PTSD and first responders
Introduction
First responders are the mostly affected people by traumatic events. First responders
experience trauma when addressing emergency and disasters. Traumatic events cause depression,
substance abuse, stress, suicide attempts, acute stress problems, and PTSD. Most affected first
responders include fire fighters followed by police. Fire fighters and police face risky and fatal
events that might cause PTSD and depression. First responders should be offered with adequate
training and quality tools to ensure they execute their job accurately to avoid loss and death that
can cause them trauma. Many disasters leave huge destruction and fatalities that can affect the
mental health of people responding to the traumatic event. The mental health illness and
depression is due to compounded environmental, historical and mental determiners. Every single
trauma developed must be triggered by certain condition that can be fixed through psychological
treatment (Klein, 2011). Military service members should be offered psychological education
that is connected to the traumatic events they experience. During world second world war
various veterans developed traumatic conditions that were connected to the traumatic events they
exhibited while war. During the war the veterans witnessed their fellow soldiers being fatally
murdered by their opponents. These bad memories have remained in their minds and they
continuously recall how the battle fields traumatized their lives. Today, various federal
organizations have prioritized mental illness military personnel than other health related issues.
The American Psychological Association, Veterans Health Administration and Department of
defense focused on developing the treatment guidelines for military service members and
veterans with PTSD. Every health care institution in the United State is expected to follow the
treatment guidelines offered by the Veteran Health Administration and Department of Defense.
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These treatment guidelines contain quality treatment methods needed to stabilize different
symptoms and effects of the Post-Traumatic Stress Disorder. Additionally, there are various
medications that the VA/DoD has recommended for prescription of veterans and military service
men with traumatic conditions. The Serotonin Reuptake Inhibitors (SSRIs) are recommended by
the American Psychological Association, Veteran Health Administration, and Department of
Defense for prescribing first responders with symptoms of PTSD and other related mental health
illness. The SSRIs are the best antidepressant commonly used in our society by people to
mitigate stress, depression suicidal idealities and anger. However, pharmacists are not allowed
selling the Serotonin Reuptake Inhibitors without the instructions from certified medical
professional. Serotonin Reuptake Inhibitors can be risky to patient health when they instructions
given are not well observed. Psychologist and psychiatrist offer the instruction for using the
Serotonin Reuptake Inhibitors that pharmacist could not manage to offer. Treatment of mental
illness required involved of qualified health care professional to control further development of
the mental health diseases. Mental health diseases are likely to accumulate with time if the
treatment is poorly managed by unskilled health care staffs. The Veterans Health Administration
and Department of defense focus on recruiting qualified psychologist and psychiatrist to
effectively manage the numerous traumatic events experienced by first responders. The Combat
related traumas are mostly experienced by military men since they are deployed in combat fields.
However, women remain the most affected by traumatic events in military. People believe that
women are deployed in less risky roles in military. However, women have been injured and
killed in various battle grounds leading the war. During Vietnam War, many women soldiers
were injured and killed in their line of duty. Thus the preventive measures of traumatic events
should be addressing both genders. It is true that, military personnel are at high risk of
PTSD AND FIRST RESPONDERS 4
experiencing PTSD due to traumatic events they see and experience in their daily roles, and if
suitable preventive measures are not deployed police cases of traumas are likely to shoot.
Symptoms of PTSD
Military service members are exposed to harsh conditions where they face enemies
during war. During war military members might witness mass number of deaths that can lead to
post trauma. The federal government should offers necessary help to military service who
experience traumatic events to prevent development of mental illness. Traumatic events are
likely to trigger mental illness if left untreated. Psychiatrist and psychologist should be increased
in military camps to offer counsel and therapy to military service members (Robinson, 2018).
Military service veterans might experience various symptoms of PTSD after experiencing a
traumatic event. Military veterans might experience low moods and energy in their daily routine.
People develop negative thoughts on their lives and activities they engage. Military veterans
might feel guilty of something they did and feel shame because of such actions. The negative
changes leads to low esteem and lack of self-confidence when attempting various actions.
Moreover, military service members might tend to greatly avoid traumatic events including
places, events they connect with bad memories, and people (Mei, 2020). People with post
traumatic events finds themselves alienated and keep away from friends and family members.
They fear meeting familiar people to avoid panic and heartbreaks. Military services men might
also continuously remember previous traumatic events through dreams, flashbacks and
disturbing thoughts. These past traumatic events tend to last in memories for long period and one
might find it hard to stop remembering them without effective psychological therapy. We can all
help each other through study of the symptoms PTSD. People leaving with traumatic events are
easily identified through the various behaviors explained above. Thus, within the society we
PTSD AND FIRST RESPONDERS 5
should form preventive and treatment measures of PTSD to help people survive without
developing stress, substance abuse and suicidal idealities. If you are experiencing some of these
PTSD symptoms explained above, do not wait feel free to ask for help from your close people.
Most of youths and women have committed suicide attempts resulting from various traumatic
issues that can be addressed locally. Some of us are depressed after failing in certain goal and
tend to develop depression. We always consider the last chance we had as the final that is why
we get stressed. Always think about trying again when you fail in certain activity. Consult your
mentors on the best ways forward to make a triumph from your previous activities. We are not
perfect all the times, and thus we should appreciate the mistake we make and encourage
ourselves to adjust on the errors in future. Let’s learn to apply what we learn from internet, class
and society through helping each cruise in their hard times including those affected by trauma.
Various scholarly journals have identified that military service staff and military veterans
determined that both groups experience the same levels of PTSD. The research shows that one
traumatic event can cause big damage in mental health of military personnel. Veteran group and
military member after screening showed the high stress and anxiety symptoms.
Risk factors associated with PTSD
Not all first responders experienced PTSD. Some of soldiers might experience PTSD and
others don’t. The risk factors of PTSD to first responders include the increased tours and combat
experience. Military service members are deployed in risky areas which trigger PTSD
development. The environment an individual is leaving greatly determines the traumatic events
experienced. Military men and women experience violent actions in most of their daily works.
They are assigned in securing the country from enemies and maintaining law and order. In places
affected by terrorism the environment develops panic due to continuous fight involving shooting
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and grenades. During this time the soldiers get hurt and this affects their mental health
negatively.
Another risk factor of PTSD includes little or no social support after traumatic event.
When an individual experiences trauma, it is advisable for the close people to offer necessary
support to the victim including provision of basic needs such as health care, food and clothing.
After suffering from traumatic event, people might lose their financial income which might
further trigger development of trauma (Wang, 2015). Medical settings should focus on making
regular visit to victims of PTSD in their homes to determine if there are comfortable with their
life in home. If there is no sufficient assistance to the victim, the physician should concentrate on
finding the suitable solution such as educating the relatives of friends of the victim on social
support plan. We should be ready to service the needs of close people affected by PTSD to build
a health community.
Furthermore, dangerous events and traumas that occur continuously in life can trigger
PTSD. Military service members and fire fighter live through risky activities that might cause
PTSD. Continuous experience of dangerous activities and action in life is potential risk to PTSD.
Military men are persistently sent to establish peace and unity to dangerous events that including
fatalities and critical injuries. This continuous risky traumas and events should be addressed in
the shortest time possible to avoid piling of bad memories (Mei, 2020). Today we are living in a
community full of extremism and terrorism supported by big organizations and prominent
people. multiple soldiers deployed in the middle east by United State, Britain and Germany
experience gun fire exchange with terrorist who fight to control the middle east territory. These
soldiers should be trained on how to overcome such traumas and also be accompanied by mental
therapist to facilitate effective and assessable health care services.
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Additionally, we might develop PTSD after we see dead people or witnessing people
brutalized, tortured or being hurt. Most people who witness brutality, torture and see dead bodies
include the first respondent. The first responders are assigned duties that include saving people’s
lives and property. During the process of saving peoples’ life, police, health care providers and
other first responders might see dead bodies that remain in their memories. It is hard for first
responders to avoid seeing dead bodies while in their daily routine (Mei, 2020). Dead bodies
arises while they are conducting their services and thus, impossible to avoid the situation. The
continuous handling dead bodies by first responders lead to Post Trauma and Stress Disorder.
Prevention of PTSD to Military Service Members
There are fundamental strategies that can be applied to reduce PTSD in combat
deployment. Before combat deployment, the military members should be screened to determine
any risk factors connected to PTSD. The military are afterwards offered an intervention before
combat deployment where they are provided with skills and tactics to control the effects of
combat trauma. The third strategy is appropriate assigning of units to specific individuals to
mitigate the effects of combat trauma. Screening and assessment of the services members is
important in determining the risk markers. Various tests are administered during screening and
assessment process (Kane, 2016). The pre-deployment candidates testing include the
neurophysiological, biological, psychological and genetic factors. The testing tool should have a
prospective power of required testing targets. Uses of multiple predictors are essential for
efficient testing. Multiple predictors can be used to compare the results that are important in
making the final decision. The modified results are obtained from the combination of the
multiple predictors.
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Educating the military personnel oh ways of controlling traumatic impacts is essential in
mitigating PTSD. Military organizations can apply modern technology to enhance their
psychological and mental illness trainings through use of internet and social media. Since
military service members are involved in mobile roles hence having limited time to attend
physical educational trainings, tutors can be employed by the federal government to offer skills
and prevention measures of PTSD through company website, Twitter, Facebook, and Zoom. The
use of internet in achieving various goals has been employed by many successful companies.
Military service members can easily learn at their remote areas by use of smartphones powered
by power banks to access learning materials related to PTSD. Various studies have determined
that there is need to enhance prevention programs of PTSD in military service (Wang, 2015). It
might appear as a normal life to soldiers, but that traumatic events can interfere with their mental
health in future. Thus, it is better to engage in comprehensive determination and implementation
of PTSD preventive strategies among military service members. Military personnel should be
informed on potential negative impacts after experiencing a traumatic event. Understanding the
potential negative impact of a certain traumatic event, the victim will be ready to overcome the
trauma through reaching the suitable assistance. Persistent education stress and anxiety
management skills raise awareness on the prevention of PTSD and hence instilling resilience
among the first responders. People have the mentality to adapt on the new measures and
strategies offered by an organization or within the society. Harmony is needed in an organization
when efforts of defeating an enemy are being applied. Consensus builds teamwork and good
relationship needed to check the welfare of co-workers. The military organization should seek
on training the soldiers to their own therapist when their need psychological intervention. During
military training, various candidates can be selected to lead the mental health programs in the
organizations. Through internal training, the first responders will easily assess the psychological
PTSD AND FIRST RESPONDERS 9
intervention they need. Deploying psychological therapist from military service group increases
services delivery since the psychological and psychiatrist therapists will be trained to specifically
offer mental health assistance to the military service members. The therapist will have enough
time to research on risk factors and effects of the traumatic events. Determination of risk factors
facilitates effective development of preventive strategies and measures of PTSD. The risk factors
can only be controlled through extensive research. Effective determination of the risk factors is
essential in determining how PTSD might affect the first responders. Physicians and other
experts who aim at solving certain problems aim at researching of the risk cause of the problem
to increase the understanding of the problem. A quality solution is achieved after a thorough and
consultative mission led by the professional in specified field. The military organizational
therapist assigned to treat mental health should offer continuous mental health classes to educate
the military service men the weight of certain traumas and how they can mitigate the effect
(Robinson, 2018). There is big gap in accomplishing PTSD prevention mission in many military
camps across United State. Many soldiers have engaged in suicide attempts resulting from
traumatic events in military. Other police are involved in killing of their family and later
committing suicide due both mental illnesses. There is need to increase preventive measures
connected to PTSD and other mental illness to control the increasing cases of mental illnesses
among the first responder including military service men. Military service men deployed in
combat conditions should be given long vacation to relax mind and socialize with their loved
ones. Reduction of workload is important in mitigating the effects of traumatic events
experienced by first responders.
Diagnosis and Treatment of PTSD
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Diagnosis testing is essential in facilitating the treatment of a mental health problem. A
comprehensive diagnostic assessment helps health care providers to determine mental health
issues to be prioritized and offer projection to future intervention. Before, conducting a
diagnostic assessment to any traumatized military member, the therapist should investigate and
understand the past life of the first responder. The most important history to look at is the
medical conditions and operational status. The military organizations should employ numerous
standardized clinical interviews and personal-report strategies for testing traumatic event
symptoms. The use of standardized clinical intervention enables accurate determination of data
connected to PTSD (Kane, 2016). These tools are available in the market and thus, the
organizations with first responders should invest in acquiring the tools and skills needed.
Effective screening of military services members is needed to ensure right treatment is gained. In
some cases, mental health patients have complained about receiving of wrong medications for
their mental problems. Administering of drugs or treatment can worsen the condition of the
victim. Some of these medicines are contained specific chemicals meant to treat certain condition
and thus, if redirected to other health complications it can lead to increased mental illness.
The diagnostic assessment should be conducted by qualified personnel to ensure correct
data is collected. Military organizations should employ qualified psychologist and psychiatrist to
ensure to lead the process of diagnosis, prevention and treatment of traumatic events impacts.
Employment of the psychological specialist should be based on the qualifications required for
the position. Various federal organizations fail to prosper due to corruption and fraud found in
governmental organizations (Robinson, 2018). Most government officials engage in corruption
cases in employment and promotion of employs. The quality of employees recruited by the
company determines the success of the company. Thus, military organizations and other
organizations offering first response services should invest in employing qualified psychologists
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to facilitate smooth management and intervention of impacts of traumatic events. The
psychologist employed should possess high level of experience to analyze the behavioral
conditions and mental illness of law enforcers. Military services members should constantly
engage in diagnostic assessment to determine existence of stress and depression. Early diagnosis
of traumatic events on military services members is the cornerstone of providing suitable and
quality treatment to the victim. An early diagnosis helps the therapist to understand the specific
type of mental illness affecting the first responder. Thus military leaders should encourage junior
officers to visit mental health clinic within their organization of private clinic to monitor their
mental health. Mental health illness can result to negative impacts to the first respondent
including loss of job.
Treatment guidelines for PTSD
There are several mental treatments for PTSD including trauma focused process and
cognitive processing therapy. Cognitive Processing Therapy and Prolonged Exposure both focus
mental health resulting from PTSD. The non-trauma focused intervention strives at decreasing
the symptoms of PTSD. Relaxation and interpersonal intervention are examples of non-trauma-
target intervention. In the last two decades various federal organizations including National
Institute for Health and Clinical Excellence and Institute of Medicine have generated
intervention guidelines for PTSD (Kane, 2016). The American Psychological Association,
Veterans Health Administration and Department of Defense developed special intervention
guidelines for their workers who experience traumatic events. The recent guideline produced by
Veterans Health Administration and Department of Defense highly approved the following drugs
for medication treatment of PTSD; Fluoxetine, Sertraline, Venlafaxine, and Paroxetine. These
treatment guidelines are reviewed continuously to include latest research on the PTSD treatment.
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In the year 2017, the VA/DoD and the American Psychological Association released
intervention procedures to PTSD medical staffs. The treatment guidelines include set of
instructions for health care providers to apply when treating military service members and
veterans with PTSD. The development of the PTSD treatment guidelines are reviewed
thoroughly based on the existing literature. The existing literature shows the treatment history of
military service members and veterans. The existing treatment guidelines are updated to include
the ant current intervention procedure for PTSD. Similarly the treatment guidelines developed by
the American Psychological Association in 2017 included systematic evaluation of the existing
treatment guidelines (Mei, 2020). The American Psychological Association applies inclusivity
in reviewing the treatment guidelines of PTSD. Various parties are invited to make
recommendation connected to the treatment of PTSD among the first responders. The parties
involved by the America Psychological Association include the psychologist, nurse practitioners,
psychiatrist, customers, and social workers.
Treatment of PTSD
Most of the Post-Traumatic Stress Disorder can be cure through various treatments
ranging from counseling to medication. The treatment guidelines for Veterans Health
Administration and Department of defense were published in 2017. The guidelines explained the
treatment procedures for Post-Traumatic Stress Disorder that should be applied by the health
care professional who offers PTSD intervention (Robinson, 2018). The most effective
procedures treatment guidelines recommended for Veterans Health Administration and
Department of defense include trauma-focused cognitive behavioral, cognitive processing
therapy and prolonged exposure. The three treatment guidelines for PTSD are evidence based
models that focus on the traumatic event.
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Since the inception of PTSD, the treatment of the PSTD has increased at a better rate.
The treatment strategies and drugs for mental health have been developed in the past decades to
address the increasing cases of depression, stress and PTSD. People with existing suicidal
conditions can use trauma-focused intervention as a drug. Trauma focused processing can be
contraindicated in trauma patients without social assistance and safety. Trauma focused cognitive
therapy involves evidence based psychological intervention (Wang, 2015). Trauma focused
process is mostly administered to children and adolescents with PTSD and other mental health
issues. Trauma focused cognitive behavioral therapy can be integrated with little exposure
substances in addressing mental health problems affecting the first responders like military
service members. The aim of the trauma focused cognitive behavioral is to offer psychological
knowledge to first responders and other people affected by mental health problem. The trauma
focused processes resolves specific mental health problems of military service members and
veterans struggling to control the negative impacts of traumatic event. Military service members
require essential psychological education after experiencing risky events in their daily routine.
The cognitive behavioral process helps the military members to adjust their behavioral
conditions facilitating effective treatment.
Recommended PSTD Treatment
There are various PTSD intervention strategies that are strongly recommended by the
Veteran Health Administration and Department of Defense. Prolonged exposure is the most
recommended treatment in treatment of PTSD affecting the military service members and
veterans. The prolonged exposure is based on the emotional cognitive model. Prolonged
exposure suggests that the effects of traumatic events are not experience at the very time but at a
later time (Wang, 2015). The emotional processing theory reveals that, traumatic events
PTSD AND FIRST RESPONDERS 14
experience by the first responders lead to mental health illness after some time. The fear created
during traumatic event is developed as feared stimuli and the fear later reignites when the patient
recalls the events. The traumatic events experienced by military service members are stimulated
and response organs are connected to the Post-Traumatic Stress Disorder. The prolonged
exposure targets transforming the fear sear structures induced by the traumatic events in their
minds. The fear is activated by the prolonged exposure and the new data that is incompatible
with the wrong data is integrated in the structure. The three treatment recommended by the
Veteran Health Administration and Department of Defense include Cognitive Processing
Therapy, Cognitive Behavioral Therapy, and Prolonged Exposure
Cognitive Processing therapy is also recommended by the VA/DoD treatment guidelines
of PTSD. Cognitive Processing therapy is focused is based on the social cognitive behavioral
theory. The cognitive processing therapy also draws the basics from the informed emotional
processing model. The traumatic events that are experienced by first responders are relevant to
what had happen before. The Cognitive Processing Therapy starts with provision of
psychological education to the first responders or any other individuals affected by the Post
Trauma Stress Disorder (Wang, 2015). Psychoeducation helps the first responders affected by
the PTSD to become more informed of the connection between moods and thoughts. The first
responders are advised to write a consequence statement that shows the current knowledge to
why trauma happened and the effects it has caused to self-esteem of the patient. The next stage
involves the internalizing if the trauma by the patient. The first responded then writes an
informed report of the risky traumatic events. Identifying the worst traumatic events helps the
therapist to determine the suitable cure for a specific mental health illness.
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The second treatment recommended by VA/DoD includes the
Cognitive Behavior Therapy (CBT) for PTSD. CBT is targets the trauma connected events that
causes mental illness. Cognitive Behavior Therapy focuses on determining, comprehending, and
transforming thinking and behavioral aspect of the first responders. Psychological therapist
attached to first responders applies numerous techniques to facilitate effective reduction of
symptoms and impacts of PTSD. Psychologists using the Cognitive Behavioral Therapy should
encourage the first responders to assess their thinking status to determine the irrelevant patterns
in their critical thinking (Mei, 2020). CBT also focuses on educating the first responders on how
trauma affects their mental health and how they can overcome the symptoms of PTSD.
Management of PTSD and getting ready for future traumatic events that first responders
experience is important in helping the first responders to remain productive and focused in their
assigned roles. After the patient has gained skills to determine and resolve irrelevant thinking,
the patient continues optimizing beliefs connected to traumatic event. During this point, the
psychologist aims at assisting the patient create the potential to apply the new adaptive models.
During treatment of Post-Traumatic Stress Disorder the therapist should focus maintaining the
safety and confidence to ensure preciseness and effectiveness during the treatment.
Conclusion
The article has elaborated that it the increasing and severe traumatic events first
respondent experience requires evaluation of unique risk factors including risky events and
dangerous places. Military service members are deployed in war avenues to stabilize security.
During these occasions of marinating security and fighting enemies, military service members
are injured and others killed. The continuous eruption of war events creates traumatizing
memories to the members of the military service. The article has revealed that concentration on
PTSD AND FIRST RESPONDERS 16
evaluating and intervention of PTSD to the first responders is immensely required. The depth of
the treatment guidelines should be enhanced by engaging in comprehensive study on matters
connected to the PTSD. The number of the first responders affected by the traumatic events
continues to increase hence there is needed to apply the international guidelines for treating
PTSD. During PTSD assessment the clinical officers and psychologist should investigate the
past health history of the first respondent being assessed. Inquiring past information about the
PTSD patient is useful in offering psychological education to patient connected to current
behaviors, occupational and childhood information. Various treatment including, cognitive
processing therapy, trauma-focused cognitive behavioral and prolonged exposure are applied in
PTSD treatment. The traumatic focused treatment is deployed to treat mental illness connected to
the traumatic events.
There is great need to focus on eliminating the trauma affecting the military service men
because they play an important rule of protecting the country. Military service men should be
offered long resting hours relax their mind. Relaxation is considered as a treatment for PTSD
conditions resulting from work-related issues. The federal government should thus increase the
number of military service members employed per year to ensure that, their shifts are shortened.
The VA/DoD must ensure that the treatment guidelines applied by the health care providers are
the one recommended. Use of right treatment guidelines is essential in facilitating effective and
fast recovery of the patient. First responders under PTSD treatment should be offered with be
offered with safety assessment including social support. Social support includes consulting with
peers, psychologist, and safety evaluation. Nurse practitioners treating first responders gain
increased awareness on matters connected to mental illness. Keeping educated and informed in
the trending health issues helps the society to maintain the 2020 healthy goals. We can also
overcome the severe impacts of PTSD by voiding traumatic thoughts, traumatic events, and
PTSD AND FIRST RESPONDERS 17
witnessing people being hurt or tortured. Various people including women in military forces
exhibit traumatic events that leave traumatic memories in their life. The only recommended
treatment of PTSD is a kind of antidepressant treatment that includes the SSRIs. The Serotonin
Reuptake Inhibitors is administered to first responders suffering from PTSD to regulate the
symptoms and effects of the trauma including anger, stress and depression. Various health
organizations in America such as American Psychological Association have revealed that SSRIs
and other treatments of PTSD can be administered alongside psychotherapy.