Every day you might get up and go to work, without a thought in the world about it impacting on your mental health. For some occupations this is not the case.
Everyday police officers, paramedics, firefighters, and emergency dispatchers run toward situations the rest of us flee. They witness death, violence, trauma and suffering as a routine part of their jobs. In helping the vulnerable, they have an increased likelihood of having PTSD (Jones et al., 2024).
The mental health risks, such as depression, anxiety, panic disorders and posttraumatic stress disorder (PTSD), faced by first responders are not a product of individual weakness or a lack of resilience. They arise from the nature of emergency service work itself (Jones et al., 2024).
By The Numbers
Phoenix Australia reports a 10% PTSD prevalence rate across first responders in Australia, approximately three times higher than the general population (Jones et al., 2024). Research also indicates PTSD commonly co-occurs with depression, anxiety, sleep disturbance, alcohol misuse, and chronic pain and that one in four police officers experience moderate to high psychological distress at any given time (Police Health, 2024).
Perhaps the most confronting dimension of this issue is suicide. First responder suicide rates are higher than in most other occupations (Petrie et al., 2023) and research has found that one first responder dies by suicide approximately every six weeks in Australia (Police Health, 2024).
Why is prevalence higher in First Responders?
The real answer is we don’t know.
Some possible explanations include:
- First responders have more frequent exposure to traumatic content (Arena et al., 2025; Even et al., 2024; Harvey et al., 2016; McFarlane et al., 2010; Pao et al., 2023).
- These exposures also tend to be of greater severity (Klimley et al., 2018).
- First responders are trained to be hypervigilant, to identify any possible sources of threat, and to react in high stress situations. But does this training cause a delay in recognising and seeking help for PTSD, whose symptoms mirror the behaviours their training has reinforced? (Arena et al., 2025; Haugen et al., 2017)
The Barriers
Despite these alarming rates, a high proportion of first responders who need mental health support do not seek it (Jones et al., 2025). Barriers include fears about confidentiality, concern over job security and the perception that reaching out is a sign of weakness (Rikkers & Lawrence, 2021). The stigma surrounding mental health in these high-pressure cultures remains a significant obstacle to care.
There Is A Way Through
The good news is that effective, evidence-based treatments exist and they work. The leading therapies for PTSD are Cognitive Processing Theory (CPT), Prolonged Exposure (PT), Eye Movement Desensitisation and Reprocessing (EMDR) and Cognitive Behaviour Therapy – Trauma Focused (CBT-TF).
Research suggests that CPT may be a treatment of choice for the first responder population (Lewis-Schroeder et al., 2018). Crucially, its benefits extend beyond PTSD as it also addresses co-occurring conditions making it especially well suited to the presentations of first responders (Lewis-Schroeder et al., 2018).
First responders are trained to act under pressure. With the right support, recovery is possible.
If you are concerned about your mental health as a first responder one of our team can help you. To book an appointment at the Centre for Clinical Psychology please call (03) 90770122 or book via the website www.ccp.net.au
References
Arena, A. F., Gregory, M., Collins, D. A. J., Vilus, B., Bryant, R., Harvey, S. B., & Deady, M. (2025). Global PTSD prevalence among active first responders and trends over recent years: A systematic review and meta-analysis. Clinical Psychology Review, 120, 102622. https://doi.org/10.1016/j.cpr.2025.102622
Bryant , R., Glozier , N., Harvey, S. B., Felmingham, K., Phelps , A., & Steel , Z. (2024). Expert Guidelines: Diagnosis and treatment of post-traumatic stress disorder in emergency service workers. Black Dog Institute and University of New South Wales . https://www.blackdoginstitute.org.au/wp-content/uploads/2024/11/BDI_PTSD_Guidelines_A4_DIGITAL_V2.pdf
Even, D., Cohen, G. H., Wang, R., & Galea, S. (2024). The cumulative contribution of direct and indirect traumas to the production of PTSD. PLOS ONE, 19(8). https://doi.org/10.1371/journal.pone.0307593
Jones, R., Jackson, D., Ranse, J., Arena, A., Clegg, L., Sutton, C., Gayed, A., Rice, K. and Usher, K. (2024), A Scoping Review of Trauma, Mental Health and First Responders in Australia. Int J Mental Health Nurs, 33: 1817-1839. https://doi.org/10.1111/inm.13397
Harvey, S. B., Milligan-Saville, J. S., Paterson, H. M., Harkness, E. L., Marsh, A. M., Dobson, M., Kemp, R., & Bryant, R. A. (2015). The Mental Health of Fire-fighters: An examination of the impact of repeated trauma exposure. Australian & New Zealand Journal of Psychiatry, 50(7), 649–658. https://doi.org/10.1177/0004867415615217
Haugen, P. T., McCrillis, A. M., Smid, G. E., & Nijdam, M. J. (2017). Mental health stigma and barriers to mental health care for First Responders: A systematic review and meta-analysis. Journal of Psychiatric Research, 94, 218–229. https://doi.org/10.1016/j.jpsychires.2017.08.001
Klimley, K. E., Van Hasselt, V. B., & Stripling, A. M. (2018). Posttraumatic stress disorder in police, firefighters, and emergency dispatchers. Aggression and Violent Behavior, 43, 33–44. https://doi.org/10.1016/j.avb.2018.08.005
Lewis-Schroeder, N. F., Kieran, K., Murphy, B. L., Wolff, J. D., Robinson, M. A., & Kaufman, M. L. (2018). Conceptualization, Assessment, and Treatment of Traumatic Stress in First Responders: A Review of Critical Issues. Harvard review of psychiatry, 26(4), 216–227. https://doi.org/10.1097/HRP.0000000000000176
McFarlane, A. C. (2010). The delayed and cumulative consequences of traumatic stress: Challenges and issues in compensation settings. Psychological Injury and Law, 3(2), 100–110. https://doi.org/10.1007/s12207-010-9074-z
Pao, C., Arbona, C., Fan, W., & Tran, J. (2023). Duty-related trauma and PTSD symptoms in US urban firefighters. Occupational Medicine, 73(6), 324–331. https://doi.org/10.1093/occmed/kqad076
Petrie, K., Spittal, M., Zeritis, S., Phillips, M., Deady, M., Forbes, D., Bryant, R., Shand, F., & Harvey, S. B. (2023). Suicide among emergency service workers: a retrospective mortality study of national coronial data, 2001-2017. Psychological medicine, 53(12), 5470–5477. https://doi.org/10.1017/S0033291722002653
Police Health. (2024). Emergency services at greater risk of suicide. https://www.policehealth.com.au/information-hub/news-and-articles/health-articles/emergency-services-at-greater-risk-of-suicide/
Rikkers, W., & Lawrence, D. (2021). Mental health help-seeking experiences and service use among Australian first responders. Australian Journal of Psychology, 73(2), 125–133. https://doi.org/10.1080/00049530.2021.1882271
