A nonprofit publication of the Kentucky Center for Public Service Journalism

Keven Moore: First responders and the risk of PTSD — the problems are real and need to be addressed


As a parent of three adult kids, I have raised them to always show first responders the respect that they deserve. To role model this behavior my kids have seen me buy first responders meals while we were out visiting a local restaurant or they have seen me go out of my way to stop and thank them for the work that they do. 

Like most of us, my kids have had some encounters or witnessed situations where they thought a police officer was acting rude, abrupt or seemed unfair. They would often ask me why do they have to be that way?

My answer was pretty simple, … “what kind of person would you be if you had to deal with people that were always lying, cursing or calling you names every single working day?  Wouldn’t you eventually become curt and rude?”

The fact of the matter is that 85-90% of the public are good-hearted law-abiding citizens, but the rest is evil, malicious, lying, cheating, thieving, wife-beating and law-breaking individuals. They take up too much of a police officer’s work shift. Over time this has to change the soul within any good-hearted person.

For people like me, the worst thing that can happen during a typical workday is losing a client, having to work overtime, getting caught in a traffic jam, spilling coffee on your shirt, getting delayed in an airport or missing a flight to a meeting.

Police officers, EMT’s and firefighters deal with the degenerates of society on a regular basis. Despite their kindness and willingness to serve, many are treated disrespectfully when responding to calls. They also have to respond to calls where adults and children may have been killed in a car accident, murdered, raped, abused, committed suicide, or severely injured.  

They are exposed to danger, mayhem, chaos and sometimes even experience personal tragedy. Some are injured and killed in service, leaving their co-workers to deal with the emotional scars that can linger for many years afterward.

The fact is law enforcement officers, firefighters, paramedics, and other first responders continually see the worst of human experience.

In one city I work with, I was told that a large majority of the EMT calls today are opioid overdoses and many of those calls have become dangerous. Many EMT’s and firefighters are assaulted serving and protecting their communities. Just the other day in Appleton, WI, an overdose suspect was revived by Narcan and he then fatally shot the firefighter and injured the police officer who had just saved his life. 

The truth of the matter is first responders are unable to unsee some of these images. Those visions, smells and cries for help all become embedded in their minds and it eventually changes them.  Over time, exposure to this type of stress can take a toll on their mental and physical health, and sometimes leads to post-traumatic stress disorder (PTSD).

When most people hear of the term “PTSD” they visualize soldiers from combat zones, but most of us do not think about the first responder who lives next door.  We know that they are wired to run towards danger. They have the mindset of a sheepdog, always willing to protect and save those that are around them. In addition, many first responders have served in the military. It takes the same type of mindset to serve the public. 

But as a risk management and safety professional, I can tell you PTSD is a very real hazard that sneaks up on first responders no matter how tough of a person they may be perceived. According to a survey by the University of Phoenix, PTSD is common for these everyday heroes:

· 80 percent of firefighters report being exposed to a traumatic event.
· 90 percent of police and EMTs report exposure to trauma.
· 49 percent of first responders were offered “Psychological First Aid” after traumatic events.
· 85 percent of first responders experienced symptoms related to mental health issues.

The same data found that 34 percent of first responders have received a formal mental health disorder diagnosis, like depression or PTSD. Those PTSD symptoms can include:

· Flashbacks, nightmares, and recurring thoughts
· Emotional numbness
· Extreme worry, guilt, anger or hopelessness
· Avoidance of people, places or things that are reminders of the trauma
· A loss of interest in things that once gave pleasure
· Feeling anxious, on edge or jumpy and startling easily
· Sleep disorders
· Problems with alcohol, drugs or food.

The Ruderman White Paper on Mental Health and Suicide of First Responders examines a number of factors contributing to mental health issues among first responders and what leads to their elevated rate of suicide. One study included in the white paper found that on average, police officers witness 188 ‘critical incidents’ during their careers. This exposure to trauma can lead to several forms of mental illness. PTSD and depression rates among firefighters and police officers have been found to be as much as 5 times higher than the rates within the civilian population, which causes these first responders to commit suicide at a considerably higher rate (firefighters: 18/100,000; police officers: 17/100,000; general population 13/100,000).

The difficulty with PTSD in first responders is that it’s hard to spot. Mental health services are available to first responders in every municipality, city or state, but those services are not used to their full potential. Many first responders won’t acknowledge the problem and the PTSD just simmers and grows. 

To complicate matters, many first responders mask the pain by self-medicating and end up dealing with substance abuse or alcoholism problems. This only drives them deeper into a state of depression.

The truth of the matter is that help is available to these first responders, but much more needs to be done.

Next week: What more can be done to help identify, reduce and prevent the tragic suicides that are occurring.

Be Safety My Friends!

Keven Moore works in risk management services. He has a bachelor’s degree from the University of Kentucky, a master’s from Eastern Kentucky University and 25-plus years of experience in the safety and insurance profession. He is also an expert witness. He lives in Lexington with his family and works out of both Lexington and Northern Kentucky. Keven can be reached at kmoore@roeding.com.


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