COPING WITH TRAUMA EXPOSURE
To better understand the types of support sought by first responders after trauma exposure, we conducted a study exploring the relationships between trauma exposure, coping, support seeking, and impairment using data from a policing sample. Individuals reported using a range of coping strategies after experiencing a stressful or traumatic event at work, but strategies associated with attempts to avoid or numb emotional reactions (e.g., denial, disengagement, substance use, self-blame) were most strongly associated with impairment.
Survey respondents reported spouses/partners and friends as the most helpful sources of support following a stressful or traumatic event at work, with responses highlighting the importance of receiving emotional support. In cases where the support from these sources was not helpful, responses suggest a misalignment between the respondent's needs and the support they received (e.g., being given advice when needing to vent).
The most commonly reported source of unhelpful support was a supervisor or organizational leadership, with responses highlighting stigma and fear of negative repercussions as barriers to seeking help within the organization.
To better understand spouses' experiences when providing support, we interviewed 38 spouses of first responders (police: 13; fire: 3; paramedic: 22). Responses highlighted the number of demands spouses face, including navigating their partner's schedule and ensuring home demands are met, over and above their own work or life stressors.
Despite being highly motivated to support their partners, spouses frequently described the difficulty associated with providing effective support. This included barriers that limit their partner's willingness to seek support from them (e.g., stigma, fear of traumatizing others) and challenges associated with their ability to provide effective support in return (e.g., lack of understanding of partner's job/demands).
Spouses, including those who also work as first responders, frequently described a desire to provide advice or suggestions to their partner (i.e., informational support). However, emotional support, such as listening, comforting, and validating, was frequently described as the most effective strategy, particularly when paired with letting a partner have time and space to process their reactions before receiving support. Whereas, pushing a partner to communicate before they were ready was most frequently described as ineffective.
These findings highlight the complexity of social support and that the support provided must be the right type, delivered in the right way, at the right time in order to be effective.
WHAT CAN ORGANIZATIONS DO?
Despite many organizations offering internal mental health programs and resources, previous research has found that many individuals still seek help outside of the organization from friends and family. Although some individuals utilize these internal supports, barriers such as stigma and professional culture can limit individuals' willingness to seek support from their organizations.
Respondents frequently recognized the efforts organizations have made to address stigma but recognized that this is an ongoing process. To supplement current initiatives, there is an opportunity for organizations to extend resources and supports to spouses and families. Suggestions from respondents included:
Pamphlets (e.g., outlining benefits, internal programs, and contact information)
Information sessions (e.g., when first responders are first hired on to the organization)
Educational initiatives (e.g., Mental Health First Aid training; MHCC)
These suggestions reflect cost-effective resources that help build connections between organizations and families, and can enhance the quality of support provided at home.
FOR FIRST RESPONDERS
It is important to recognize the value in seeking support from others. Attempts to cope alone are often ineffective and may fail to support long-term health and well-being.
When attempting to seek support, it is important to identify and understand your personal support needs in order to effectively communicate your needs to others.
Although different types of support (e.g., emotional, instrumental) can be sought from various sources, it is unlikely for a single person to fulfill all social support needs. It is important to recognize which sources are most effective at providing the type of support you need in the moment, and that you may need to seek support from multiple sources in your network (e.g., coworkers, supervisors, partners or spouses, trained professionals).
FOR SPOUSES AND FAMILIES
It is important to recognize the value of the support provided by loved ones to first responders. Based on our research, emotional support (e.g., comforting, listening) was most frequently described as helpful by both first responders and spouses/partners.
Contrary to popular belief, not all support is helpful. Providing the wrong type or ineffective support can have a negative impact on the receiver and limit their future help-seeking behaviour. For support to be effective, it is important to recognize and respond to a partner's needs as communicated, and recognize your own personal limitations.
It is also important to be aware of your own support needs. As much as you want to support your loved one, it is equally as important to reflect on your own needs and seek help from others when necessary.
It is important to recognize that social support in relationships is a learned process. Providing effective support takes time and practice.
There may be an opportunity for couples to incorporate norms and expectations regarding communicating and evaluating personal support needs to help facilitate this learning process for both partners. For example, establishing expectations and boundaries around:
Seeking support (e.g., how long partners can take space before seeking support from one another)
Communicating individual needs (e.g., in-person vs. written communication, words or phrases to use, words or phrases to avoid)
Providing feedback (e.g., when to have a 'cool off' period and for how long)
Such practices help ensure both partners have a shared understanding of the support process and the necessary tools to support their communication efforts.
It is important to recognize the value in providing resources for mental health in the workplace and to remember that one size does not fit all.
Stress experiences are complex and require organizations to take a comprehensive approach to stress management in order to meet the range of individual needs present. This includes developing resources to support individuals before, during, and after stress or trauma exposure.
There is an opportunity for organizations to build connections with external resources, including families and third party resources or community groups, to ensure members have access to a range of supports.
By strengthening connections between resources in a broader network, there is an opportunity to take a more holistic and proactive approach to mental health and well-being. Only through collaborative efforts can we move towards a battery of resources to address current gaps and support the long-term health and well-being of first responders and their families.
Thank you to our participating organizations, including the Ontario Paramedic Association, and to all of those who participated in our research. Thank you for sharing your stories, experiences, and insights with us. This research would not have been possible without your support.