For most people, the biggest problems they face at work are short deadlines, juggling projects and stressful client meetings. However, first responders have much bigger issues to deal with when they clock in for their shifts. Firefighters, police officers, and EMTs encounter danger, turmoil, and even tragedy throughout their careers.


Most first responders are aware of potential risks when they begin schooling, training, and certification, but many are not prepared for chronic trauma. Exposure to injury, destruction, and even death takes a toll: it would for anyone.


Contrary to what many may think, witnessing horrific events does not get easier the longer first responders are in their fields. The cumulation of trauma mounts over time, increasing the likelihood of mental health issues arising. Each event has the potential to weigh heavily on them, and it can be difficult to process the chaos, let alone make a complete recovery.


Dealing With Trauma and PTSD

Over time, the daily stress first responders experience can have debilitating physical and mental effects. Even one tragic event has the potential to lead to post-traumatic stress disorder, or PTSD.


Dealing with trauma and PTSD can be extremely challenging without support and treatment resources. Instincts and natural defense mechanisms may push traumatic memories to the back of a first responder’s mind, temporarily avoiding the painful process of working through trauma. First responders never know when they’ll face the next traumatic event; every day has the potential for tragedy, so what choice is there but to push through the pain and keep going?


Suppressing these memories does more harm than good. Untreated trauma and PTSD can lead to anger, depression, anxiety, flashbacks, insomnia, and many other serious issues. The struggle to manage PTSD symptoms eventually impacts the way first responders interact with family, friends, and coworkers. Depression and isolation can lead to suicidal ideations, which are more prevalent in these professions than the national average. A 2016 survey found that 37 percent of fire and EMS professionals have contemplated suicide, which is nearly 10 times the average rate of all American adults. 6.6 percent of EMT professionals said they have attempted suicide, compared to just 0.5 percent of all adults.  


Fortunately, first responders struggling with issues related to trauma and PTSD can find support from trained mental health professionals. Counseling and therapy are designed to help individuals process trauma and emotional distress, and develop coping skills for exposure to traumatic events in the future. Despite the benefits that treatment can provide, first-responder culture and the stigma associated with therapy keeps many first responders from seeking out help.


The Stigma and Challenges of Seeking Help

Seeking counseling to improve mental health is commonplace for many Americans—but not for first responders. Studies demonstrate the disproportionate rate of mental health injury in the first responder community, yet they are far less likely to receive treatment than the general public. Police, firefighters, EMTs, and emergency dispatchers are always the first to help others, but are too often the last to help themselves.  


While first responder culture is improving, mental health hasn’t always been a priority. Their professions require considerable training, but there is no way to prepare someone for the anguish and pain caused by routinely witnessing trauma. Still, first responders are tasked with bringing calm and order to chaotic situations. Police comfort loved ones at the scene of a car accident. Firefighters tell families that, despite all efforts, their home could not be saved from a fire. EMTs must be strong when informing parents that their son didn’t survive a drug overdose. This work environment helps create the strong men and women that we rely on, but it also forces them to privately carry considerable pain and grief. They keep it from their co-workers to project strength and hide it from their family to protect them from the grim realities that come with the job. They don’t see the value in exposing others to the tragedies they’ve faced. After all, why burden others?


So how common is exposure to trauma in these career fields? A 2017 national survey found 84 percent of first responders have seen a traumatic event while on the job, and 85 percent have experienced symptoms of mental health issues. No one could go through these traumas without consequence, and first responders are only human.


Signs and symptoms of PTSD in first responders:


  • Insomnia, nightmares, and night terrors
  • Anger, irritability, and a “short fuse”
  • Unwanted thoughts, daydreams, and images
  • Self-isolation or fear of social interaction
  • Substance abuse (alcohol, drugs, food, etc.)
  • Emotional numbness, lack of interest
  • Suicidal thoughts and/or attempts
  • Fear of becoming violent
  • Marriage, family, and relationship issues


The reality is that avoiding treatment for PTSD is extremely dangerous. First responders suffering from PTSD may not perform as well as they would like at work, or they might take out frustration and stress on their friends and families. They might be up all night with bad dreams, or they might struggle with intrusive thoughts of self-harm. They might resort to substance abuse in an attempt to quell unwelcome feelings and terrifying flashbacks.


The culture of emotional suppression that surrounds first responders is extremely toxic. If they are struggling with trauma, PTSD, or substance abuse, first responders must seek help for their own safety, as well as that of their friends and families.


Why First Responders Don’t Get the Help They Need

It can be difficult to understand why a person struggling with trauma-related issues doesn’t speak up about their struggles. They assume that by not thinking about it or keeping busy, the problems will go away. However, that’s not how trauma works. PTSD and cumulative trauma are not easily forgotten or filed away—especially for those whose job requires potential exposure to new trauma every day.



  • Most mental health professionals are inexperienced in dealing with first responders. EMTs, paramedics, firefighters, and police officers have seen things that most of us could never imagine. While mental health professionals may have experience helping patients deal with trauma surrounding neglect, sexual assault, mental illness, and other issues, first responder trauma issues are unique and should be treated as such. First responders need to process past trauma, but they also have to learn coping skills to prepare for future exposure to the tragic events. For some, staying in a first responder career field may no longer be a realistic or healthy option.



It is imperative that first responders find mental health resources specializing in first responder care. With experienced counselors, first responders can be honest without fear of judgment. Well-trained mental health professionals can help first responders process trauma and find ways to help them continue their careers.



  • Peers, coworkers, and supervisors will judge their mental health issues. In a survey of first responders, over 40 percent had access to mental health support but didn’t seek help because they were afraid of how they’d be judged at work. Many first responders are afraid that peers and coworkers might have a lower opinion of them or think that they can no longer cut it. They fear being ridiculed, ostracized, or even fired due to questions surrounding their fitness.


First responder culture requires an appearance of strength and discipline. Traumatic events are expected to be handled calmly and professionally. However, processing tragedy and dealing with grief cannot be governed by the same guidelines. Each individual reacts differently, which is why having resources for confidential support outside of a first responder’s agency is critical. Those with privacy concerns can access specialized care without hesitation.



  • Fear of family members’ opinions. In addition to hiding a perceived weakness from co-workers, first responders often hide trauma-related difficulties from their families. But being open with family will likely provide comfort for the first responder and their loved ones. Concerned relatives will be glad their loved one acknowledged that a problem exists and is taking proactive steps to solve the issues in a healthy way.



Family therapy can be a great option for first responders and their spouses, as it helps everyone understand the challenges first responders are facing in their jobs, and how they can impact life at home.


Mental Health and Addiction Counseling for First Responders

It’s time to end the silence surrounding first responder trauma, PTSD, and addiction. It’s never too late to take the first step. Mental health counseling is more accepted, available and specialized than ever. More unique resources are becoming available to first responders dealing with issues caused by chronic trauma and PTSD. With remote delivery of these services, those reluctant to seek help are no longer left alone to suffer in silence.


  • One-on-one online counseling for first responders: One of the best benefits of modern mental health care is anywhere, anytime access. With online counseling, first responders can use our HIPAA-compliant video platform to meet with a counselor whenever works best for them: before or after a shift, after a traumatic event, or during a particularly stressful period. Stepstone Connect offers confidential, safe, and evidence-based trauma therapy for first responders dealing with PTSD, chronic trauma, and other mental health issues.
  • Group therapy for first responders: Sometimes first responders can better process their own trauma by joining a group with shared experiences. With group therapy, first responders can talk to people in their own fields who experience the same difficult events at work.
  • Family therapy for first responders: First responder trauma and PTSD does more than affect the individual themselves. Entire families can be affected, and that’s why Stepstone Connect offers family therapy sessions for first responders. Family members can meet with families of other first responders to share their experiences and process difficult emotions.
  • Addiction counseling and recovery programs for first responders: Many first responders turn to substances to self-medicate trauma and PTSD. If a first responder does not seek help, self-medication can quickly turn into addiction. Stepstone Connect offers group and one-on-one counseling for first responders struggling with drug and alcohol addiction, no matter where they are. First responders may also take advantage of intensive outpatient programs to ensure they have the resources and support to recover from addiction.


Stepstone Connect’s first responder counseling programs are designed specifically for EMTs, firefighters, police officers, active military personnel, and other first responders. That means they are discrete, confidential, and flexible to clients’ needs. First responders don’t need to worry about coworkers finding out about their personal mental health recovery processes because all treatments are protected by doctor-patient confidentiality. Stepstone Connect counselors are specifically trained to help first responders, and first responders can thus expect no judgment during treatment.


What to Expect from First Responder Online Counseling

It’s never too soon to begin improving mental wellness. As with any mental or physical condition, delaying treatment can prolong the healing process. The sooner action is taken, the quicker recovery is possible.


With Stepstone Connect online counseling for first responders, patients will find the following:


  • Caring, discreet professionals
  • A safe environment to share openly, free of judgment
  • Confidential, reliable technology
  • Improved communication and coping techniques
  • Stronger personal relationships
  • Strategies for healthier self-care and processing skills
  • Improved patience and methods of reducing stress


Stepstone Connect’s licensed counselors teach first responders lessons they can carry for the rest of their careers and through their lives. Start on your path to healing with the strong, meaningful connections and anywhere access of StepStone Connect online counseling for first responders. Contact us today to schedule a session. In a world where barriers to treatment are constantly disappearing, don’t miss an opportunity to discover the path back to being you.

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