Mental health is increasingly recognized as a critical concern for EMS and fire service professionals. The demands of the job—exposure to violence, injury, destruction, and death—create challenges that can lead to burnout, depression, and even suicidal ideation. The COVID-19 pandemic only intensified these pressures, underscoring the need for meaningful support and solutions.
Attitudes are slowly changing, reducing the stigma of mental health services among emergency services personnel. With more options for support and a greater understanding of the importance of mental well-being, the tide is turning. In addition, some best practices for supporting mental health and wellness among EMS and fire service personnel are emerging.
The State of Firefighter and EMS Mental Health
First responders are on the front lines of people’s worst moments—saving lives, homes, and families. It’s a job few others truly understand, and the toll it takes can’t be overstated.
On top of the everyday challenges, the increasing frequency of devastating events like major wildfires and school shootings has compounded the stress. The COVID-19 pandemic only added to this burden, with many departments reporting more emotional exhaustion and thoughts of suicide.
First responders also sacrifice their physical health and safety: EMS professionals report 22 times more lost workdays due to violence-related injuries compared to the national average.
These experiences don’t just stay at the scene—they follow you home, affecting your sleep, mood, and overall well-being. The statistics reflect the challenging reality:
- Depression and PTSD are up to five times more common among public safety personnel
- 85% of first responders report experiencing symptoms related to mental health issues
- 37% of first responders meet the clinical diagnosis for PTSD
Leaders in the field recognize there is a major need for more first responder mental health programs. At a recent U.S. Fire Administrator’s Summit on Fire Prevention and Control, behavioral health was one of the critical issues discussed.
However, the culture of self-sufficiency ingrained in EMS and fire professions, combined with the stigma around mental health, often makes it difficult to seek help. Faced with immense stress, some may turn to coping mechanisms like alcohol or other short-term fixes. Addressing this stigma and creating safe, judgment-free spaces for support is critical to ensuring healthier outcomes for those who dedicate their lives to serving others.
Improving First Responder Mental Health
Nonprofits are designing programs that emphasize things like peer support and confidentiality, addressing the specific mental health needs of EMS and fire services personnel. Many of these involve hanging out with others in a peaceful setting.
Recognizing that time in nature can support mental wellness, a Navy veteran and former police officer founded Camp Hero, a retreat in Kentucky where first responders can hike, fish, hunt, ride ATVs, or observe wildlife.
Clayton Garcia, Assistant Fire Chief and Fire Marshal of the Clive Fire Department in Iowa, focused on hunting for his nonprofit, Operation Impact 22, as a way to get around first responders’ reluctance to “raise their hand” for help. He notes that having members of this profession get together develops a sense of comfort and community where “things start getting talked about that don’t get talked about” around the campfire.
Garcia also created a Proactive Annual Checkup (PAC) program in which firefighters are required to spend an hour a year with a mental health professional. However, there’s no pressure to talk about personal issues or anything at all. “You’re required to go, you’re not required to talk,” he says. “You can talk about baseball.” This low-risk requirement can build trust among firefighters who may be suspicious of mental health initiatives because they are afraid of losing their jobs or the respect of their coworkers.
The Idaho Falls Fire Department (IFFD) also recognized the importance of integrating the first responder community into its mental health initiatives. Leaders there developed a peer-support program called the Traumatic Response Unified Support Team (TRUST) to foster a welcoming environment. The department also partnered with a local mental health counseling center to provide up to three visits at no cost, with a special focus on privacy and confidentiality.
Other groups provide workshops and facilities specifically for emergency services and fire services personnel, indicating a growing understanding of the importance of mental health among this population.
Promoting Resilience to Prevent EMS and Firefighter Burnout
Emergency management and firefighting are inherently challenging, with exposure to high-pressure, dangerous, and traumatic situations.
While these realities won’t change, building resilience—adapting to adversity and significant stressors—can help first responders better cope and reduce the risk of long-term effects like depression and burnout. Developing strategies for resilience provides tools to manage ongoing challenges, empowering individuals to “bounce back” more effectively.
Building resilience can feel easier said than done, especially in a profession where long shifts and constant emergencies are the norm. However, small practices can make a difference over time:
- Practice breathing exercises or mindfulness techniques to stay calm during high-pressure situations.
- Maintain regular exercise and a balanced diet to support physical and mental well-being.
- Build a support network by connecting with colleagues who understand the challenges of the job.
- Make time for activities that bring you joy, like hobbies or spending quality time with family.
Leaders in emergency and fire service agencies play a critical role in promoting resilience and supporting their teams’ mental health. Encouraging employees to take time off and truly “unplug” is essential—but leaders must also model these behaviors themselves to build a culture that prioritizes well-being.
Relying on short-term fixes, such as pizza parties or small perks, doesn’t address the deeper issues of stress and burnout, explains James Boomhower, a paramedic with 20 years of experience who advocates for mental health awareness in EMS.
“The pizza is just the mechanism for covering up junkie leadership or systemic problems that we can fix,” Boomhower says. “It not only worsens the mental health and wellness of the teams, but really puts a poor spin on the idea of helping to foster and grow our agencies.”
The Future of First Responder Mental Health
Addressing the mental health challenges faced by EMS and fire service professionals requires continued focus and commitment. While progress has been made, ongoing efforts to advocate for resources, implement effective programs, and foster a culture of openness are essential to ensuring long-term change.
By prioritizing mental well-being, agencies can empower their teams to navigate the demands of their work while building stronger, more resilient communities. Supporting first responders’ mental health isn’t just a benefit to individuals—it’s an investment in the people they serve every day.
