The Silent Struggle: PTSD and First Responders in Alberta

Post-Traumatic Stress Disorder (PTSD) can be a significant challenge for first responders, including police officers. It’s important to understand what PTSD is, how it affects people, and what help is available, especially in Alberta.

Understanding PTSD in First Responders

PTSD isn’t a sign of weakness. It’s a natural human reaction to very disturbing or traumatic events. For a long time, the mental health impact of jobs like policing was often ignored. Officers who experienced trauma were sometimes seen as not tough enough, instead of recognizing their normal response to difficult situations. This made many officers afraid to ask for help, fearing they’d be judged or lose their jobs. The website Benchmark Analytics talks about how common this misunderstanding used to be.

A big change happened in 1980. Newsweek reported that PTSD was officially recognized as a specific mental health condition. It was included in a guide called the Diagnostic and Statistical Manual of Mental Disorders (DSM-III). This was important because it confirmed the experiences of many people, including first responders.

Later, the DSM-IV provided a more detailed description. The U.S. Department of Veterans Affairs explained that the DSM-IV included not just experiencing a traumatic event, but also having specific groups of symptoms. These are:

1. Intrusive Symptoms: Things like flashbacks, nightmares, and constant, upsetting thoughts.
2. Avoidant/Numbing Symptoms: Avoiding anything that reminds you of the trauma, feeling emotionally distant, and losing interest in things you used to enjoy.
3. Hyperarousal Symptoms: Being easily startled, having trouble sleeping, feeling irritable, and being constantly anxious.

This better understanding helped doctors and therapists diagnose and treat PTSD more effectively.

Treatments have also improved over time. As understanding of PTSD grew, so did the ways to treat it. Neurolaunch notes that therapies like Cognitive Behavioral Therapy (CBT), Eye Movement Desensitization and Reprocessing (EMDR), and exposure therapy became more widely used. These offered different ways to heal and dealt with different parts of PTSD.

Ways to Deal with Trauma

Several therapies have been shown to work well for treating PTSD. Each one has its own benefits, so treatment needs to be tailored to each person’s needs.

• Cognitive Behavioral Therapy (CBT):

  How it Works: CBT is based on the idea that our thoughts, feelings, and actions are connected. It helps people identify and change negative thinking patterns that cause distress. For PTSD, CBT helps first responders rethink their traumatic experiences, learn coping skills, and reduce avoidance.

  • Evidence: Clinical Schizophrenia shows that CBT is effective in reducing symptoms and improving the recall of personal memories. CBT often involves working with others, which can be helpful for first responders, creating a sense of shared experience.

  • Advantages: Many studies support CBT’s effectiveness for PTSD. Sage Journals mentions that it can reduce the risk of future violence in relationships, which can be a result of untreated trauma.

  • Disadvantages: While CBT is good at addressing thoughts and behaviors, it might not fully address the deep emotional parts of trauma. Some people might find it hard to examine their own thinking.

• Eye Movement Desensitization and Reprocessing (EMDR):

  How it Works: EMDR is a special therapy that uses side-to-side eye movements (or sometimes taps or sounds) to help the brain reprocess traumatic memories. The person focuses on a specific memory while doing the eye movements. This is believed to help the brain’s natural healing process, making the memory less intense.

  • Evidence: The Journal of Neuropsychiatry shows that EMDR is effective, especially for officers involved in shootings while on duty. Studies have shown big improvements in PTSD symptoms after EMDR. It seems to have real effects on the body, reducing the physical stress linked to traumatic memories.

  • Advantages: EMDR can be very effective in reducing the emotional pain of specific events. It may take fewer sessions than other therapies.

  • Disadvantages: How exactly EMDR works is still being studied, but it has been shown to be helpful. Therapists need special training to use it. Some people might be unsure about the eye movements at first.

• Prolonged Exposure (PE) Therapy:

  How it Works: PE therapy involves slowly and safely exposing the person to memories, feelings, and situations related to the trauma. This is done step-by-step, starting with less upsetting reminders and gradually moving to more difficult ones. The goal is to reduce avoidance and help the person learn that the memories, while painful, aren’t dangerous.

  • Evidence: A study published by Science Direct showed good results and low dropout rates for PE therapy. It’s considered a main treatment for PTSD.

  • Advantages: PE therapy directly targets avoidance, a key symptom of PTSD. It can be effective in reducing the power of traumatic memories.

  • Disadvantages: This therapy can be emotionally intense. It requires a strong relationship with the therapist and careful monitoring. It might not be suitable for people with other conditions, like severe depression or substance abuse, until those are treated.

• Mindfulness-Based Interventions:

  How it Works: Mindfulness teaches people to pay attention to the present moment without judging it. This can help first responders become more aware of their thoughts, feelings, and body sensations, reducing their reactions to triggers.

  • Evidence: PMC shows early data that mindfulness can reduce PTSD symptoms and overall stress. People tend to stick with these practices.

  • Advantages: Mindfulness can be a useful tool for managing stress and anxiety. It can be used in daily life, giving first responders ongoing coping skills. Mindfulness can be adjusted to meet the specific needs of first responders.

  • Disadvantages: While mindfulness seems promising, PMC highlights the need for more research to prove its effectiveness for PTSD. It might not be enough as a standalone treatment for severe PTSD.

Challenges in Getting Help

Even with better understanding and treatments, there are still significant challenges that prevent first responders from getting the help they need.

• Stigma: One of the biggest problems is the stigma around mental health. In some workplaces, asking for help can be wrongly seen as a sign of weakness. Officer Survey highlights this. First responders may fear that admitting they have PTSD will hurt their reputation, lead to being made fun of, or even risk their jobs.

• Culture of Toughness: Some jobs, like law enforcement, often emphasize being tough and not showing emotions. This can make it hard for first responders to admit they’re struggling. Officer Survey also mentions this, noting that the workplace culture can reinforce the idea that people should be able to handle anything without showing distress.

• Fear of Career Problems: First responders may worry that a PTSD diagnosis will negatively affect their careers. They might fear being seen as unfit for duty, missing out on promotions, or losing their jobs. Officer Survey specifically mentions this concern.

• Differences in Access: There isn’t a lot of research on how access to PTSD treatment changes based on things like rank, gender, ethnicity, or years of service. PMC includes a study that touches on this, suggesting that regular work stress is linked to PTSD symptoms, and gender and ethnicity might play a role. More research is needed to understand these differences and develop targeted help.

New PTSD Treatments

Besides traditional therapies, researchers are looking at new ways to treat PTSD. These offer hope for more effective and accessible options.

• Telehealth:

  How it Works: Telehealth uses technology (like video calls) to provide mental health services remotely. This can be helpful for first responders seeking mental health support in rural areas or those who have trouble getting in-person care.

  • Evidence: PubMed shows that cognitive-behavioral interventions delivered through telehealth are effective in treating PTSD.

  • Potential Benefits: Telehealth increases access to care and can reduce the stigma of seeking help. First responders can get support from the privacy of their homes.

Support and Training

Beyond individual therapy, support systems and training are crucial.

• Peer Support Programs: These programs involve first responders supporting their colleagues. Peer support provides a safe space to share experiences, receive understanding, and learn coping strategies.

  • Key Components: Officer Survey emphasizes anonymous surveys to assess needs, leadership support, and access to confidential counseling.

• Mental Health Training: Regular training on mental health, including PTSD, stress management, and resilience, is essential. This training should increase awareness, reduce stigma, and equip first responders to recognize and respond to signs of distress. With adequate mental health therapy, first responders are better equipped to cope with work related trauma.

• Best Practice: Easy access to confidential counseling and other mental health resources is crucial. This creates a supportive environment where first responders feel comfortable seeking help.

Research and Guidelines

Reviewing research and guidelines reveals important findings.

• Effective Therapies: Research, like that from Taylor & Francis Online, shows the effectiveness of psychological therapies in treating PTSD.

• High Prevalence: Studies consistently show that PTSD rates are much higher among police officers and first responders compared to the general population. PubMed highlights this.

• Burnout and PTSD: Research from Springer Link shows a strong link between burnout (emotional, physical, and mental exhaustion from stress) and PTSD.

Ethical Considerations

Providing mental health care to first responders raises unique ethical issues.

• Confidentiality and Duty to Warn: Therapists must balance confidentiality (keeping patient information private) with the duty to warn (disclosing information if a patient is a threat to themselves or others).

• Avoiding Coercion: First responders shouldn’t be forced into treatment.

  • Mandatory Treatment: Neurolaunch states that mandatory treatment should only be considered in extreme cases, like when someone is an immediate danger to themselves or others.

• Early Intervention: Early intervention is crucial in addressing PTSD. Providing prompt mental health services can significantly improve outcomes.

The Cost of Ignoring PTSD

PTSD has a significant economic impact.

• Healthcare Costs: PTSD leads to high healthcare costs, including therapy, medication, and hospitalization.

• Lost Productivity: First responders with PTSD may have reduced work performance and increased absenteeism.

• Disability Claims: PTSD can lead to disability claims, creating financial burdens.

  • Cost Per Officer: Research cited by PubMed estimates PTSD costs about $4,489 per officer annually due to lost productivity.

• Cost-Effectiveness: Investing in prevention and treatment programs may be more cost-effective in the long run.

Canadian and Alberta Programs

Several programs in Canada and Alberta specifically address the mental health of first responders. The RCMP mental health support program is one of the most established in the country.

• RCMP-PTSD Program: The Royal Canadian Mounted Police (RCMP) has a national program that started in Alberta.

  • Reach: The RCMP Gazette reports this program serves seven provinces and two territories, providing early intervention and support.

• Alberta First Responder Support Groups: Alberta offers drop-in support groups for first responders.

  • Purpose: The Government of Alberta describes these groups as providing a safe environment to learn about mental health, share experiences, and develop coping skills. Alberta also leads the way in providing presumptive coverage for police officers.

• Public Safety Canada Action Plan: Public Safety Canada has a plan to address the mental health of public safety personnel.

  • Goal: Public Safety Canada states this plan aims to improve mental health through collaboration, research, and evidence-based practices.

Next Steps with Responders First

If you’re a first responder in Alberta and you’re struggling, know that you’re not alone and help is available. Responders First is here to provide support and connect you with the resources you need. Reach out to us to learn more about our programs and how we can help you on your path to well-being.

Don Davis

15+ years of emergency response experience. Passionate about connecting our first responder communities with critical resources. Author of hundreds of articles and guides on First Responders mental health care. When not responding to emergencies, you can find me playing with my dogs, hiking, or enjoying a good book.