October 2018

Addressing Behavioral Health Needs of First Responders

By Doug Nemecek, MD
Chief Medical Officer, Cigna Behavioral Health

First responders – notably firefighters, police, emergency medical teams and 911 dispatchers – are dedicated and heroic public servants in our communities. In the course of their service, they face frequent and direct experiences with violence, death, destruction, trauma and societal struggles that can have emotional consequences.

And because many first responders reside in the communities they serve, there is a higher potential that they will personally know those impacted by the situation that they’re responding to.

All of these factors have contributed to the alarming rate of unaddressed behavioral health and substance-use issues among first responders. Samantha Dutton, PhD, MSW, of the University of Phoenix, spoke about the April 2017 survey* conducted by the university, which surveyed first responders on their experiences with behavioral health issues. “Some of the more pertinent findings were that 85% of the first responders had experienced symptoms related to behavioral health issues,” says Dutton. One-third of them were formally diagnosed with either depression or post-traumatic stress disorder (PTSD). Half of them had received pre-exposure training and another half had received follow-up care after the traumatic event.* 10% have been diagnosed with PTSD. 75% of those diagnosed with PTSD have sought treatment.*

Associated stigma

Further to this study, while three-quarters of the survey respondents said they have behavioral health services readily available to them, nearly 70% also said those services are seldom or never used at their organization.* That could be due to the pervasive stigma associated with mental illness and behavioral health treatment. In fact, 39% say there are negative repercussions for seeking behavioral health help at work.*

It is important that communities and the health care delivery system focus on responding to these trends. If not addressed, the behavioral health challenges within first-responder populations will put health and lives at risk.

Community leaders must be prepared to come to the rescue of first responders and their loved ones. How can this be done? Offering solutions like an employee assistance program (EAP), access to a quality and affordable local network of health care providers, education and awareness resources, and public and private collaboration. All will help reduce the stigma of seeking treatment, and also help first responders to better manage their behavioral health and address substance use issues.

Some companies, like Cigna, in the insurance industry have been a leading voice in addressing the many concerns unique to first responders. These issues, including burnout, compassion fatigue, vicarious trauma and critical stress, may lead to an increased rate of PTSD and other ongoing behavioral health and substance use issues.

Available services

Treatment solutions for those with PTSD and other behavioral health issues include behavioral health programs and EAP services. Many times, these services are also open to the general public; for example, during natural disasters or incidences of traumatic violence in our communities. By giving first responders and the public access to online resources available for physical, behavioral and emotional self-care during turbulent times, greater strides in combating PTSD can be made. There are programs available through employer benefit programs which are designed to assist with PTSD. Cigna has recently added the International Association of Fire Fighters (IAFF) Center of Excellence for Behavioral Health Treatment and Recovery to its network. This one-of-a-kind facility located outside Washington, DC focuses on treating firefighters experiencing post-traumatic stress and other behavioral health issues. The center provides better and more affordable access to specialized care for current and retired IAFF union members.

Together, the allied health care industries and the behavioral health community will continue to explore the extremely complex and specific behavioral health needs of this population.

* Reference in University of Phoenix releases first responder mental health survey results article, Majority of First Responders Face Mental Health Challenges in the Workplace, April 18, 2017.

This information is not intended for residents of New Mexico.