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When work comes home: Help for responders and their family

The cumulative toll from many different incidents over time impact responders’ mental health


Getting someone help to address their mental health can be difficult.


By Kathleen L. Mangeri, MA, LPC, Program Director of Human Development and Family Studies at American Military University

Bringing work home with you takes on a whole new meaning for fire and EMS personnel. It can be incredibly difficult for first responders to separate the emotions in their jobs from their personal lives. For example, a first responder with young children may have a significant reaction to an emergency call that involves children. Similarly, a responder with teenagers at home may be particularly impacted after responding to a call that involves the motor vehicle crash of a young driver.

While some calls have a greater effect than others, it is often the cumulative toll from many different incidents over time that impacts responders’ mental health. This ongoing trauma can often lead to visible changes in the responder and start to have an effect on their “normal” day-to-day functions as well as on family interactions.

When to Get Help for First Responders

Often, it is the spouse or other family member who first notices changes in a first responder. Telltale signs of psychological stress include poor sleep, unexplained irritability, moodiness, increased alcohol or substance use, marriage and family/relationship issues, a change in eating habits, and vague physical ailments. If left untreated, these symptoms can intensify and evolve into depression, post-traumatic stress disorder, and/or suicidal ideation. This stress and trauma can impact any responder at any time. Even the most well-trained and seasoned responder can be impacted by the incidents they experience.

Upon noticing changes, spouses and family members should not and do not need to stand idly by. Many family members try to give the individual some “time and space” to “work things through.” However, sometimes the stress becomes too much to process and a responder needs help right away. Family members can play an active role in getting the responder help and assisting throughout the recovery process.

Getting someone help to address their mental health can be difficult. If someone is injured, they can be quickly treated with first aid measures. But when the first aid that is needed is psychological first aid, many people often don’t know what to do.

The first, and often biggest, obstacle to getting a responder psychological help is convincing them they need it. It can be extremely difficult for someone who has been trained and dedicated to helping others accept the fact that they themselves need help. After all, first responders are accustomed to being the first ones called in times of crisis.

How to Start the Conversation Toward Wellness

Family members should be prepared for first responders to be in denial and express feelings that they should be able to handle all stresses of the job. For some, it is the stigma of seeking help – there is a lingering perception that seeking help is a sign of weakness. While this perception is far from true, it nonetheless remains a roadblock to seeking help. Unresolved strong, psychological emotions can take a toll on even the most well-trained personnel.

The conversation about seeking help is not an easy one, but the reality is that first responders are simply human beings. Letting your loved one know that you are concerned about them can open the door to a much deeper conversation. A spouse or family member can help in the following ways:

  • Be willing to listen if they want to talk about what is on their mind – but only if they are willing. Forcing someone to talk can sometimes make things worse.
  • Be willing to just spend time with the person. Sitting in comfortable silence with a loved one can go a long way in making them feel calm and safe.
  • Encourage regular physical activity. Talking a walk together or going for a run can help them expend the pent-up physical energy that is associated with unmanaged emotions.
  • Encourage routines at home. This helps make things more predictable and provides a sense of stability, comfort and control over one’s life.
  • Be patient. Coming to terms with the need for help and accepting help is a process that needs to be nurtured.
  • Practice self-care. If you become overly stressed then your ability to help your loved one will be diminished. Take time for yourself and be in tune with how you are processing your own stress.

Professional and Specialized Counseling

Encourage your loved one to seek professional help if there is no improvement after a few weeks or if active suicidal thoughts are being verbalized. Safety from harm is of utmost importance. If possible, find counselors who specialize in working with public safety professionals — they are specifically trained to understand the types of trauma experienced by first responders. Be willing to attend counseling sessions along with your loved one if asked, but do not be offended if they choose to attend on their own.

In addition to getting counseling for the first responder, it may be very beneficial to attend family counseling. Families may be worried about the health of their loved ones but they may also be worried about the situations that the first responder may encounter in their daily work. This worry can easily transition to anxiety and other psychological issues for family members. Family counseling can open the lines of communication between all family members so that all issues can be addressed and family bonds can be strengthened.

The first step to good mental health is admitting there is a problem. Then, with the support of family and/or professionals, a first responder can work to identify what the problem is and find ways to help address or minimize those stressors. By taking these steps to get a loved one the help they need and deserve can be the impetus needed to put them on the path to wellness and provide them with needed comfort and reassurance. Resiliency is a powerful human characteristic but sometimes resiliency needs a little help.

About the author:
Kathleen Mangeri is an active clinician and educator as well as the spouse of a firefighter. Mangeri has more than 25 years of experience in the field of mental health. She is a New Jersey Licensed Professional Counselor, NJ Certified School Counselor and is trained as a Crisis Intervention Specialist and a Critical Incident Stress Debriefer.

She is on the faculty of American Military University’s School of Education where she serves as Program Director for Human Development and Family Studies and teaches courses on child and family development. Mangeri earned a Master of Arts degree in Counseling and Student Personnel Services from Trenton State College. She is a past president of the New Jersey Clinical Case Management Association and was a board member of the Gloucester County Mental Health Board.

To contact the author, please send an email