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February 10, 2016

PPE for emergency responder psyche

Fire and EMS personnel — whether it is their career or they volunteer time to the community — are exposed to hazards that affect their physical and mental well-being far beyond the comprehension of most of the public that they serve.

We are just beginning to learn about the scope and magnitude of the impact that responding to the emergency needs of our fellow citizens has on our psyche.

Based on what we've learned thus far, I'm comfortable saying that the protection of our mental health is right there at the top of the list of threats to firefighter health and safety.

In particular, the daily or weekly exposure to the traumas and misfortunes of fellow human beings, and efforts to resolve their problems, can manifest itself in many ways. Some of those include failed personal relationships, substance abuse, domestic violence, suicide and feelings of loneliness and alienation.

But perhaps the greatest threat to our psychological well-being is the general reluctance to accept that these hazards exist and that their negative impact on our lives, our families and our organizations are real. In many respects, to quote the old adage, "We have met the enemy and it is us."

Combat veterans and firefighters
The military services of both the United States and Canada have been devoting an increasing amount of resources to understand the detrimental effects that the continuous combat rotations in Iraq and Afghanistan have had on the mental health of their men and women.

The mainstream media in both countries has also been doing a better job of searching out and writing stories that are shedding new light on the challenges facing these veterans when they return home and try to resume their civilian lives.

When it comes to mental health issues, there are many parallels between the exposures for the combat veterans and firefighters and EMS providers. Both populations are exposed to common mental health exposures — here are six of those.

  • Being thrust into chaotic, high-stress situations with limited information and the expectation for quick resolution of the problem.
  • Technical training that develops a highly specialized set of skills, along with an expectation that failure is not an option.
  • A strong sense for taking responsibility for both the problem and its outcome. Listen to the language we use. "We burned that house down." "I lost that that pediatric cardiac-arrest patient."
  • A strong sense of camaraderie and teamwork where there are great pressures not to let one's team members down in a critical situation.
  • A culture that rewards risk taking and quick decision making and has a negative view of self doubt. 
  • Extended periods of separation from family and friends and other influences outside the job that creates a sense of a second family.

Psyche protection
We have made great strides in providing better equipment, protective clothing, and training to our people to better protect them from the physical hazards of firefighting and EMS delivery.

Our recognition of the hazards to our mental health, and similar efforts to successfully manage those hazards, has not been adequate. We have personal protective equipment to protect our bodies from physical injuries, but we lack PPE for the psyche.

In the mental health world, resilience is the capacity of an individual to recover quickly, resist and possibly even thrive in the face of direct or indirect traumatic events or adverse situations. 

How can you develop resilience for yourself? How can you help the members of your team to develop resilience?

Share your thoughts and ideas here and I'll pull them together for the next article for this topic. I understand that some folks can be a bit shy about posting for the entire world to see.

So you can also send your comments to me using the e-mail address below. Anything I get through e-mail will be used anonymously unless you state otherwise.

About the Author

Battalion Chief Robert Avsec (Ret.) served with the Chesterfield (Va.) Fire & EMS Department for 26 years beginning as a firefighter/EMT; he retired as an EMT-Cardiac Technician (ALS provider) certified by the Commonwealth of Virginia. During his career he was an active instructor, beginning as an EMT Instructor, who later became an instructor for fire, hazardous materials, and leadership courses at the local, state, and federal levels, which included more than 10 years as a Contract Instructor with the National Fire Academy. Chief Avsec earned his bachelor of science degree from the University of Cincinnati and his master of science degree in Executive Fire Service Leadership from Grand Canyon University. He is a 2001 graduate of the National Fire Academy's Executive Fire Officer Program. Since his retirement in 2007, he has continued to be a life-long learner working in both the private and public sectors to further develop his "management sciences mechanic" credentials. He makes his home near Charleston, W.Va. Contact Robert at