Co-founders of Status Code 4 Inc. Ann Rush and Daniel Cramption don’t call it post-traumatic stress disorder (PTSD). They call it post-traumatic stress injury.
Status Code 4 Inc. is a nonprofit that provides mental health and financial resources to first responders who have experienced significant emotional trauma on the job. Considering the very nature of the job of a first responder, experiencing trauma is pretty much unavoidable.
“It’s really an unrealistic expectation for individuals when they’re exposed to the calls that they have and the things that they run into to not be affected by it. It’s like walking through a storm and not expecting to get wet,” Rush said.
The wet of the storm
The word disorder implies something is wrong internally, but Cramption and Rush point out that in the case of PTSD, a person’s brain has been wounded by something exterior, just like any other medical injury. “We like to call it post-traumatic stress injury rather than disorder because we work off the premise that these are injuries to the psyche and that they can be healed,” Cramption said. ”And that once we get them through they can get back on the job and do their job effectively.”
Rush says that there is a lot of misunderstanding about post-traumatic stress, even among first responders themselves.
“A lot of it is leadership in the culture, because it’s a very stoic industry. And so, a lot of individuals think that they shouldn’t be affected when in fact [it’s] just a normal response to an abnormal situation,” Rush said. “Educating the individuals on what’s going on with their body and how it’s a natural physiological response to protect individuals helps with this.”
Spotting the signs
Symptoms of post-traumatic stress and mental injury that first responders experience can be severe and overwhelming. And, if they’re not properly addressed, these injuries have the potential to derail responders’ entire lives.
“They’re reliving either a single call or multiple calls,” Cramption said. “It’s almost like a movie that they just can’t shut off. But it’s not just a movie where they’re watching; they’re actually in it. So, they’re getting the heightened states of emotion — fear, anger, and they’re experiencing a lot of depression that goes along with that.” This leads to symptoms like hypervigilance, where the tiniest thing can set a person off.
Ways of dealing
Cramption says that when people don’t have adequate coping mechanisms for mental injury, they turn to unhealthy coping tools like self-medicating with alcohol and eventually isolating themselves. And, when they begin to isolate themselves, they also begin to ruminate on the event, making the symptoms of the injury even worse. Left for too long, this not only detracts from responders’ abilities to do their jobs, but can be devastating to their mental health, leading in some cases to suicidal ideation or even completion.
Rush and Camption say that in order to adequately support first responders, education has to start within the administration itself.
“We’re trying to talk with administration and get them to the point where they allow their workers to be able to acknowledge that they’re having these experiences.” Cramption said. “And then once they’re experiencing it, there’s not a punitive thing. They’re not put behind the desk or they’re not forced into medical retirement or they’re not ridiculed or belittled. And then help them get the help that they need and the resources that they need to get through it as early as possible.”
New needs, new training
Rush and Cramption have also seen a big uptick in the request for resiliency training, which would endow first responders with tools for managing trauma ahead of time, and prepare them for what they might experience.
“We’re working with some of the academies — fire academies and paramedic and EMT classes — trying to get these resiliency skills and awareness at the beginning of their career and in their training so that they’re more aware of the potential of it happening, rather than trying to fix it in a way that is reactionary rather than proactive,” said Cramption
Status Code 4 tries to encourage and teach social support and empathy skills among the workforce, so coworkers know that they’re there for one another and don’t have to face it alone. But, the first line of defense is really the families. That’s why they have been teaching families of first responders about post-traumatic stress symptoms, how to respond when they notice troubling signs, and how to help their loved ones process a bad call or traumatic experience. “We’re working with the family members especially on dealing with when they have some bad calls and that kind of thing,” Rush said. “And, how can they help process the stress and the trauma.”
The underlying cause
A person dealing with post-traumatic stress might lash out or fly off the handle, so understanding that this is due to a mental injury can also help keep issues from arising within households. “If they have that awareness they may be able to mitigate some of those [symptoms] when they get home… and give them whatever support that person needs at that particular time, so that it doesn’t escalate any family issues that they’re experiencing,” said Cramption.
Rush says first responders often don’t know how to express themselves or don’t want to relive their trauma by talking about it with family. But through greater education and more access to mental health tools, it looks like this could be changing.
