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Treating Mental Health in Public Safety Starts Locally


By Allison G. S. Knox
Contributor, EDM Digest

Recently, Emergency Management Magazine published an article on first responders and mental health. The article stated that it’s only recently that first responders have started addressing mental health issues.

In many ways, this article is correct in saying that first responders now pay more attention to mental health issues. But in many other ways, the importance of their mental health issues has been gaining momentum the past few years.

It’s become increasingly apparent that some first responders need mental health assistance. For instance, many servicemembers join law enforcement, fire and emergency medical services agencies after they leave military service.

Servicemembers work well in public safety agencies because of the nature and teamwork mentality of military service. But after serving in war zones such as Iraq and Afghanistan, they must often receive treatment for post-traumatic stress disorder (PTSD).

As a result, it is no wonder that there has been an increased emphasis on the mental health of first responders in public safety agencies in the last few years. The understanding of PTSD has increased, as well as the understanding of how working in public safety can greatly impact whether or not an individual develops PTSD later in life.

Combat’s Influence on Emergency Medicine

Civilian emergency medicine traditionally follows the latest treatment methods used in major American wars.  In World War II, for example, Medical Anti-Shock Trousers (MAST) were used to handle major trauma. Usage of these pants continued through the 1990s.

“It was postulated that the MAST reversed hypotension by three different mechanisms: 1) Increasing peripheral vascular resistance; 2) tamponading of intra-abdominal bleeding; and 3) autotransfusion of blood from the lower extremities and abdomen to the head and upper trunk,” EMS World explained.

More recently, the tourniquet was used in the Iraq and Afghanistan wars and is now widely used across the United States for major hemorrhagic trauma. A rather unfortunate truth is that emergency medicine makes tremendous strides through experience gained from combat-related emergency medicine. Where mental health is concerned, combat continues to have an impact on the overall understanding and treatment of PTSD.

Local Municipalities and PTSD Treatment

PTSD is not an easy topic to broach. It can be difficult for some first responders to recognize that they need professional assistance.

While there is certainly a great deal of understanding about PTSD, the details of managing mental health resources is still an issue that needs to be worked out in public service agencies. While the military offers mental health resources to its servicemembers, public safety employees may experience difficulties accessing the same type of treatment.

Budgets associated with mental health services are increasingly complicated, especially when civilian public safety agencies employ volunteers, a situation that further complicates employee benefits. PTSD is certainly a national issue, but how it is handled in public safety agencies is very much a local government issue.

PTSD Treatments for Public Safety Employees Needs Accommodation at Local Government Levels

Public safety agencies are taking PTSD seriously. Unfortunately, the problem is complicated by numerous factors at the local level.

Local governments need to make the effort to provide mental health services at their level. However, getting mental health treatments to local first responders is a complex issue and will not be as easy as offering services at the national level for returning servicemembers.

Allison G. S. Knox Passionate about the issues affecting ambulances and disaster management, Allison focuses on Emergency Management and Emergency Medical Services policy. Allison has taught at the undergraduate level since 2010. Prior to teaching, she worked in a level-one trauma center emergency department and for a member of Congress in Washington, D.C. She holds four master’s degrees in Emergency Management, National Security Studies, International Relations, and History; a Graduate Certificate in Homeland Security; and a Bachelor of Arts in Political Science. Allison is an Emergency Medical Technician, Lifeguard, and Lifeguard Instructor, and is trained in Technical Large Animal Emergency Rescue. She serves on the Board of Trustees for Pi Gamma Mu International Honor Society as Chancellor of the Southeast Region, Vice Chair of the Tactical Emergency Medical Support Committee with the International Public Safety Association, and serves as the Advocacy Coordinator of Virginia with the National Association of Emergency Medical Technicians. She is also a member of several committees including the Editorial Committee with APCO, the Rescue Task Force Committee with the International Public Safety Association, and the Advocacy Committee with the National Association of Emergency Medical Technicians. She also serves as Chair of the Leadership Development Program for the 2020 Pi Gamma Mu Triennial Convention. Allison has published several book reviews and continues to write about issues affecting ambulances, emergency management, and homeland security.