. Early intervention for PTSD is important. First responders report higher levels of resilience and are more likely to seek support when they experience a supportive workplace culture. ^{1, 2} Workplace strategies that have been found to be helpful include: ²

• supportive line managers who have undergone Mental Health First Aid or similar training ⁴
• open discussion of workplace experiences and attention to ‘mental health literacy’
• providing time to recover from stressful events
• psychological review and support if required
• support to return to the workplace and to meaningful work.

Support for those who are applying for worker’s compensation or for first responders who have retired from service should also be part of the workplace culture. ²

Social support from first responders working together is important, as well as the support of family and the community. It is important for communities to understand the challenges faced by first responders and to acknowledge the vital role they play in the safety of the community. Despite the growing awareness of, and attention to, the mental health of first responders, a recent Senate report noted the discrepancy between policy in place and the lived experience of some first responders. ² There are still factors that may make it difficult for an individual to seek help, such as a culture of self- reliance, a perception of stigma, fears of being removed from operational service, and simply being unaware that there is the problem and ask for help. ² Beyond Blue is currently (2020) working on a national strategy to translate recommendations for the support of first responders into guidelines for all workplaces.

1. Paterson, Andrew, 2018 “They call It ‘the job’ because it isn’t a job. That’s the joke.” Resilience among police in South Australia”. [Thesis]. Flinders University, College of Business, Government and Law https://theses.flinders.edu.au/view/7dcbe77e-2ecd-4f43-aa95-b0f5953f1578/1
2. Beyond Blue Ltd. (2018). Answering the call national survey, National Mental Health and Wellbeing. Study of Police and Emergency Services – Final report. [accessed 2/9/2019] https://www.beyondblue.org.au/about-us/about-our-work/workplace-mental-health/pes-program/national-mental-health-and-wellbeing-study-of-police-and-emergency-services
3. The Senate Education and Employment References Committee. 2019. The people behind 000: mental health of our first responders. Report. Canberra: Commonwealth of Australia. [accessed 2/9/2019]. https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Education_and_Employment/Mentalhealth/Report
4. Mental Health First Aid Australia. 2019. Why Mental Health First Aid? Website. [accessed 24/4/2020]. https://mhfa.com.au/why-mhfa

Page last updated: 24 August, 2020