Supporting First Responders Through Trauma and Stress

Being witness to, or experiencing traumatic events is not rare – studies show that half of us will experience at least one significant trauma in our lives. Traumatic stress is a normal reaction to events such as automobile accidents, natural disasters, and personal assaults. These events can cause intense and frightening emotions.

The emotions can be stressful not only for the survivor but also for those witnessing or providing aid. First responder occupations, such as police, firefighters, and paramedics face daily exposure to life-threatening situations. This constant barrage of contact with abuse, violence, and danger takes a tremendous toll and can impact their lives and health over time and may continue long after an event. Thankfully, the effects of trauma, especially for first responders, is becoming more well known, and this awareness has led to a greater understanding of the support needed for those affected.

Understanding PTSD

Post-traumatic stress disorder (PTSD) is a mental health condition related to anxiety disorders that are triggered by experiencing a traumatic event – either experiencing it first-hand or witnessing it. Following a traumatic event, the impact on individuals is expected to decrease over time with a return to normal daily function. For some however, the experience may result in on-going symptoms that interfere with day-to-day life. This may be evidence of PTSD.

Not everyone who experiences a traumatic episode will develop PTSD. In Canada, approximately eight percent of persons who experience a traumatic event will develop PTSD.

PTSD and First Responders

Recent studies report that a substantial proportion (20-45%) of first responders have one or more mental health disorders, proportions that are higher than findings within the general public (about 8%). About 23% of first responders screen positive for PTSD.

Work-related health disorders experienced by first responders have increasingly been relabelled by community members as Operational Stress Injury or OSI. The term was originally created for Canadian military experiencing mental health disorders directly tied to their service. In 2016, the Canadian Government recognized OSIs as an issue faced by all first responder organizations, not just the military. PTSD is among the most commonly diagnosed disorder in this category.

There is a growing recognition that workplaces can be a direct cause of post-traumatic stress disorder. In response to the direct impact workplaces may have, Alberta, British Columbia, Manitoba, New Brunswick, Saskatchewan, and Ontario, have passed legislation that acknowledges the increased risks first responders face for PTSD resulting from workplace traumas. The legislation allows first responders to access workers compensation benefits if their trauma and/or illness is proven to have been caused by their workplace.

Symptoms of PTSD

Most people who experience traumatic events may have temporary difficulty adjusting and coping, but with time and self-care, their symptoms may improve. If symptoms worsen, last for months or even years, and interferes with day-to-day functioning, PTSD may be the cause. For first responders, the results of these symptoms may affect their work with serious consequences. Presenteeism, the word given to the scenario where workers are physically on the job but not fully functioning, is a major concern in the first responder community due to the nature of the work.

Post-traumatic stress disorder symptoms may start within one month of a traumatic event, but sometimes symptoms may not appear until years after the event. PTSD symptoms are generally grouped into four types; Intrusive Memories, Avoidance and Numbing, Negative Thoughts and Mood changes, and changes in Physical and Emotional Reactions.

Symptoms can vary over time and from person to person and may include:

Intrusive Memories:

• Intrusive, upsetting memories of the event

• Flashbacks (acting or feeling like the event is happening again)

• Nightmares (either of the event or of other frightening things)

• Intense physical reactions to reminders of the event (e.g., pounding heart, rapid breathing, nausea, muscle tension)

Avoidance and Numbing:

• Avoiding activities, places, thoughts, or feelings that remind you of the trauma

• Inability to remember important aspects of the trauma

• Loss of interest in activities and life in general

• Feeling detached from others and emotionally numb

Negative Thoughts and Mood Changes:

• Guilt, shame, or self-blame

• Feeling alienated and alone

• Feelings of mistrust and betrayal

• Difficulty concentrating or remembering things

• Depression and hopelessness

Physical and Emotional Reactions:

• Sleep disorders

• Irritability, angry outbursts, self-destructive or reckless behaviours

• Feeling jumpy and easily startled

• Physical aches and pains

• Aggressive

• Hyper-vigilance

Support for First Responders - Lifting the Stigma

While camaraderie is deeply engrained in first responder culture, so too is the culture of hiding emotions. Historically, the culture didn’t allow individuals to be different, to show emotion, or to cry. However, people need to be able to talk about their painful experiences on a free and open basis.

Fortunately, thanks in part to legislation and attention in the media, public awareness and workplace acceptance continue to grow for those suffering from PTSD. For example, the Invictus Games Foundation provides sport recovery opportunities to support physical and mental health improvement of wounded service personnel and veterans and inspire change, while also providing a window into the struggles that first responders face. The Invictus Games illustrate the resilience of the community. Much more work needs to be done to promote education and open discussion with an eye towards prevention and intervention.

The following are ways in which leaders can help support first responders:

Prevention

Build Resilience: Understanding and accepting that aspects of our daily routines and workplace experiences are beyond our control is important in building resiliency within the workplace. Recognizing where we have the ability to influence or control our experiences, such as resiliency training can help to minimize future incidences of PTSD or trauma.

When off duty, do things that are enjoyable: It’s important to remain active in your community. Volunteering time to help others gives an important sense of accomplishment and purpose. Engaging in a hobby, being physically active, or spending time with friends and family helps to build resiliency and fosters positive mental health.

Intervention

Leadership training: It’s critical that managers and leaders are educated to accept that Operational Stress Injuries occur and to watch for signs in their staff, as well as themselves. Having a better understanding of the concerns and challenges that individuals face in the workplace increases the ability to be proactive in developing support systems and policies that support and encourage those facing PTSD to seek help.

Develop a PTSD intervention plan and promote it: Employees need to be aware of options available to them, including treatment options if the illness persists.

Provide education around prevention and treatment options: Create internal programs to provide on-going education and support to keep employees informed and up-to-date about PTSD symptoms, prevention techniques, and the options available for treatment.

Treatment and Recovery

Provide extended support upon return to work: To promote on-going healing, there needs to be a culture of openness, honesty, and understanding surrounding those who have received treatment.

Provide support for the family: When an individual is experiencing PTSD or trauma, it not only affects the individual, but their family members as well. Providing family members with community and resources can help them understand what PTSD or trauma is, how to support their family’s mental health during the recovery period, and what they can do to provide the support needed to overcome the disorder.

References

1. Statistics Canada. (2024). “Survey on Mental Health and Stressful Events, 2023.”

2. Public Safety Canada. (2023). “Evaluation of the Initiatives to Address Post-Traumatic Stress Injuries (PTSI) Evaluation Report.” Accessed 24 December 2024.

3. Mayo Clinic. (16 August 2024). “Post-traumatic stress disorder (PTSD).” Accessed 4 March 2025.

4. Smith, M., Robinson, L., & Segal, J. (17 October 2024). “Post-Traumatic Stress Disorder (PTSD).” Accessed 4 March 2025.