By Kathryn Millán, LPC/MHSP

First responders are usually the first to arrive to scenes of accidents or disaster. They are strong men and women who have chosen careers to help others in need, even on days when they don’t feel their strongest.  Firefighters, police officers, paramedics, EMTs, nurses, rescuers and crisis counselors are highly trained to cope with a variety of incidents, but often face unique and even dangerous situations on a daily basis.

Self-care is a necessity for first responders. Many people don’t understand the depth of what crisis workers see every day, so it is up to those workers and their supporters to build community and understanding. Even then, the first step of healing begins within each individual.

The United States Opioid Crisis as Seen by First Responders

Gas gauge on emptyMore than 90 people die of an opioid overdose each day in the United States, impacting people of every age, every background, and every location across the country.1 Many first responders have witnessed a number of tragic stories related to the opioid crisis.

While these men and women work to save lives, they cannot force addicted people to accept recovery or make changes toward healing. Many crisis workers see the same people over and over, or witness the effects of the opioid epidemic on the most vulnerable people: children and the elderly.2

These often physically-demanding jobs are incredibly rewarding but they also carry physical risks. First responders are often in a place to incur injuries that may require opioid painkiller prescriptions. Truly, no one is immune to the physical dependence that opioid drugs create.

Understanding Compassion Fatigue

Although first responders are highly trained to handle stressful incidents, repeated exposure to the effects of the opioid crisis may lead to compassion fatigue, a condition that is well-named. Compassion fatigue begins when a first responder works dedicatedly to help others, but eventually becomes worn out after seeing so many traumatic incidents and their effects.

Symptoms of this type of burnout include:

  • Physical or mental overwhelm or exhaustion
  • Changes in perceptions of safety, community and trust
  • Intrusive memories or thoughts about past traumas
  • Excessive worry about loved ones or personal safety
  • Unfounded doubts that you do your job well
  • Increases in anxiety or arousal, or feelings of numbness and disconnection3

The Importance of Self-Care

There are risks to a career in first response. The hours may be long, and the tasks can be demanding. Workers may find themselves sleeping and working odd hours. It may become a struggle to eat regular, nutritious meals. First responders often work in cramped quarters, or stay “on the road” for extended periods of time. Because many of these jobs are state-funded or grant-funded, it may be difficult to get modern supplies. Nights and weekends working on-call shifts may qualify as time off, but the need to be ready for a crisis at any moment can make it very difficult to relax.

There are ways to prioritize self-care. It may take practice, but self-care is not an option when you are a first responder — it is a necessity. Consider the following:

  • Prioritize sleep. Adults need an average of seven to nine hours of sleep per night.4
  • Eat healthy meals. Nutrition will help you stay stronger both mentally and physically.
  • Make time for exercise. Physical activity will help your brain process trauma and build body serotonin and other mood-boosting hormones.
  • Give yoga or meditation a try. These therapies are proven to treat symptoms of stress.
  • Create a break. Although somewhat symbolic, changing clothes or washing your hands after leaving work can help create a mental shift between work and home.
  • Connect with your coworkers. Camaraderie builds strength and positive regard of others; make it a priority to engage in a connected workplace.
  • Take time away. Take time to get away from the sights and sounds of your work environment. Even a small day trip or weekend getaway can be rejuvenating.
  • Consider therapy. Therapy and counseling are not just for your clients or community members. Everyone can benefit from the support of an experienced clinician.5

First responder work can be incredibly rewarding and satisfying. There is no greater feeling than being able to help others in need, but there is no denying that these jobs can also be stressful. If you feel burned out, have turned to unhealthy coping mechanisms or if symptoms of compassion fatigue have lasted two or more weeks, it may be time to seek support.6

You have a choice when it comes to your mental health care. Compassionate, evidence-based programs designed specifically for first responders are available. Valley Hospital has such a program called Freedom Care that has served military professionals for several years and is happy to announce specialty care for all first responders as well.


1 National Institute on Drug Abuse. Opioid Crisis. June 2017. Web. Accessed 20 Oct 2017.

2 DeMio, T. More victims of ODs: First responders suffer compassion fatigue. Cincinatti.com. 31 May 2017. Web. Accessed 20 Oct 2017.

3 National Child Traumatic Stress Network. What is Secondary Traumatic Stress? 2017. Web. Accessed 20 Oct 2017.

4 National Sleep Foundation. How Much Sleep Do We Really Need? 2017. Web. Accessed 20 Oct 2017.

5 Substance Abuse and Mental Health Services Administration. Tips for Disaster Responders: Understanding Compassion Fatigue. 2014. Web. Accessed 20 Oct 2017.

6 Adams, Richard E., Joseph A. Boscarino, and Charles R. Figley. Compassion Fatigue and Psychological Distress Among Social Workers: A Validation Study. The American Journal of Orthopsychiatry. 2016. 103–108. PMC. Web. Accessed 20 Oct 2017.