Contributed by MnFIRE Medical Director Dr. Zeke McKinney, MD, MHI, MPH, FACOEM
The job of a firefighter means helping people, including during times that are traumatic and devastating for everyone on the scene. Firefighters can experience – through all of their senses – dangerous, deadly, scary and extreme cases of human suffering that can stay with them long after the call is complete. Over time, it can become impossible to ignore these feelings and the repercussions. There are countless stories of firefighters mentally or emotionally struggling in their day to day or while on duty – and it isn’t their fault.
It’s a proven fact that ongoing exposure to trauma can lead to developing post-traumatic stress disorder (PTSD), also known as post-traumatic stress injury (PTSI). There is a movement to use the term PTSI instead of PTSD, to better emphasize the condition as a recoverable “injury” as opposed to a chronic disorder.
The International Association of Firefighters (IAFF) indicates that around 20% of firefighters will experience a post-traumatic stress injury during their careers, compared to the general population’s 6.8% risk. It’s less well-known that people can experience short-term stress after trauma, and mental health can return to its baseline or even to a higher level of resilience. This is called “post-traumatic growth.”
When your mind and body don’t process trauma effectively and you don’t return to the same level of mental health after one month, that is PTSI. This is not a sign of weakness or wrongdoing. It’s a reaction by your body, just like if someone broke their arm from falling or had a heart attack.
PTSI can sometimes be difficult to identify. Even though a person may not have experienced any physical trauma, it can cause physical symptoms such as abnormal heartbeats, chest pain and dizziness, as well as psychological symptoms such as flashbacks, nightmares, sleep problems, anxiety, being on guard or easily startled, among many other symptoms. Health professionals are still learning about PTSI, including the differences between how to understand, diagnose and treat PTSI after a single traumatic event versus when someone consistently experiences traumatic events.
Fortunately, there are ways to treat PTSI. The most effective treatments for PTSI include a combination of talk-based therapy, medication and other specialized approaches such as eye-movement desensitization and reprocessing (EMDR) or accelerated resolution therapy (ART). For firefighters, one of the most effective tools is consistently checking in and debriefing about traumatic events after they happen.
For career firefighters with an official PTSD or PTSI diagnosis, it is possible to receive workers’ compensation from the state of Minnesota. Even though the workers’ compensation system is not perfect, Minnesota is working to improve how PTSI is addressed, and the Department of Labor and Industry recently produced a report for the state about how to best ensure workers can get the help they need.
It can be challenging to start a workers’ compensation claim, but MnFIRE provides many no-cost resources for firefighters that are easy to access, including therapy sessions and a Critical Illness insurance policy, which covers a PTSD/PTSI diagnosis. Those who receive a qualifying diagnosis are eligible to receive a cash payment to help manage expenses your health insurance might not cover. You can call our helpline anytime at 888-784-6634 to get connected with these resources or visit the Hometown Heroes Assistance Program page for more information.
