In the earliest days of Ground Zero (9/11/2001), we have all watched countless rescue workers on the pile, passionately and pointedly searching for any life in the rubble while trying to stay focused from the devastating images and emotional effects of the disaster around them. Twenty years later, many of these same responders are sharing the after effects of their experiences both physically and psychologically- some finding great cathartic benefit in sharing, while others still struggle with their memories.
Throughout a firefighter's career, rescue calls mean racing to accidents or disasters- often including traumatic images and sensations. They are usually first on the scene of any life-threatening incident, witnessing and interacting with event-related injuries, deaths or some of the most graphic and violent accidents. According to fire training experts and SAMSHA (Substance Abuse and Mental Health Services Administration), public safety personnel are expected to witness horrific scenes in the line of duty. These professionals respond to tragic events that permeate all senses including sight, sound and smell. Repeated exposures, coupled with the immense stress of roles in emergency services, can lead to an increased risk for adverse behavioral health outcomes such as distress, worry, disturbed sleep or concentration, alterations in work function, difficulties with interpersonal relationships, increases in substance use, somatization, and depression. 
Active and retired responders comment on the "limited training offered to adequately prepare public safety professionals to process trauma." What training and experience does not provide is the individual's ability to sustain the part of the human condition to reinforce one's internal defenses and ability to heal. Each traumatic experience (where rescue calls do not end well) contains its own unique elements that can shock or surprise the system. These traumatic elements have a tendency to carry latent or cumulative effects, which adds to the challenge of treating them as disorders (ie. PTSD, substance abuse, depression etc)
RE-EVALUATING "SUCK IT UP, BUTTERCUP"
Bar none, rescue responders are a unique breed of caregiver, selflessly dedicated to acting on a call to save lives. Their professional heightened focus to the rescue response can often occur at the cost of THEIR OWN personal safety. The "toughness" that comes with the job is one that is fostered in part from within, but is also largely enforced by the strong camaraderie and collective support of their fellow team members.
But what happens when the rescue worker goes home?
- Coping Mechanisms & Endurance Training
- Collapse and Breakdown of Professional Composure
- Aftermath: The Many FLAVORS of Depression
- Diagnostic Protocols for Suicide Prevention
- Does Therapy REALLY Work?
- Medical Innovations in Mental Health Care
- It Takes a Village: Forming a Collaborative A-Team