Who Helps Those That Help Us

by Steven Gerlang, EMT
Central Islip Hauppauge Volunteer Ambulance

Steven Gerlang
Steven Gerlang

Our emergency service workers; Police Officers, Firefighters, Paramedics and Emergency Medical Technicians: psychological well-being is often taken for granted and over looked. Studies have shown that there are roughly 18 to 20 members of our Emergency Services that take their own lives each day here in the United States (the exact amount is unknown as many of these deaths go down as “accidental overdoses” or “accidental weapon discharges”). More services should be offered to these individuals that we expect so much from. What can be done about it and why hasn’t the media stirred public outrage over these numbers? What causes these men and women to feel so isolated and alone that they decide to take their own lives?

The mental well-being of our nation’s first responders goes unnoticed and untreated: the media would rather keep us occupied with the circus of the current presidential debates; than the current growing suicide epidemic facing our nation’s bravest and finest. Why do we as a country look at mental illness as a taboo? We are one of the most advanced countries in the world when it comes to technology and medicine; yet we ignore or stigmatize those we entrust with public safety and security for seeking help after they have seen too much of humanities worst. This stigmatization in our country is one of the key reasons many of our first responders do not seek help for mental health issues they may experience from the traumas they experience; one of the fears they have is being ostracized by their co-workers or employers for asking for help. By being afraid to seek help, these brave men and woman are left feeling isolated, alone and helpless with their emotions.

There is currently very little research on first responder suicides in the United States; which is why I am choosing to go after this taboo topic head on. The key questions I want to answer through my research are: what can we do to encourage our government to provide more adequate mental health services for our first responders, how can we destroy the stigma of mental illness, why are we so afraid to make television public service announcements on PTSD in first responders? Canada does this and it has made a positive impact on responders seeking help.

Canada has finally recognized the growing mental health emergency plaguing their first responders for the last ten years and have begun several public service campaigns to put an end to it and show their first responders that they are not alone. Canada has started the social media campaign (#ivegotyoureback911), to show those first responders suffering in silence that they are not alone. You can also go to YouTube and look up their public service campaign by searching “TEMA PTSD,” this will bring you to their numerous television commercials that they have been airing.

As we see in {Bradley, Louise} Canada is leading the way in exposing and treating the current epidemic of first responder suicide by implementing more advanced training programs for all members of Canada’s emergency services. Canadian mental health authorities not only heard the silent cries of its emergency service community; but responded with massive amounts of public service announcements from everything to first responder suicidal ideation warning signs commercials to bill boards. It is mind blowing on how behind America is with identifying one of our emergency service workers having work related psychological issues; from the rest of the world. The main cause for American emergency service workers to not seek treatment or help; is the fear of being labeled, losing their jobs, and being stigmatized by their co-workers. The example Canada is giving us poses more questions as to why isn’t the United States government taking the same leap forward in public education; why is it that in our society one is looked at as weak if they need to cry out for help?

Whereas here in the United States our first responders need to worry about bureaucratic “red tape” once he/she actually makes the call for help and than finds they need to file for workers compensation because they can no longer do the job they once loved. As we see in {Lindahl, Mary W. } where a Fairfax Virginia Fire officer who was diagnosed twice with job related PTSD; had to sue the county he worked for to get benefits. Luckily this Firefighter was already in treatment and was strong enough to fight for his rights; whereas someone who was not mentally strong enough may not have been as strong and might have given up and went on to suffer in silence.

Our first responders should not have to sue to get benefits they have earned by their countless hours and years of self-sacrifice. We see this abandonment of our first responder’s from our own government time and time again; there has been a steady increase in first responder suicides as well as Cancer related deaths since the terrorist attacks on the World Trade Center on September 11th 2001. Our government needs to stop turning their backs on our first responders as they tried to do just this past year with the attempted defunding of the Zadroga Act. {Gordy, Kimberly.}

The Zadroga Act of 2011, federally funds the health monitoring of first responders to the Attack on the World Trade Center on September 11th, 2001. The act gets its name sake from NYPD Detective James Zadroga, who responded to the World Trade Center and was involved in the rescue and recovery efforts and later died in 2010 from a World Trade Center related cancer he contracted from the air he was exposed to while working at the pile: the air which the Environmental Protection Agency told the Rescue and Recovery workers was safe to breathe. This piece of legislation pays for the healthcare screening/monitoring and treatment of first responders suffering/dying from World Trade Center related illnesses.

In 2015 the congress of the United States attempted to defund the Zadroga act and once again turn their backs on our first responders. It was not heavily reported in the media and it was not until Jon Stewart got involved that the public became aware of what the government was trying to do. With the celebrity status of Jon Stewart we were able to have congress reverse their decision and re-fund the Zadroga Act. This very important act would have been defunded and not brought to the public light if it were not for the actions of Jon Stewart.

Time and time again our government turns their backs on our first responders; most of them are over worked and under paid, but they still go on day in and day out being there for us when we are at our worse. How can we as the tax paying public allow our government officials to get away with abusing our first responders? There should be public outrage over the governmental neglect they are given. The reason there is not such a public outcry over this issue is it is kept in silence; your first responders do what they do out of love and pride for the communities in which they work. People who get into public safety are not doing it for the money; for example, a five year Paramedic for the Fire Department of the City of New York base salary is only fifty thousand dollars a year. Basically, what I am saying is our first responders are not the type to ask the public for help. In EMS they have a motto of, “We save lives” in reality it should be, “we bare witness.” They are trained that we can save everyone, when in reality we cannot and that is why when you lose a young child they take it to heart and are emotionally affected by it.

It has only been within the last few years where some states have started to recognize this growing epidemic in our first responder population. (Rutkow, Lainie) PTSD or emotional trauma is not currently covered by workers compensation nationwide; that only a few select states have recognized this epidemic and made amendments to their states workers comp laws. “Employees, including first responders, who experience work related mental health harms, should receive the same workers compensation coverage as those who face work-related physical health conditions.” Post-Traumatic Stress Disorder can be triggered by the same stimulus as physical injury, yet again there are very little coverages for our nation’s first responders whom chose to suffer in silence rather than seek help.

Which is another reason first responders do not initially seek out help. They are so use to being the ones in control of the chaos around them and can miss their own warning signs of needing help. This topic is extremely personal to me as I have lost friends to this ongoing epidemic and someone needs to take a stand and say enough is enough and get the word out that there is help out there and there is no shame in seeking out professional psychological help when you cannot cope with the horrors of the job anymore. As we see with this article {WIKLANSKI, DAVID.} Firefighters/emergency responders attempt to cover up their emotional traumas for fear of ridicule by their comrades. The article also goes into detail about the resources that are becoming more and more available to first responders in crisis. He mentions how his department has an, “Employee Assistance Program” (EAP) that not only provides psychological services for the responder, but extends them to his/her family as well. The author goes into detail about how we always look out for each other and are comfortable with calling on each other for help when we need it, except when it comes down to psychological/emotional situations and that is based on a fear response of being labeled or looked at as weak by our peers. He sums it up by saying; “On the fireground, when you call a MayDay you know we will move mountains to come to rescue you. But if you have a mental health issue, you wont call for help.” This article illustrates the shift in mentality of first responders. We are beginning to recognize there is a problem and we need to do all we can to fix. The one key we are still waiting on is support from the government and our employers.

There is some light starting to show at the end of the tunnel, those in the emergency services are starting to realize there is no shame in asking for help or talking about a “bad call” with their peers. Most emergency service agencies have peer counseling teams called “Critical Incident Stress Management teams;” these teams are made up of fellow highly experienced emergency service workers that are trained to talk through or “debrief” first responders dealing with a tragic incident. {Volkmann, Peter} The CISM teams are activated by a member who is having trouble letting go with a traumatic incident or by a chief officer of a department to debrief the members of his/her department that were on scene of a highly stressful incident such as a fatal car wreck where multiple people or a child died. These teams usually consist of four to five fellow emergency service workers and a team leader who is a licensed mental health professional. The purpose of these teams are not to diagnosis or treat PTSD, depression, anxiety or alcohol abuse; their purpose is to attempt to prevent it or see the early warning signs and give those emergency responders a safe place to vent their frustrations, fears, anger, guilt and/or depression. The only downside to the availability of these teams is you can find a flier hanging somewhere on a bulletin board in most firehouses, but they are usually covered up by fliers of events, fundraisers, upcoming classes and things for sale. This all goes back to this “macho” type attitude firefighters/EMS personnel and police officers have throughout our country. First responders fear teasing or rebuttal not only from their employers but also their co-workers/ “Brothers in arms;” if they show emotions or weakness. Too many members go on holding in pains that they are scared to expose because they don’t want to be looked at as weak or unable to do their job. These stereotypes are the ones in which we are still trying to break away from, and they vary from agency to agency. There are some agencies that are very proactive in recognizing the potential for their members to be affected by the horrors they are exposed to; whereas there are also agencies who feel their membership joins knowing what they may witness or encounter while on the job and it is up to them to deal with it on their own.

What is even more troubling is the studies on law enforcement suicides; show and prove that the “blue line” would rather cover up the event as a “accidental death,” then admit to what an officers death was really caused by. (Violanti, John M.) This study showed that there was a correlation with the officers retirement from the “job” and his decision to take his own life; it is believed that the fear of being away from the “police subculture” is the primary cause to this epidemic. “The police represent a highly cohesive subculture whose members tend to “take care of their own.” The desire to shield victim officers, their families, and their departments from the stigma of suicide may lead investigators to overlook certain evidence intentionally during the classification process. One study of the Chicago Police Department estimated that “as many as 67 percent of police suicides in that city had been misclassified as accidental or natural deaths.” We as a society need to break away from the stigma of mental illness; especially with our emergency service workers and show them it is okay to feel the way they do and help them help themselves.

For whatever reason in our country it is looked down upon if a firefighter or police officer is struggling with a “ghost” from their last call; meanwhile in Canada they’re being proactive to the point that they have television commercials depicting first responders in crisis along with information on how to reach out for help. Canada has even gone as far as to depict emergency service workers struggling with varies levels of PTSD in their television show “Flash Point,” which depicts the Canadian version of a Special Weapons and Tactics team (S.W.A.T), in one episode they went as far as showing a retired member going to their station and holding himself hostage as he was having flash backs of a call he had where a home invasion turned into an entire family getting killed. The officer depicted wanted to take his own life and he was “talked down” by another officer who expressed his own issues with PTSD. (“Haunting the Barn”:Flashpoint) Yet here in the United States our emergency service workers are left to fend for themselves in silence. The mainstream media refuses to cover this epidemic, they rather fill our lives with meaningless things that happen hundreds of miles away from us that do not affect our lives, than cover stories about the brave men and women who are sworn to protect and serve us.

In 2011 there was a study down at a “large urban professional fire department” on the effects of firefighters and PTSD. (Farnsworth, Jacob K.) The study wanted to find a link between social interactions and fear of displaying emotions within firefighters. What the researchers found was, firefighters in this fire department coped better socializing with their peers after a critical incident then they did with anyone else. This study did admit that more research is needed to determine the effects on volunteer, suburban and other large urban professional firefighters. This study also found that firefighters are reluctant at discussing the critical incident for fear of losing emotional control of themselves in everyday socialization.

A Lieutenant with the Fire Department of the city of New York’s Emergency Medical Services, wrote an article in 2007 reflecting on the psychological impact of the terrorist attacks on the World Trade Center. (Kanarian, Steven) The EMS Lieutenant came to several conclusions on the psychological after effects September 11th 2001 had on the members under his command, after having a flashback to the scenes of the chaos after the collapse of the Towers while working at the scene of a school bus accident. He goes on to say how a first responder used to be looked down upon if he or she expressed psychological problems from “the job” it used to be looked at as a form of weakness. Since the attacks on September 11th that negative stereo-type has begun to shift; some their co-workers are more understanding to each other. He also went into detail on some of the triggers that one can undergo that will bring them back to the event as if it is happening in real time.

This fear of being labeled “weak” or “soft” is what hinders emergency service workers dealing with the mental trauma from the things they have witnessed on the job from seeking out help. This fear of being labeled and fear of being ostracized from their peers leaving them with a feeling of being alone and distant from their fellow first responders. Studies have shown that how social isolation is linked to suicidal ideation in people. (Zigmond, Jessica) Statistics have proven that there is a link between suicidal ideation and social isolation. This study in 2010 showed that there is a link between social isolation and people getting depressed and either attempting or following through with taking their own lives out of utter despair and loneliness. Human beings are “social creatures,” meaning we need to have that one to one interaction with others and do not like being felt isolated from others. This is kind of what first responders fear if they come forward and ask for help with mental health problems from their jobs. Which is why we as a country need to break away from the “taboo” way of thinking when it comes to mental health, especially among our first responders who out their lives on the line for us every single day.

My research into this growing epidemic has shown that while the United States leads the world in technological advances in everything from medicine to computers; we completely miss the mark when it comes to recognizing and helping out our first responders, leaving them to suffer alone in silence in the shadows. We as Americans have this “tough-guy John Wayne” attitude, that we pride ourselves on, yet we take it too far when dealing with the mental health our first responders whom we expect to go into harm’s way to protect us every single day. As this paper has shown; our neighbor to the north (Canada) has been trailblazing when it comes to identifying and helping their first responders to the point that they inform their general public on the psychological strain these brave men and women go through. It is really sad that we live in a society that would rather spend money airing commercials on practically every channel depicting people with very serious medical conditions that could be related to smoking as a scare tactic to get people to stop/never start smoking; rather than spending that same money to educate the public on the growing epidemic of first responder suicides and Post Traumatic Stress Disorder. We as a nation could make a big difference if we spent a quarter of that money on public service announcements aimed at letting our first responders know that they’re not alone in their struggle and that there is help readily available to them and they do not need to feel ashamed or embarrassed of seeking out help. Sadly the mainstream media outlets/the press do not see the value of fully supporting our first responders; instead they rather push other topics onto us because their attitude and the consensus of the general public is those that decided to put on the uniform, the duty belt and “walk the walk” know what they’re getting themselves into the moment after they raise their right hand and take the oath to support and defend the community in which they serve and the Constitution of the United States. This statement couldn’t be further from the truth; no one goes into the emergency services expecting to see half the things that they see or deal with some of the destructive situations they encounter on a daily basis. The men and women of our emergency services see the worse of humanity and ninety-nine percent of what they see never make it to the evening news. This growing epidemic is going to continue until we as a nation band together to erase the social stigma that comes along with seeking help for psychological issues. As I conclude this paper let me leave you with this question/thought; would you be able to go to work every day ready to put your life on the line, knowing there are people out there wishing for your death and ready to take your life because of the uniform you chose to wear?

Works cited:
Bradley, Louise. “A Silent Killer: Giving a Voice to the Quiet Mental Health Crisis among First-Responders.” Psynopsis: Canada’s Psychology Newspaper 2015: 10

Farnsworth, Jacob K., and Kenneth W. Sewell. “Fear Of Emotion As A Moderator Between PTSD And Firefighter Social Interactions.” Journal Of Traumatic Stress 24.4 (2011): 444-450.
“Haunting the Barn”:Flashpoint Season 1 Episode 12; 2009;CBS/CTV, Toronto; Television

Gordy, Kimberly. “The 9/11 Cancer Conundrum: The Law, Policy, & Politics Of The Zadroga Act.” Seton Hall Legislative Journal 37.1 (2013): 33-90

Kanarian, Steven. “The Psychological Aftermath Of Terrorism.” Fire Engineering 160.8 (2007): 121-128

Lindahl, Mary W. “A New Development In PTSD And The Law: The Case Of Fairfax County V. Mottram.” Journal Of Traumatic Stress 17.6 (2004): 543-546

First Responders: Legal And Ethical Considerations.” Journal Of Law, Medicine & Ethics 39.(2011): 56-59.

Violanti, John M. “The Mystery Within: Understanding Police Suicide.” FBI Law Enforcement Bulletin 64.2 (1995): 19

Volkmann, Peter. “When Traumatic Events Affect The EMS Worker: The Role Of The CISM Team.” Fire Engineering 156.(2003): 51-54.

WIKLANSKI, DAVID. “PTSD: Calling The Psychological Mayday.” Fire Engineering 168.12 (2015): 62-66.

Zigmond, Jessica. “Searching For Answers.” Modern Healthcare 40.34 (2010): 36-38

About the Author: Steven Gerlang is a decorated 17 year New York State EMT and a former volunteer Firefighter from Long Island,New York. He is currently going into his senior year as a Psychology major at Long Island University at Post in Brookville, New York. Steven has plans to get his PhD in Psychology and become a Psychologist specializing in Post Traumatic Stress Disorder among First Responders and Veterans. Steven is also a member of the Theta Chi Fraternity Kappa Beta chapter, where he has organized four events in the last two years to bring public awareness to the growing PTSD/suicide epidemic among First Responders. Steven currently volunteers with the Central Islip Hauppauge Volunteer ambulance and is also a peer counselor on the Suffolk County Critical Incident Stress Management Team.