First responders – including police, firefighters, 911 operators, coroners, and emergency medical technicians (EMTs) – are often regarded as society’s heroes. When an accident, a crime, or a tragedy occurs, these individuals come running, helping to save lives and assisting in the aftermath of some of the worst pain any of us will ever experience.
Their jobs are vitally necessary and unquestionably sacred. However, in the performance of their duties, these brave men and women often experience trauma unlike anything the vast majority of society will ever face. Tragically, such involvement in traumas often results in these brave individuals turning to alcohol or drugs in order to cope with what they have experienced. Indeed, first responders have higher rates of mental illness and addiction than the rest of society. As a result, they have unique problems that demand unique solutions.
Mental Illness, PTSD, and First Responders
Sadly, the connection between mental illness, PTSD, and first responders has been well-documented. A report from SAMSHA, the Substance Abuse and Mental Health Services Administration, revealed some highly distressing data. For example, the report noted that 30% of first responders develop some sort of mental health condition; this is a number that is 1.5 times higher than that of the rest of the population. Additional studies in the report note that rates of mental illness are more likely to increase in the aftermath of a massive, traumatic event, such an earthquake or a terrorist attack. This was particularly the case in the aftermath of the 9/11 terrorist attacks, which resulted in huge spikes of PTSD for individuals impacted by the events.
These issues can have major ramifications, including suicide. According to a 2017 study, more firefighters and police officers died that year as a result of suicide than in the line of duty. The same study also noted that these individuals were more than five times as likely as the rest of the population to suffer from PTSD.
The results of studies like this have led to many public policy ramifications as states work to further enhance their resources for first responders and to ensure that they have access to the mental health help they need. For example, states like Wisconsin and Pennsylvania are working to designate PTSD as an illness that can be covered by workers’ compensation, ensuring that first responders can take the time they need in order to recover from a traumatic event. Pennsylvania is also working to create more training and a peer-to-peer hotline specifically for first responders.
What is the cause of this stress and trauma for first responders? Unfortunately, it’s their jobs. During the course of their day, many first responders are exposed to countless situations that can, over time, erode their mental states and cause them tremendous pain and stress. These issues cannot be solved by simply “powering through” or “toughening up.” Indeed, that sense of machismo can often lead to real psychological issues being repressed instead of being dealt with by a professional.
It is also worth noting that the trauma caused by their jobs is often not the only thing that contributes to high mental illness rates among first responders. Indeed, these issues are exacerbated by a variety of other concerns, including injury, chaotic hours, and poor sleep hygiene.
As noted by the CDC, first responders of all types, including professionals and volunteers, have more elevated risks of injury and death than the rest of the general population. Police and firefighters are in the top 15 most dangerous professions when it comes to riskiest jobs.
Because their jobs are so physical by nature, first responders are also extremely likely to get injured on the job. Tragically, this can affect mental illness in two ways. First, there is no question that physical pain, and particularly pain caused by significant injury, can degrade someone’s mental state and make him or her more likely to suffer from a variety of mental illnesses, including depression and anxiety. Second, many first responders turn to painkillers as a way of managing the pain caused by their on-the-job injuries. Unfortunately, as has been well documented over the years, people can become dependent on prescription painkillers, leading to addiction.
Furthermore, there is no 9-5 work shift when it comes to being a first responder. The job necessitates working at all hours, 365 days of the year. There is ample evidence that shows that shift work can lead to worse physical and emotional health, particularly if that work is also coupled with serious stress. This work can also disrupt sleep, and there is no question about the connection between sleep and health.
All of these factors, when combined, can place a heavy burden when it comes to mental illness.
First Responders and PTSD
A wide array of studies have revealed that huge swaths of first responders have endured some sort of PTSD. These impacts can be even higher in certain areas. For example, in rural America, first responders are more likely to report mental health challenges like PTSD and are less likely to report having access to the care they need. Indeed, another study notes that up to 75% of first responders who experienced mental health attributed those problems directly to a trauma they suffered while on the job.
PTSD, in turn, can have a variety of devastating impacts on a person’s mental health, ultimately destroying relationships and the ability to hold a job. PTSD also leads to higher rates of addiction. Studies have found some horrifying information about the connection between PTSD and substance use disorders. For example:
• 20% of veterans with PTSD also have some sort of substance use disorder.
• One out of every three veterans who seeks treatment for addiction also has PTSD.
• Veterans who are returning from war are more likely than the rest of the population to suffer from both PTSD and substance use disorders.
Drug and Alcohol Abuse Among First Responders
A brief look at the available information reveals that first responders have major problems when it comes to addiction to drugs and alcohol.
These problems are well documented among all sorts of first responders. For example, a 2010 study found that 11% of male and 16% of female police officers drink alcohol to levels that are “at-risk” for alcoholism. The work and lifestyle culture among police officers plays a role in this heavy alcohol consumption with one in four police officers saying he or she drinks as part of an effort to fit in with the rest of the squad.
Both career and volunteer firefighters report higher than average levels of alcohol use and abuse than when compared to the rest of the population. Among male firefighters, 50% report binge drinking within a month in one survey, and another 9% report that they have driven while under the influence of alcohol. Among female firefighters, rates of drinking and binge drinking are higher than the rest of the population. In another survey, an astonishingly high 29% of firefighters may be abusing alcohol, and 10% may be abusing prescription drugs.
There are many reasons why first responders tend to have problems with substances. As we noted above, trauma and PTSD are often heavily correlated, and we know that first responders experience a lot of trauma on their jobs. First responders tend to experience PTSD in one of three different ways. Those are re-experiencing, hyperarousal, and avoidance.
Unfortunately, many victims of addiction note that the use of substances can help to numb the pain associated with this PTSD. Firefighters also report that alcohol use is their second-most preferred “coping strategy” when it comes to dealing with the stress of their jobs. Unfortunately, drinking alcohol is a poor coping strategy and one that will just fuel depression and addiction in the long run.
All of these factors, combined with a culture that seems to reward and to encourage alcohol consumption, creates a potentially potent and deadly cocktail that feeds addictions.
Veterans and First Responders
The connection between serving as a veteran, PTSD, and addiction is well documented with large swaths of veterans suffering from some sort of PTSD after their service times. The rates vary, depending on their time of service, but more veterans have died by suicide caused by their time in service than have died as a result of combat in recent years. According to studies, veterans are 50% more likely to die by suicide than the rest of the population.
Furthermore, as noted above, veterans are also more likely to suffer from addiction issues. All of this may necessitate special treatment options.
The Role of Stigma
Stigma remains a powerful barrier when it comes to seeking help for addiction or mental health. The first responder culture tends to be one that prioritizes “being a man” and pushing through pain, even though this isn’t possible and is often detrimental to one’s health. A SAMSHA report also notes the role that stigma plays in keeping people away from getting the help they need.
Unfortunately, first responders have a history of having trouble accessing mental health care, with one survey finding that 92% of all first responders reported barriers to accessing this care. Studies like these, particularly when combined with the barrier that stigma still places on seeking help, show the importance of specialized programs to help first responders in particular.
One such program is offered by The Granite House. The Granite House is an addiction recovery facility located in Derry, New Hampshire. It is a residential location that offers a wide array of services. Residents who enroll in The Granite House are guaranteed individualized treatment plans that will reflect their personalities and specific mental health needs. Our client-to-client program will help residents transition into the facility by pairing them up with a resident who is further along in the program than they are. We have found that this mentorship can be exceptionally helpful in assisting new patients to get used to the treatment process.
At The Granite House, we know that not every treatment plan will work for everyone. That’s why we offer a wide range of clinical modalities designed to best meet your needs. We base our treatment plans on the 12-step curriculum, and we use a variety of evidence-based treatments in order to assist you in achieving a full and long-lasting recovery.
We have treated individuals of various professions at The Granite House, including first responders, and we have ample experience to know their specific issues and struggles. Contact us today for more information about how we can help you recover from substance use and help you to lead a better life.