The COVID-19 pandemic and Australia’s 2019-2020 Black Summer bushfires have taken a heavy toll on those working on the frontline.
While the physical impact continues to be reckoned, what remains largely unknown is the fallout from the prolonged psychological trauma on our first responders.
Edith Cowan University disaster response expert Associate Professor Erin Smith has spent decades studying the long-term impact facing paramedics, firefighters, police and other emergency first responders.
Her research has uncovered the startling reality of the lasting emotional trauma affecting first responders in the weeks, months and years after a disaster.
"Our emergency services play an integral role on the frontline of catastrophic events," Professor Smith said.
"The mental health burden of witnessing devastation, particularly over a long period of time, can be traumatising and exhausting."
A ticking timebomb
Australian emergency services personnel are in a “state of crisis” as suicide rates have increased by around 450 per cent to 800 per cent annually over the past few years.
We need an approach that removes the onus on the individual. We need to find appropriate ways to ‘reach in’ to identify those who may be silently struggling.
Around every six weeks a firefighter, paramedic or police officer dies by suicide in Australia.
Professor Smith said first responders pay a heavy price for their selfless service.
Her research has revealed that during a typical period almost 30 per cent of paramedics report high levels of psychological distress.
"Emergency service workers suffer from higher rates of mental health illness and stress than the general population," Professor Smith said.
"Imagine the cumulative stress of responding to prolonged disasters like the COVID-19 pandemic or months of catastrophic bushfires – it’s creating a ticking timebomb for our first responders’ mental health."
Large-scale disasters can have far-reaching and long-term impacts.
Professor Smith’s 20-year study involving first responders of the 9/11 terrorist attacks in the United States uncovered the challenges facing survivors long after the incident.
Her research found that almost twenty years later the prevalence of mental health disorders and need for treatment remains elevated among first responders, with almost half still needing mental health support.
Reaching in
According to Professor Smith, the increased prevalence of mental health issues among first responders suggests many existing wellbeing programs are failing those who need them most.
"These programs are largely focused on people 'reaching out' and seeking help when they think they need it," Professor Smith said.
"Instead, we need an approach that removes the onus on the individual. We need to find appropriate ways to 'reach in' to identify those who may be silently struggling."
The psychological burden of risking your personal safety, particularly over a long period of time, can be traumatising and exhausting.
Importantly, Professor Smith said there’s no one size fits all approach to mental health support.
"Different methods will work for different people at different times and we need to have flexible and holistic approaches that equip people to have meaningful conversations about their wellbeing," she said.
Professor Smith's research with 9/11 responders found that debriefings and support offered in the immediate aftermath of a disaster are not effective at helping people cope in the long term.
"People process their experiences at different times, so we need a much longer-term and wide-reaching solution to support their recovery," Professor Smith said.
After the dust settles
Professor Smith is currently working on a pilot program with the Emergency Services Foundation in Victoria, Australia, to equip leaders with the skills to recognise and address mental health issues in their teams.
She is also researching the role of emergency services during COVID-19 and the Australian Black Summer bushfires to understand community experiences and expectations.
Professor Smith believes governments and communities should be a driving force in supporting the recovery of first responders to emerge mentally resilient post-disaster.
"We can’t eliminate the risk emergency services workers will suffer with mental health problems, but we can make a difference by empowering social connections, creating support networks and checking in with people long after the disaster," she said.
More reading
Associate Professor Erin Smith is regarded as a leading voice on disaster response and recovery in Australia, particularly in relation to the mental health of first responders.
Recent The Conversation articles authored by Associate Professor Smith:
- Collective trauma is real, and could hamper Australian communities' bushfire recovery
- To improve firefighters’ mental health, we can’t wait for them to reach out – we need to 'reach in'
- It's OK to be OK: how to stop feeling ‘survivor guilt’ during COVID-19
ECU articles:
Research papers: