When COVID-19 struck, many of us were grateful for the valuable service of first responders. As conversations shifted to highlight the work they do to keep us safe, we began paying more attention to the toll their jobs may have on their mental health.

First responders include police officers, firefighters, paramedics, emergency medical technicians (EMTs) and others who provide assistance when there is an emergency. Given the nature of their jobs, they are usually the first on the scene of traumatic events. First responders are exposed to high levels of stress, danger and trauma on a daily basis. These elements combined can have negative effects on their mental health.

According to a study by the Ruderman Family Foundation, first responders are more likely to die by suicide than in the line of duty. This alarming statistic highlights the need for increased mental health awareness and support for first responders.

In this article, Valley Hospital of Phoenix, Arizona, explores the issue of mental health among first responders. This includes discussions of the most common mental health issues among first responders, the stigma they face and coping mechanisms for managing the stress and trauma of the job. By the end of this article, we hope to raise awareness about first responders’ mental health issues and provide a pathway for improved health and well-being.

Stigma Surrounding First Responders’ Mental Health

Two paramedics and a doctor standing at rear of an ambulance.

Despite the high rates of behavioral health issues among first responders, there is still a mental health stigma in the profession. In the aftermath of nationwide traumatic events, news outlets often highlight first responders for their heroism and dedication to public safety. Given this, many first responders may feel pressure to appear strong and resilient, which can prevent them from seeking help for their mental health.

Additionally, first responders may not report common mental health symptoms such as increased stress or suicidal thoughts due to the fear of being considered ‘unfit’ for their position. As a result, although we know that first responders suffer from suicide and mental health at a higher rate than regular civilians, the data we have is likely not telling the full story. For example, the Firefighter Behavioral Health Alliance (FBHA) estimates that only 40% of firefighter suicides are actually reported.

Additionally, first responders may fear being stigmatized or seen as weak by their colleagues and superiors. This can lead to a culture of silence and avoidance of seeking help, which can have serious consequences for the mental health of first responders.

Mental Health Issues Among First Responders

According to one study by the Substance Abuse and Mental Health Services Administration (SAMHSA), 30% of first responders develop a behavioral health condition as opposed to 20% of the general population. Common behavioral health conditions include PTSD, depression and substance abuse.


PTSD, or post-traumatic stress disorder, is a common mental health issue among first responders. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), one in three first responders suffer from PTSD, as opposed to one in five in the general population.

Symptoms of PTSD among first responders may include intrusive thoughts or memories of traumatic events, flashbacks, nightmares, hypervigilance and emotional numbness. The constant exposure to traumatic incidents can lead to the development of PTSD, which significantly affects the quality of life and overall mental health of first responders.


Depression is another significant mental health issue among first responders. Symptoms of depression among first responders may include persistent sadness, loss of interest in activities, feelings of hopelessness, changes in appetite or sleep patterns, and thoughts of self-harm or suicide. In instances where death is involved, they may also experience survivor’s guilt. The constant exposure to traumatic events, long hours and the pressure to perform can contribute to the development of depression in first responders.

Substance abuse

Finally, substance abuse is another prevalent issue among first responders. The constant exposure to traumatic events may lead some to turn to substances such as alcohol or drugs to soothe their emotional pain and escape reality. Symptoms of substance abuse among first responders include experiencing cravings and urges to use, neglecting responsibilities, difficulty maintaining relationships, reliance on substances to deal with mental health and more.

Substance abuse can have many negative impacts on the overall health and well-being of first responders. It can negatively affect their physical health, cognitive abilities, job performance and relationships. Although many first responders turn to substances as a way of alleviating their mental health issues, substances can exacerbate those issues. Substances may provide temporary relief, but in the long run, they do more damage than good. Substances cannot help solve mental health issues, but developing healthy coping mechanisms with the help of outpatient services can.

How Outpatient Services Can Help First Responders

Outpatient services can be a helpful resource to first responders struggling with their mental health for many reasons.

Seeking professional help

The first step in managing mental health issues is seeking professional help. Many first responders may be hesitant to do so due to the stigma surrounding mental health, but prioritizing one’s well-being should always come first.

Outpatient services such as therapy and counseling can provide a safe space for first responders to process their experiences and develop healthy coping mechanisms. It can also help them address any underlying issues that may be contributing to their mental health struggles and provide a pathway toward a brighter future.

Outpatient services provide many benefits first responders may take advantage of. For example, outpatient services usually provide flexible treatment schedules. This can help first responders receive the care they need despite their complicated schedules. For more structured levels of care, first responders can also participate in dedicated outpatient programs. Valley Hospital, for example, provides the Freedom Care Program for military members and first responders.

Building a support system

Support systems are important for maintaining and improving overall mental health. This is especially true for first responders. Support systems can include colleagues, friends, family and mental health professionals who can offer a listening ear and safe space for first responders to share their experiences and emotions without fear of judgment. It enables first responders to receive validation and understanding, and build connections with others with similar experiences.

Outpatient services can help first responders recognize the cause of their mental health issues and develop appropriate coping mechanisms, including improved communication skills. Furthermore, outpatient services also provide opportunities for group therapy sessions, support groups, and peer support programs specifically designed for first responders. This type of environment enables them to share challenges, coping mechanisms and support with one another.

Practicing self care

Self care is an important practice for first responders to manage stress and improve mental health. Self care does not just improve mental health, however, it is also physical and emotional. Self-care techniques may include getting enough sleep, eating a healthy diet and engaging in activities that bring joy and relaxation. It can also include setting appropriate boundaries between their personal and work life and learning how to nurture personal relationships.

First responders can learn these self-care techniques (and other strategies) by participating in outpatient programs. Mental health professionals can educate first responders on the importance of self care and develop personalized strategies to address their specific needs.

Outpatient programs also provide an ongoing path for implementing and practicing self-care routines. This includes identifying potential barriers or unhealthy coping mechanisms (such as substance abuse) that may prevent first responders from effective self-care practices.
Overall, outpatient services equip first responders with the tools and resources they need to prioritize their mental health through self care.

Help Is Here at Valley Hospital

First responders put themselves on the frontlines for our safety and well-being. Yet, they often suffer mental health conditions such as PTSD, depression and substance abuse in silence. By raising awareness about the mental health stigmas and challenges first responders face, we hope to begin carving a path toward renewed well-being and health. Although seeking help can seem like a difficult step, prioritizing mental health should never be something to be ashamed of.

Valley Hospital of Phoenix, Arizona, is here to provide the behavioral health services you need. Our dedicated team provides compassionate mental health services. Learn more about our inpatient program and outpatient program today.

If you or someone you know is a veteran struggling with mental health issues, know that help is available. Reach out to Valley Hospital at 602-957-4000 or complete this form to get started on your mental health recovery journey today.

If you are in crisis and need assistance immediately, call 911 or 988 for the Suicide Prevention Hotline.