Unspoken Impact of Trauma on First Responders by Michael V. Genovese

unspoken-trauma-first-responders-michael-genovese

Michael V. Genovese, M.D., J.D., is the chief medical officer of Acadia Healthcare which operates a network of 585 behavioral health facilities with approximately 17,900 beds in 40 States, the United Kingdom and Puerto Rico. As well, he is the Medical Director of the Officer Safety and Wellness Committee of the FBI National Academy Associates. Dr. Genovese is also an advocate for attorneys and first responders seeking treatment for addiction and co-occurring disorders.

Dr. Genovese writes, speaks, teaches and consults widely in the disciplines of pharmacology, neuromodulation and pharmacogenomics. He has kindly agreed to allow us to share his article on the impact of trauma on first responders. 


Bravery is one act, but courage is consistent. And our nation’s first responders are the very definition of courage. Each day, they make the difficult choice to run towards the danger that we run from. In doing so, these officers experience significant trauma, yet rarely have the opportunity to process those experiences before speeding off to the next emergency. 

Science shows that repeated trauma alters the neural pathways and injures the brain. These Post-Traumatic Stress Injuries are linked to startling, yet often unreported, rates of mental health illness, which can manifest into substance abuse or worse. In fact, first responders are more likely to die by suicide than in the line of duty. 

So why are our heroes not receiving the help they need? In my role as medical director of the Officer Safety and Wellness Committee of the FBI National Academy Associates, I’ve met countless officers who have struggled to overcome the trauma experienced in their line of work. Many say they’re expected to be mentally and physically tough, and the stigma around mental health treatment prevails. Admitting they have a problem may cost them their badge – and their identity. 

This is quickly becoming a national crisis, but too many departments are reluctant to admit this crisis exists, much less implement programs to address it. Here are four ways we can change that:

 

Acknowledge mental health injury

Post-traumatic stress is an injury, not a weakness. If a first responder broke his or her leg in the line of duty, treatment would be a no-brainer. We must recognize and treat brain injuries in the same way. 

 

Build resiliency through training

It is not enough to wait until officers are injured. We need to proactively provide training to help officers build resiliency. Resiliency can be learned and can help officers manage the extreme pressure and trauma inherent in the job. 

 

Shift the culture, from the top

Law enforcement agencies must normalize mental health care by proactively offering support services and treatment. This requires a shift in culture which must be led from the top. Support systems can include employee assistance programs, peer support policies and confidential resources, to name just a few.

I am proud to be a part of Treatment Placement Specialists, which provides treatment guidance that reflects the individualized needs of officers. Substance Abuse and Mental Health Services Administration (SAMHSA) also provides excellent resources for mental health treatment.

 

Build pathways back to work

In most professions, overcoming personal challenges, such as depression or substance abuse, is supported and celebrated. But for first responders, the result is often the loss of their job. This severe punishment is unnecessary and leads to further trauma and depression. We need to formalize a pathway back to service, so individuals aren’t penalized for seeking help. 

These are not just academic suggestions. These are practical measures that progressive departments are already taking – and they are working. 

We all know the saying, “To whom much is given, much is required.” When we consider all that is asked of our first responders, we should consider a new phrase:

From whom much is required, much should be given.

We must support those who serve by acknowledging the trauma they experience and providing treatment to address the very real impacts on their health. Will you join me? 

References: 

Genovese, M. (2018, October). How Trauma Causes Alternate Pathways in the BrainRebuilding Officer Resiliency: A Treatment Guide, 4-6.

Heyman, M., Dill, J., & Douglas, R. (2018). Mental Health and Suicide of First Responders [White Paper].

 

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