After the gruesome stabbing of 10 people at a child’s birthday party here in Boise, concerns have surfaced over mental health treatment for first responders. A recent article by KTVB highlighted this concern as Boise Fire Chief Dennis Doan discussed the inability for first responders to be covered by worker’s compensation to get treatment for the mental health stress and trauma received while working every day. The Idaho law requires that any and all injuries to be covered must be "proven" and stated a PTSD diagnosis cannot be proven. Combined with struggles to get other insurance carriers to cover mental health services, and low pay as public servants, first responders have little access to mental health treatment.
As discussed in the previous blog, "Idaho's Alarming Rise in Suicide", suicide in America has been on the rise and first responders are not immune to this epidemic. Policemen, firefighters, correction workers and others in protective services ranked 6th on the CDC’s list for Suicidality by occupational group. This can be attributed to accessibility to suicide methods, high competition in the career field, social isolation due to long hours or shift work and high-stress, traumatic situations. Pair this with Idaho’s rapidly rising suicide rates, population growth, increase in violent crimes across the state and significant increase in assaults on police officers, our first responders are in high need of mental health assistance.
Despite their high risk, this population-along with veterans, struggle to reach out for mental health help due to high stigma in the field. Stigma is defined as either “a mark of disgrace or infamy, a stain or reproach, as on one’s reputation” or “a mental or physical mark that is characteristic of a defect or disease” (dictionary.com). Mental health is often viewed to be the same thing as “crazy” which is a dirty label no one wants on their reputation. However, research has shown that the majority of humanity suffer from some sort of mental health issue in their lifetime, which in fact makes it relatively normal despite the fact we treat it as irregular and bad. In first responder culture, misunderstanding of mental health, specifically trauma response and anxiety is often believed to mean the person is unstable, unpredictable and possibly violent. Although this may be true sometimes, this typically only happens in severe cases that have gone without treatment. In these cases, severe mental health can be a liability which can have adverse effects on lives, both of the individual and in situations that they respond to. However, most first responders do not get violent or become unstable as they suffer from trauma. If they speak out and seek help, they may be labeled a liability or weak and their career might be altered. If they don’t, their symptoms may increase, causing decline in ability to function in all areas of their life and sometimes leading to suicide. In walking this line, most first responders decide keep their struggles a secret.
Compassion fatigue and trauma are big themes to first responders. Repeatedly, they arrive to find disaster, accidents, horrors that most others avoid throughout their lives. These things build up over time, snowballing until the body’s ability to cope becomes overwhelmed. Most of the time, our body functions in the parasympathetic nervous system (“rest and digest”), this is where all your organs and body functions run how they should. However when the body registers a threat, such as when someone jumps out and scares you or your hair rises on the back of your arm, the body switches into the sympathetic nervous system (“fight or flight”). In this system, hormones are released giving you bursts of energy, increasing your alertness, and many regular systems are turned down or turned off. For example, your body can decide it does not need to control your bladder to survive, which is why often people wet themselves when scared. Your digestion system is another organ that slows or is disrupted, memory may become foggy, sometimes even your ability to speak, as all these things are not necessary to keep you alive in a sudden threat. In the case of first responders, registering this threat over and over can have lasting effects on your body, making it harder to manage the mental health symptoms as well, but are necessary during high stress times on the job.
Idaho has fallen behind in mental health and our first responders are suffering. Other than education and creating and offering specific services to these men and women, how do you believe we might be able to aid our public service workers?