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Topic: Mental Health: Survivors and Firefighters May Experience PTSD, Anxiety, or Depression

Research Question: How well is the mental health impact of trauma on firefighters and survivors understood, supported, and addressed in society?

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Survey on Public Awareness of PTSD in Firefighters

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Survey on Public Awareness of PTSD in Firefighters

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Type:

Survey (15 respondents)

- Summary:

80% had heard of PTSD

60% said firefighters face high mental health risks

90% believe more support is needed

What it adds: Real-world evidence about what the public knows and believes.

Plan for paper: Use to show awareness is growing, but gaps remain.

Questions prompted: Why is PTSD still underdiscussed despite general awareness?

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Interview with Navy Veteran Who Worked with Navy Firefighters

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Interview with Navy Veteran Who Worked with Navy Firefighters

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Type: Interview
- Summary:
My dad served in the Navy and worked closely with Navy firefighters. He witnessed the emotional toll of shipboard fires and saw firsthand how mental health challenges, like burnout and PTSD, often went untreated due to stigma and a lack of support.
What it adds: Personal, real-life experience that humanizes the research. It shows that this issue spans both military and civilian settings.
Plan for paper: Use for narrative introduction or emotional support section.
Questions prompted: What resources were available then vs. now?

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“First Responders and Mental Health: How We Can Support Our Firefighters, Police Officers, and Emergency Medical Personnel” – Relief Mental Health

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“First Responders and Mental Health: How We Can Support Our Firefighters, Police Officers, and Emergency Medical Personnel” – Relief Mental Health

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Type: Informative article from a professional mental health provider

What it adds: This article provides up-to-date statistics on depression, PTSD, and suicide among first responders. It highlights that 85% of first responders show symptoms of mental health conditions and that they are five times more likely than the general public to experience depression or PTSD. It also discusses barriers to care, like fear of being fired, and introduces new treatments such as TMS, SPRAVATO®, and ketamine infusions.

Plan for paper: Use to show the severity of the mental health crisis in first responders and how stigma and fear stop them from getting help. Also used to discuss emerging treatment options.

Questions prompted: Why do so many departments still not provide mental health care as part of standard training? Are innovative treatments like these accessible to all departments?

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“PTSD (Post-Traumatic Stress Disorder)” – Cleveland Clinic

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“PTSD (Post-Traumatic Stress Disorder)” – Cleveland Clinic

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Type: Informative article from a reputable nonprofit academic medical center

What it adds: Provides a comprehensive overview of PTSD, including causes, symptoms, risk factors, brain changes, and evidence-based treatments such as cognitive behavioral therapy, EMDR, and medication options. It also covers statistics (5–10% of trauma survivors develop PTSD) and specific challenges like misdiagnosis in children.

Plan for paper: Use to explain the science behind PTSD and why it develops, including brain chemistry and trauma responses. Also valuable for defining different therapy types and providing accurate clinical descriptions of symptoms.

Questions prompted: How many first responders suffer from untreated or misdiagnosed PTSD? Could more training in trauma recognition help leaders and peers spot the signs earlier?

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Post-traumatic stress disorder (PTSD) is a mental health condition that some people develop after they experience or witness a traumatic event.

What are the symptoms of PTSD?

To receive a PTSD diagnosis, symptoms must last for more than a month and must cause significant distress or issues in your daily functioning. The symptoms of PTSD fall into four categories:
Intrusion:

Intrusive thoughts, such as repeated, involuntary memories.

Nightmares.

Flashbacks of the traumatic event, which can be very vivid and feel real.

Avoidance:

Avoiding reminders of the traumatic event, like people, places, activities, things and situations.

Avoiding remembering or thinking about the traumatic event.

Avoiding talking about what happened or how you feel about it.

Changes in thinking and mood:

Ongoing fear, horror, anger, guilt or shame.

Memory loss of important aspects of the traumatic event.

Ongoing negative and distorted thoughts and feelings about yourself or others.

Distorted thoughts about the cause or effects of the event that lead to wrongly blaming yourself or others.

Feeling detached from others.

No longer enjoying activities you once did.

Being unable to experience positive emotions.

Changes in arousal and reactivity:

Irritability and angry outbursts.

Reckless or self-destructive behavior.

Being overly watchful of your surroundings (hypervigilance).

Being easily startled.

Problems concentrating or sleeping.

Symptoms of PTSD in children

Children with PTSD may have difficulty expressing how they're feeling or they may have experienced trauma that you don't know about. They may seem restless, fidgety, or have trouble paying attention and staying organized.

These symptoms can be confused with symptoms of attention-deficit/hyperactivity disorder (ADHD). Because of this, it's important to take your child to a specialist (like a child psychologist) who has experience in diagnosing PTSD.

Complications of PTSD

The following conditions are common in people with PTSD, which can make PTSD symptoms worse:

People with PTSD also have an increased risk of suicidal thoughts and attempts.
If you or a loved one is thinking about suicide, call or text 988 to reach the Suicide and Crisis Lifeline. Someone is available to help you 24/7.
What causes PTSD?

Approximately 61% to 80% of people experience a traumatic event at some point in their lives. PTSD develops in about 5% to 10% of this population.

It's unclear why people respond differently to trauma. But studies show that people with PTSD have abnormal levels of certain neurotransmitters and hormones. They also experience brain changes.

Neurotransmitter and hormone changes

Studies show that people with PTSD have normal to low levels of cortisol (the "stress hormone") and elevated levels of corticotropin-releasing factor (CRF) despite ongoing stress. CRF triggers the release of norepinephrine, which leads to an increased sympathetic nervous system response. This "fight or flight" response leads to increased:

In addition, some studies show altered functioning of other neurotransmitter systems, including:

Brain changes

PTSD is associated with changes in the functioning and anatomy of your brain:

The size of your hippocampus (a part of your brain that regulates motivation, emotion, learning and memory) decreases.

The amygdala (the part of your brain that processes emotions and fear responses) is overly reactive in people with PTSD.

The medial prefrontal cortex, which partly controls the emotional reactivity of your amygdala, appears to be smaller and less responsive in people with PTSD.

What are the risk factors for PTSD?

There's no way to predict who will develop PTSD after a traumatic event. But PTSD is more common in people who have experienced:

Certain types of trauma, particularly military combat or sexual assault.

Trauma during childhood.

Injury during the event.

Horror, helplessness or extreme fear at the time of the event.

Lack of social support after a traumatic event.

Long-lasting or repeated trauma.

Mental health conditions and/or substance use.

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PTSD (Post-Traumatic Stress Disorder): Symptoms & Treatment

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PTSD (post-traumatic stress disorder) is a mental health condition that some people develop after they experience or witness a traumatic event. It's treatable.

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Type: Informative article from a leading industry publication

What it adds: This article provides an in-depth exploration of mental health challenges, including moral injury and PTSD, faced by first responders, particularly firefighters and EMS personnel. It emphasizes the increasing frequency of firefighter suicides, which have outpaced line-of-duty deaths. It introduces the concept of moral injury—emotional scars that go beyond PTSD—and how it often plays a bigger role in suicides than PTSD. The article also discusses the stigma surrounding mental health in the fire service and how newer initiatives, such as peer support teams and behavioral health policies, are helping to address these issues.

Plan for paper: This article highlights the emotional and mental health risks first responders face, especially regarding moral injury. It will help compare how moral injury and PTSD manifest in this profession and the cultural barriers that prevent adequate support.

Questions prompted: What can fire departments do to address moral injury in addition to PTSD proactively? How can we reduce the stigma around seeking mental health support within first responder communities?

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Jesse RomanSenior Editor/Producer, NFPA Journal and NFPA Podcast

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A conversation about firefighter mental health

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The founder of the Firefighter Behavioral Health Alliance discusses moral injury and mental health in the fire service

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“Biometric Telehealth: An Innovative Solution for First Responders with PTSD” – Institutes of Health

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“Biometric Telehealth: An Innovative Solution for First Responders with PTSD” – Institutes of Health

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Type: Informative article from a healthcare provider specializing in PTSD treatment for first responders

What it adds: This article discusses the prevalence and impact of PTSD among first responders, including paramedics, firefighters, police officers, and EMTs. It provides statistics on PTSD rates within these groups and highlights common symptoms like nightmares, chronic pain, and irritability. The article emphasizes the biopsychosocial model of treatment and introduces biometric telehealth as a solution for overcoming barriers to traditional PTSD care, such as cost, stigma, and time off work.

Plan for paper: Use this article to explore innovative treatment methods for PTSD in first responders, specifically biometric telehealth, and its effectiveness in providing remote, evidence-based care. It will also help contextualize first responders' challenges in accessing care, such as job-related stigma and logistical barriers.

Questions prompted: How can biometric telehealth improve access to PTSD treatment for first responders who face barriers to traditional care? What other interventions might help reduce stigma around seeking mental health support in first responder communities?

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First responders are at the frontlines of any incident or disaster. They work tirelessly to ensure the safety of the general population. Due to the nature of the work, first responders frequently suffer workers' compensation injuries. Unfortunately, first responders don't always receive proper treatment for incapacitating conditions like PTSD, fibromyalgia, CRPS, and RSD, among others. Even when treatment is available, first responders often fail to return to work after standard PTSD treatment because it simply isn't effective.

Biometric Telehealth is an advanced technology that can help first responders with PTSD get the treatment they desperately need. This telehealth platform is much more than a simple video consultation. It is a comprehensive remote treatment platform that makes the patient-physician interaction an immersive experience. It replicates the PTSD functional restoration program offered in clinic at the Institutes of Health.

For first responders with PTSD, some of the reasons that make Biometric Telehealth care the treatment of choice are:

* It's easier to access evidence-based comprehensive treatment.
* It's cost-effective and doesn't require travel to doctor's office or clinic
* It allows the patient to receive timely treatment and continuity of care.
* It's confidential and private. No one at work needs to know you're getting help.

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Post-traumatic stress disorder (PTSD) in First Responders

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First responders are at the frontlines of any incident or disaster. They work tirelessly to ensure the safety of the general population. Due to the nature of the work, first responders frequently suffer workers' compensation injuries. Unfortunately, first responders don't always receive proper treatment for incapacitating conditions like PTSD, fibromyalgia, CRPS, and RSD, among others.

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🧠 “Addressing the Mental Health Needs of First Responders” – Rosecrance Health Network

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🧠 “Addressing the Mental Health Needs of First Responders” – Rosecrance Health Network

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Type: Informative article from a nonprofit behavioral health organization with specialized first responder programs

What it adds:

This article explores the complex mental health challenges faced by first responders, including PTSD, anxiety, depression, and suicidal thoughts. It outlines contributing factors like repeated trauma exposure, isolation, lack of recovery time, and high job demands. It also describes warning signs of declining mental health and emphasizes the importance of coping strategies, peer support, and professional treatment. The article introduces the Resilience Program, a comprehensive care model offering therapies such as DBT, exposure therapy, and TMS tailored to first responders.

Plan for paper:

Use this source to highlight the specific risk factors and symptoms first responders face due to occupational trauma. It will also help show how targeted treatment programs like the Rosecrance Resilience Program are tailored to address emergency professionals' unique needs and cultural factors.

Questions prompted:

How can workplaces better support first responders before they reach a crisis point? What role can peer support play in reducing the stigma of seeking help?

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Addressing the mental health needs of first responders | Rosecrance

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First responders are often the first to aid someone who needs help, but where do they turn when they need support? Their responsibilities are strenuous and can significantly impact their mental, physical, and emotional well-being. Despite the challenges, they are prepared to make significant sacrifices in the service of others.