Health Matters 10/4: First responders: Saving those who save others 

By Michael Bizzarro, Ph.D., L.C.S.W., B.C.D.

Our nation’s first responders are on the frontlines, protecting and saving others each and every day.

During the course of their work, first responders can be exposed to traumatic events, such as a mass shooting, natural disaster or an act of war. It’s no wonder that first responders have higher rates of post-traumatic stress disorder (PTSD), putting them at greater risk for alcoholism, drug abuse and suicide than the average population.

The First Responder Treatment Services at Penn Medicine Princeton House Behavioral Health are the first in New Jersey to provide inpatient addiction and mental health services to address the unique behavioral health needs of police and corrections officers, military personnel, firefighters, paramedics and EMTs.

Invisible Wounds

In addition to physical trauma, first responders may experience or witness horrific circumstances that can overwhelm their capacity to endure.

These wounds sustained by first responders are invisible. And more often than not, they experience traumatic events several times, creating a cumulative effect.

As a result, it is estimated that 30% of first responders develop behavioral health conditions including, but not limited to, depression and PTSD as compared to 20% of the general population, according to the national Substance Abuse and Mental Health Services Administration (SAMHSA).

Further, research has shown that police officers and firefighters are more likely to die by suicide than in the line of duty.

However, it is important to underscore the fact that not everyone who experiences a traumatic event will develop PTSD. In fact, many first responders are able to overcome these challenges and gain strength through the experiences.

Serious Consequences

Known by many names in the past – such as shell shock and combat fatigue – post-traumatic stress disorder is a psychiatric condition that can occur in people who have experienced or witnessed a traumatic event.

Signs of PTSD fall into four categories and can vary in severity. They include:

  • Re-experiencing symptoms such as flashbacks or reliving the trauma over and over, bad dreams, frightening thoughts and physical symptoms like a racing heart or sweating.
  • Avoidance symptoms such as staying away from places, events or objects that are reminders of the experience and avoiding thoughts or feelings related to the traumatic event.
  • Arousal and reactivity symptoms such as being easily startled, feeling tense or on edge, difficulty sleeping and angry outbursts.
  • Cognition and mood symptoms such as trouble remembering key features of the traumatic event, negative thoughts about oneself or the world, distorted feelings like guilt or blame and loss of interest in enjoyable activities.

Typically, a significant amount of time passes before first responders seek help for themselves. However, left undiagnosed and untreated, PTSD can have serious consequences and is often linked to depression, substance abuse, memory problems and other physical and mental health conditions.

Signs that someone may need help include:

  • Increased alcohol and drug use
  • Feelings of isolation and anger
  • Absenteeism
  • Problems maintaining relationships
  • Trouble sleeping
  • Difficulty concentrating

Surrender To Win

The word surrender is generally not in the vocabulary of first responders. But seeking treatment is probably one of the only times in their lives when surrender means they’ve won.

First Responder Treatment Services at Princeton House provides inpatient, evidence-based treatment for PTSD and other trauma-related disorders in a stigma-free setting where participants feel safe to discuss their problems and share their emotions.

Treatment includes many facets such as individual and group therapy, family therapy and psychotherapy, psychotropic medication management, nutrition counseling, expressive therapies and a fitness gym.

Care is directed and provided by clinicians who have had law enforcement and first responder experience.

To ensure a smooth transition back to work or back into the community, each first responder receives a recommendation for follow-up care. The care plan may include referrals to the Bottles and Badges support group, to 12-step programs and regular communication with a department or union liaison who can provide support.

Join Us – You Are Worth It

Penn Medicine Princeton Health Community Wellness and Princeton House will host a discussion with Kyle Carpenter, the youngest living Medal of Honor recipient, on Tuesday, Oct. 15 at 7 p.m. at Princeton Medical Center, 1 Plainsboro Road, Plainsboro.

As a young Marine stationed in Afghanistan in 2010, Carpenter dove onto a live grenade to protect a fellow Marine. Amazingly, he survived the attack and recovered after a dozen surgeries over the course of three years.

Carpenter will share his inspiring message of finding purpose in life and living to one’s fullest potential during this special event.

To register for the free event or for more information visit call 888-897-8979. Attendees will receive a copy of Carpenter’s book, “You Are Worth It.”

For more information about First Responder Treatment Services at Princeton House, call 800-242-2550 or visit

Michael Bizzarro, Ph.D, L.C.S.W., B.C.D. is a board certified, licensed clinical social worker. He is the Director of Clinical Services for First Responder Treatment Services at Penn Medicine Princeton House Behavioral Health and has served in the U.S. Army and as a law enforcement officer.