When the helpers need help: New methods for first responders to treat their own stress

The “fight-or-flight” response, a physical reaction to stress or traumatic situations, comes with the job of police officers, firefighters, and emergency dispatchers.

Depending on the individual, it can take a toll on one’s mental health.

The men and women we call for help in a crisis may develop post-traumatic stress disorder, a mental health condition that's triggered by a terrifying event. Their brains won’t let go of the memories of fatal shootings, gruesome car accidents, or the child who died in their arms after a rescue attempt.

But those we call for assistance might not seek help for themselves or might not realize there is help for the symptoms of PTSD.

Jo Terry knows better than most how repeated trauma can affect first responders.
Her husband, Chip Terry, died by suicide in 2017. His death came as a shock to the community, which knew Chip as a firefighter for Covington Fire Department for 26 years. Jo believes Chip was let down by a health care system he had reached out to, and which assigned him to outpatient treatment for alcohol abuse.

She believes the bigger picture – that of a firefighter who’d responded to 12 fatal fires and had researched PTSD before his death – was missed. Ten days after completing the alcohol treatment plan, Chip took his life at the Covington floodwall. Within a year, Jo formed the Chip Terry Fund for First Responders, helping them access facilities, both inpatient and outpatient, and experienced clinicians.

“There are over 100 individuals that our nonprofit has helped that are living proof right now that this does not have to end in tragedy,” Jo says of PTSD.

Growing awareness of PTSD

Covington Fire Chief Mark Pierce says Chip’s suicide was the first to affect him so closely. He believes it brought to light the seriousness of mental health issues. While 20 years ago the focus for first responders was cardiac health and eating better, now there is growing talk about PTSD.

“We're not real big about asking others for help,” Pierce says. “And, you know, you have to put on this persona, that we're big and strong and we can handle anything,” Pierce says. “As an individual, I would have a hard time or have had a hard time in admitting that I need help.”

Matthew Kremer is a former police officer and Army Reservist who saw combat in Iraq. As Erlanger’s city administrator, he advises City Council on whether the books are balanced. Kremer’s taken on another task, letting city officials know when first responders have had a particularly tough case, such as a double fatality. He is known to ask council members and the mayor to stop the first responders, let them know they are appreciated.

“Now that I’m in administration I just want to make sure people realize what (fire and police) go through every day and it’s not just cleaning up those scenes. There’s a mental toll that they take home with them every day,” Kremer says.

What police and fire calls are the most stressful?

“I would say any high-stress situation, such as responding to a person with a gun or a weapon and either claiming to harm themselves or claiming to hurt other people,” Erlanger Police Chief Kyle Rader says.

“You are showing up to a scene with a lot of unknowns,” Rader says. At a mass shooting, crowds are running away. Officers are running toward the scene.

“At the time, you just know you’re doing your job. After the call is when you kind of start to think about, ‘Hey, what the heck did I just run toward,’” Rader says.

Treatment alternatives are available

Options are available for groups of responders or one-on-one to deal with stressful situations.

The state’s Department of Criminal Justice Training rolled out a course in 2017 designed for the well-being of officers and dispatchers. It’s called the Kentucky Post-Critical Incident Seminar. A critical incident is any event that results in an overwhelming sense of vulnerability and loss of control. These include officer-involved shootings, being seriously injured on the job, high-speed pursuits that end in tragedy, events that bring prolonged and critical media attention, and personal tragedies – anything that overwhelms one’s ability to cope.

These three-day seminars are led by mental-health professionals trained to work with peace officers, and driven by a team of law enforcement and public safety dispatch peers who have experienced their own critical incidents and received training.

The Chip Terry Fund pairs up first responders with mental health counselors experienced in treatment of PTSD. It also gives grants to departments that want to set up yoga classes to deal with PTSD.

Yoga? Indeed.

Cortisol is the stress hormone that we release in a "fight-or-flight" situation. That describes first responders to a tee. Yoga has been shown to reduce cortisol, the stress hormone that first responders release every time they go out on a run.

“They're releasing this cortisol and yoga has been proven to help reduce cortisol levels,” Jo explains.

The “gold standard” for treating PTSD is eye movement desensitization and reprocessing, known as EMDR, according to Dr. Mike Reeser, a Northern Kentucky psychologist who is a former police officer.

EMDR is a form of psychotherapy that enables people to heal from the symptoms and emotional distress that are the results of disturbing life experiences. It gets pretty technical, but as EMDR.com spells out, a client will track the therapist’s hand as it moves back and forth across the client’s field of vision. These eye movements, going from left brain to right brain, are credited with unblocking emotional wounds caused by disturbing events.

Reeser first heard about EMDR at a homicide conference. The presentation was given by an officer who was on the scene of the Sandy Hook school massacre. “It was so profound for him he made sure every officer on scene had free access to EMDR,” says Reeser, who has come to primarily treat first responders dealing with PTSD.

The understanding of post-traumatic stress has grown since the Vietnam War.

“Everyone has a different sort of biological makeup,” says Dr. Ed Connor, a psychologist based in Erlanger. “I often make the analogy to Vietnam, where we send 12 people ... into a firefight in the middle of the jungle and 12 walk out alive.

“They come back to the United States and 11 are fine and one just flips out. I think people just handle stress very differently,” Connor says.

Sometimes people start having symptoms that they don’t really recognize as associated with PTSD. “They may start to drink more. They may start to overeat. They have problems with sleep,” he says.

PTSD can potentially affect anyone, from rape victims to refugees, and Connor says the history of PTSD “certainly has its roots in war.”

In World War I, “we called that shell shock,” Connor said. Loud noises would put people into a state of shock. “And then World War II, we called it battle fatigue.”
As for PTSD, “it used to be a sign of character weakness that you weren’t tough enough,” Connor says.

“But, you know, now we’re seeing this. It’s not a character weakness. It’s part of being human.”

Resources:
  • University of Cincinnati’s Stress Center, dedicated to caring for families living with PTSD. Reds player Joey Votto helped get the center off the ground financially.
  •  “I Love a Cop: What Police Families Need to Know,” a book by Ellen Kirchman.
  • “Bulletproof Spirit: The First Responder’s Essential Resource for Protecting and Healing Mind and Heart.” Author Dan Willis, a retired police officer, gave Jo Terry advice when she was forming the Chip Terry Fund.

Read more articles by Nancy Daly.

Nancy Daly is a veteran Kentucky and Cincinnati journalist. An "Army brat" who found a home in Kentucky, she is a University of Kentucky graduate. Her hobbies include reading, photography, watching streaming TV including "Succession" and "The Patient," and playing the "Alphabet Game" on Zoom with five siblings across the globe.