The Importance of EMS Mental Health Resources for First Responders

Emergency Medical Service (EMS) workers are among the first to respond during a major vehicle accident, emergency at home, or other medical tragedy. These first responders see first-hand the pain, sadness, and trauma inflicted on families and patients. Every tragic case leaves a mark on first responders, but many suffer in silence and carry on without ever truly healing. 

More than 1,100 EMS workers participated in the 2021 national Social Needs in the Pre-hospital Setting (SNIPS) Study, which assessed the mental and socioeconomic concerns of workers. More than 40 percent of EMS workers reported mental health struggles, 20.9 percent battled drug or alcohol use, 27.4 percent struggled with food insecurity, and 20.3 percent experienced housing insecurity.

EMS Providers Mental Health Stats

The Agency for Healthcare Research and Quality (AHRQ) reports a wide range of mental health concerns and struggles for EMS workers. The Agency explains that these workers are at risk for suicide, depression, PTSD, and anxiety; most concerningly, suicide rates for EMS workers are double that of the general population (5.2 percent versus 2.2 percent).

The Agency noted that a 2018 study titled "Prevalence of PTSD and common mental disorders amongst ambulance personnel: a systematic review and meta-analysis" revealed that 15 percent experienced or reported anxiety, 15 percent experienced depression, 11 percent were diagnosed with PTSD, and more than a quarter (27 percent) had general psychological distress.

Many EMS workers battle burnout and fatigue. Long hours and lack of sleep add to the stress of the role, leading many to feel overwhelmed and exhausted. The Agency cited a 2019 survey of more than 1,500 EMS workers that asked them about burnout. When asked to agree or disagree with the statement "I feel burned out in my EMS work," 60 percent of respondents from large cities agreed. In addition, 36 agreed when asked to assess the statement, "I don't want to do EMS work anymore."

Stress in EMS 

EMS workers experience stress daily on the job. These first responders are the first to a scene, witnessing death, extreme injuries (and pain), and facing patients of all ages (from infants or newborns to the elderly). These individuals are exposed to tragic scenes and witness extreme despair and trauma, but many internalize their stress or pain. 

High levels of stress can lead to sleep disruption, depression, or anxiety. In addition, witnessing tragic scenes and injuries triggers a trauma response, leading to PTSD and other mental health concerns. 

Preventing PTSD in First Responders

The Centers for Disease Control (CDC) urges first responders to practice self-care to reduce the incidence of trauma and PTSD. The CDC recommends that first responders take time to care for their emotional needs, unwind, and find solace and comfort. The CDC recommends limiting long shifts (keeping shifts to less than 12 hours), working with others to reduce personal stress during an emergency, eating healthy, engaging in breathing exercises (or meditation), and to limit caffeine and alcohol.

The CDC also advises first responders to take breaks during shifts. This provides a moment to step away from a stressful situation. Understanding personal limitations also is crucial; the CDC explains that overworking does not make an individual more impactful. Overwork may lead to burnout.

What percent of first responders will suffer from some level of PTSD during their working careers?

According to the Institutes of Health, about one in three first responders experience PTSD in their career. This is in contrast to only one in five individuals in the general population. 

First Responder Suicide Statistics

The U.S. Fire Administration published statistics related to suicide prevalence among first responders. This data was compiled from the Centers for Disease Control and Prevention's National Violent Death Reporting System (NVDRS) and the National Institute for Occupational Safety and Health. 

Per the NVDRS data, first responders accounted for one percent of all reported suicides. However, law enforcement officers were the most at-risk segment; more than half (58 percent) of all first responders suicides involved members of law enforcement. EMS workers represented 18 percent of first responder suicides.  

Supporting the Mental Health of First Responders

The Missouri Ambulance Association recognizes the importance of caring for the mental health of first responders. The MAA dedicates a section of our website to mental health and counseling resources. All resources and services listed on the site are free of charge for EMS workers. 

Visit the Mental Health Services page to find resources and toll-free helplines. Reach out to the MAA for any questions or additional resources. 

Quick Access to Help for First Responders

First responders who need help now should reach out to the Disaster Distress Helpline. Call (800) 985-5990 or Text "TalkWithUs" to 66746.

Additional Resources from NAEMT for EMS

Mental Health

The Missouri Ambulance Association understands the daily stress and trauma that EMS workers experience daily. For first responders who are suffering in silence, please know that help is available. In addition to the resources available via the MAA, the National Association of Emergency Medical Technicians also provides a list of mental health resources for EMS team members. Visit the NAEMT website for a comprehensive list of mental health resources.