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July 12, 2020
Striking a healthy balance between their pressure-filled jobs and their personal lives has never been easy for emergency responders. Many situations that first responders encounter on the job are difficult and stressful on a normal day for them. The COVID-19 crisis has made their jobs even more challenging.
“One challenge that has been clear for first responders is figuring out the balance between being able to perform their jobs and also act in the other roles they fill as parents and spouses,” said Caleb Demers, LCSW. As a clinical social worker and member of the LEADER program at McLean Hospital, Demers works with emergency responders and members of the military and law enforcement communities. He sees firsthand the pressures brought on by the pandemic.
Many frontline workers have dramatically changed their work routines. “They see their children or family less, or they stop entirely for a time,” Demers said.
For those who regularly return home from their work shifts, new pressures have emerged. “There’s an increased fear of bringing COVID-19 with them,” he said. “Many patients we work with use a lot of energy attempting to not ‘bring the work home,’ but now that is a tangible fear with more immediate consequences.”
Rachel D. Tester, MS, APRN, program director of the LEADER residence, recalled the story of a police officer who also provided a childcare role when he would return from work in the morning. “He described significant fear that he could carry the virus home and infect his children,” Tester said. “Although he was aware that the likelihood of a severe illness in children was low, he was already accustomed to belief patterns that allow for harm to come to a child, even if unlikely, due to his line of work. He had started staying in the family basement away from his child. It furthered the overall family stress and increased his isolation during a time when supports are most needed.”
Separation from loved ones, alongside fears of bringing the virus home, is taking a toll on frontline workers. “If they are unable to be close to loved ones, their mental health is certainly impacted,” Demers said. “We see first responders work very hard to maintain confidence and competence in their roles. But when their supports are not as accessible, it affects their mental health.”
Some common problems arising from the current crisis include increased substance use and relapse, ongoing sleep disruptions due to long hours and differing schedules, and increased anxiety about getting sick as well as getting others sick. Demers reported that mental health issues also arise from “increases in isolation or isolative tendencies that put strain on relationships.”
For frontline workers, additional stress can spring from the nature of the job itself. “There is a pressure that is difficult to describe,” Demers said. “It involves responding to the call to action at the expense of the self. The idea is that there is a need to remain on the front lines for just a while longer, to ‘tough it out,’ so to speak.”
Oftentimes when first responders seek help, Tester said that she and her colleagues “see the impact of guilt when they are in treatment, and there is a news report of a negative event in the area they serve. The guilt, she stated, “results in feelings that they had abandoned the others during a time of need.”
Demers said that many of these workers “have a wish or a need to not leave their fellow first responders to manage without them. This is so, even if that is not what will benefit them and their mental health the most. Though this belief was present before the pandemic, it appears to have intensified in recent months. The unfortunate reality is they will likely be more effective and able if they seek the help now.”
During the pandemic, many mental health treatments are now virtually accessible to help individuals with establishing and maintaining healthy routines.
In response to the coronavirus crisis, LEADER created a virtual partial hospital program (day program) to help patients after completing a treatment program. “What we saw occurring for some of our patients was difficulty in establishing routine and consistency after leaving LEADER,” Demers reported. “This, along with a lowered program census due to social distancing measures, led us to develop the virtual program.”
With the ability to get help from the comfort of their home, “participants are able to acclimate back to their own environment while still maintaining the day structure of the treatment program,” Demers said. “Prior to the pandemic, many responders felt they didn’t have the time or lived too far away from the outpatient services they needed,” Tester explained. But now, Tester said, patients can “access clinicians via telehealth and obtain appropriate treatment they might have never had before.”
If you are a first responder and are feeling the effects of trauma—COVID-19 related or not—the first step in seeking help may be the most difficult step. Knowing that you are not alone and that there are treatments available to help build resilience to trauma is important—not just in terms of your own recovery, but in helping your fellow first responders know that seeking help is perfectly normal.
The LEADER (Law Enforcement, Active Duty, Emergency Responder) program at McLean Hospital is proud to provide specialized mental health and addiction services, designed specifically for men and women on the front lines. If you or a loved one is struggling, call us today at 617.855.3141.