“Probably 90 percent of the people I’ve worked with have been married twice and a majority have used or abused alcohol,” said Robert McBryde. “It takes a toll on your family life and burnout is a big deal.”
According to the Substance Abuse and Mental Health Administration (SAMHA), it is estimated that 30 percent of first responders develop behavioral health conditions including, but not limited to, depression and post traumatic stress disorder (PTSD), as compared with 20 percent in the general population
McBryde, a Whitley County paramedic and a first responder for almost 38 years, attributes one cause of first responder burnout to the fact that most first responders work more than one job. There is often no time to relax, decompress or spend time with family.
SAMHA reports that first responders are usually the first on the scene to face challenging, dangerous and draining situations. They are also the first to reach out to disaster survivors and provide emotional and physical support to them. These duties, although essential to the entire community, are strenuous to first responders and with time put them at an increased risk of trauma.
The trauma is often left unsettled.
In his 27 years as a first responder, Jack Partin, Corbin Fire Department’s Battalion Chief, has seen his share of both good calls and tragic calls and said there’s no one certain method to how the stress or the burnout gets handled, but he tells how his crew does it.
“It’s mind boggling when you lay five kids out in a yard,” said Partin “Or if you have a small kid that gets killed in a car wreck and you have to tell mom or dad.”
Partin said the individuals who are first responders have to have a special mindset to do the job. What he means by that is often times these individuals work with a horrifying scene and leave that scene and go eat dinner. But Partin says every time his shift returns from a bad call, they talk about it.
“When we’re done, we’re done,” Partin said. “There’s not a specific process. If you beat yourself up over every call, you’ll drive yourself crazy.”
PTSD is a big issue in the fire service, according to Partin, who noted it’s hard to determine the triggering point, whether it’s the call from a week ago that impacted someone or the call from a year ago.
“Nobody wants to talk about it,” he said. “Some of them open up and some of them don’t.”
If a first responder is having an issue with a call, the city doesn’t have a specific policy in place for handling it, but Partin said he has his own open door policy and encourages the individuals on his shift to come to him at any time.
“Come to me or if you don't feel comfortable with me, go to anyone on shift,” Partin added.
Partin, who doesn't consider himself a grief counselor but acknowledges that he’s had to do some similar type work, said he goes about it a bit differently. He takes a small talk approach, adding that if an individual wants or needs to talk about it, most of the time the issue will likely come up in the small talk.
“You’ve got to know your people,” he said. “We interact a lot outside the fire department and I think that's a big plus to keep the family alive. If someone needs to take off, we’ll fill their shift.”
Although Partin wasn’t trained in PTSD, he said they are starting to do more training in that field now.
Trevor Allen, with the Corbin Fire Department and a volunteer with the Laurel County Fire Department, has been a first responder since 2009 and has encountered a good mixture of calls. On the calls that end well, he feels good knowing he has helped out, like the one he worked Saturday, December 14, that involved rescuing a dog from a drainage tile.
When the bad calls come in, the ones that involve small children, Allen says he’s still learning how to process those. With a toddler of his own, the calls with children hit close to home.
Like Partin, Allen is an advocate for just talking and relaxing with his co-workers outside of work. Talking but not necessarily talking about the calls they’ve been out on.
Partin who admits there are days better than others doesn’t have a sense of burnout, mostly because he said he feels he’s still making a difference.
“I enjoy doing what I’m doing,” Partin said. “When I get to the point when I don’t enjoy it, then I’ll go on.”
Much like the other first responders, Tracie Rains, Knox County 911 Director, said she copes by having relationships with other first responders.
“We kind of trade war stories and it helps to know that you’re not alone in what you’re going through,” said Rains.
There are some calls that you never leave behind, said Rains. And while the county doesn’t have a policy for treatment or therapy, Rains said her door is always open.
“This job is a thankless job, so you have to like it,” added Rains. “We are not given the recognition we deserve.”
McBryde thinks back to a call he attended to Monday December 16, when he was fortunate enough to get a thank you. After helping stabilize a patient, the man reached for his hand, shook his hand and thanked him. McBryde said that doesn’t happen very often, but it made his entire night.
With so many first responders volunteering with other agencies or having second jobs, Terry Wattenbarger, Laurel County Fire Chief, said the responders are getting double and triple doses of exposure. Helping prevent burnout from his perspective is humor and conversation with other first responders.
“The real reason anyone does what we do is because they are service oriented,” Wattenbarger added.
Rains agreed adding that if you don’t have a passion for it, you won't stick with it.
And while most individuals know almost immediately if they are cut out for a career in emergency response, Rains said the stress is unimaginable and the things that one feels from the job are very real.
“Don’t be ashamed to ask for help,” Rains said.
SAMHSA offers these tips first responders can take to protect their own behavioral health:
Be aware of personal vulnerability and signs of burnout and compassion fatigue, or profound psychological pain observed in therapists working for long periods with people who have been directly traumatized. Make plans prior to the disaster for self-care during the disaster response and plan on taking breaks, sleeping adequately, and eating nutritious meals and exercising during relief work.