Post-traumatic stress is a shock to the system for first responders

AT ANY EMERGENCY, there is a concern beyond bandages and oxygen. The victims of a car crash, fire or other event are observed and kept calm. An emergency medical technician may wrap in a blanket someone who doesn’t have any outward signs of injury. It is more than about keeping warm. It is a prescription for shock — the way the body handles an influx of stress. Shock can leave someone numb. It can disconnect the body from what is happening. It can manifest in panic and anxiety and move to physical symptoms in heartbeat, circulation or breathing. Looking for signs of shock is something everyone who shows up at an emergency learns about. But shock is what is expected in the immediate aftermath. It’s what’s looked for in the victims. What about the first responders? Police, firefighters, EMTs and others attend to scenes of trauma every day, often multiple times a day. They see all the same blood and blaze the victims see, but they don’t have the luxury of sitting down, wrapped in a blanket. This can manifest after the call is over — sometimes long after. The Substance Abuse and Mental Health Services Administration estimates that about a third of first responders have post-traumatic stress disorder. It is one of the most common mental health conditions in the U.S. It can start with the same detachment and numbness as shock, but can spiral from there into more serious physical and psychological symptoms. The Pennsylvania Legislature acknowledged the toll this year in passing Act 121 in a rare moment of agreement. It was not just a nod toward bipartisanship with a few movements from each side toward compromise. Senators voted 49-0 to change the standard a first responder must meet to receive worker’s compensation for post-traumatic stress. The House of Representatives voted 201-1. First responders are vital to keeping us safe, whether they are showing up at a pile-up on the interstate or a school shooting or a train derailment. At the same time, every kind of response agency is facing recruitment and retention problems. The mental health toll of the job has to be considered and addressed. We cannot wrap every first responder in a blanket to ward off the shock of the job they do. But if we want them to continue to keep us safe, it is important that we make it possible for them to get the help they need when they need it.