Should Mental Health Counseling Be Required For All EMT/Paramedics?

Any first responder will tell you that they've seen things. This isn't a job that's for most people. One of the reasons why is the sheer mental fortitude it takes to compartmentalize the horrors, emotions, highs, and lows of repeated calls. Many who experienced life changing events do so only once but for the first responders these calls are weekly, daily, and sometimes even hourly. In times of major crisis, most departments will offer counseling or even require it. But, what about those day to day times which simply build up?

The average service employee is not a sharer. By having to talk about a call again, they're having to relive it in full gory detail or emotional explosion. Therefore, many will bottle their feelings up, adding call after call.

Most professionals deal with the distress their own way. A study by Northwest Public Health determined that approximately 20% of EMS personnel have Post Traumatic Stress Disorder from repeated exposure to trauma.Whether it's a healthy coping method or developing an internal barrier that separates them, you either learn to cope or you get out. There is no inbetween.

Reality Check: As a Medical Professional You've Seen A Good Deal of Trauma
Process Your Traumatic Experiences in Online Therapy


Unhealthy Coping Methods

When dealing with trauma, the body goes through physical and emotional reactions. Things that might seem unrelated like diarrhea or a cold may be related to the experience. In worse cases, sleeplessness, hypervigilance, disorientation, and need for control often come out. The body deals with trauma - because naturally trauma is an abnormal event and this should only be temporary "side effects".

However, when repeatedly being exposed, it's easy to become numb, to stop empathizing, and to simply block things out as coping methods. For many, this works and over time, events are forgotten and replaced. The issue is that this is a vicious cycle which doesn't actually fix the fact that the responder isn't "dealing" with the emotions of the trauma which may eventually lead to deterioration in their own health.


Everyone can recognize the scenario - after the call, everyone sits around the table in silence. No one wants to talk about what has just happened other than the occasional nod to how bad the event was Just remembering or reliving but keeping everything inside.

Healthy Coping Methods

The healthiest method is to use whatever support system the department has in place. Talking about the trauma, even repeated trauma, with an empathetic listener means that it will no longer be internalized and would help to break the cycle. Often, the worst calls stay with you for the rest of your life. Imagine each call as a rock you must carry. Over time the rocks will become smaller as the event is forgotten or gotten over. But, some rocks will always stay the same while others are added with new experiences. Those rocks are heavy and eventually you will not want to carry them anymore. This is one of the reasons why first responder suicide rates are also so high.

Reality Check: As a Medical Professional You've Seen A Good Deal of Trauma
Process Your Traumatic Experiences in Online Therapy


Who to turn to?


Most large departments offer free services like grief counseling and spiritual counseling. Although often times, they're only available in a particularly traumatic event rather than a constant. While no single situation works for everyone, having professional counseling on a regular basis is often the best way to help yourself deal with the repeated stress of trauma. BetterHelp offers an easy search service to find local, trained specialists who can deal with the emotional well-being needed to perform properly in EMS. It's often said that you can't help others if you can't help yourself. This should also be applied to mental needs as well if you want to be a successful lifesaver.

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