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Mental illness treatment: Hope for EMS providers

Here are some things to consider about getting past the stigma of mental illness and seeking help


Persistent anxiety and depression should not be accepted as normal feelings, and seeking treatment is nothing to be ashamed of.


By Bob Sullivan and Shauna Sullivan

As part of The Code Green Campaign’s mission of raising awareness about mental health issues among first responders and eliminating the stigma about mental health treatment, their website includes hundreds of anonymous stories from first responders who share about suffering with symptoms of mental illness. Authors of many submissions describe:

  • Persistent feelings of sadness, anxiety, anger and hopelessness
  • Frequent nightmares and rumination about traumatic incidents
  • Problems with finances and relationships
  • Use of alcohol and drugs to mask symptoms
  • Thoughts about suicide
  • Hiding their thoughts and feelings from co-workers and family members

Feelings of hope, happiness and renewed passion for EMS after seeking help is another common trait of submissions. The opportunity for hope and healing is the top message for anyone reading the stories.

You are not alone if you experience these symptoms

A 2015 report published by the Fitch & Associates Ambulance Service Manager Program begins to shed light on just how prevalent critical stress and thoughts of suicide are in EMS. In a survey of over 4,000 EMS providers who self-selected to participate in the survey, 85 percent reported experiencing stress significant enough to cause a strong emotional impact. Additionally, 37 percent reported having suicidal thoughts and 5 percent reported having attempted suicide [1]. These numbers should set off alarm bells at every EMS service, and prompt a call to action for better access to mental health services.

Toxic workplace can be toxic for your mental health

Many EMS organizations have, often unintentionally, created an environment that sets us up for failure when it comes to mental health. Exposure to trauma, shift work, sleep deprivation and irregular incomes all expose EMS providers to both acute and cumulative traumatic stress, the effects of which can build up and worsen over time. The unofficial message at many services is suck it up or find a new job. Then we label and joke about our patients with psychiatric symptoms, are intoxicated or have attempted suicide. If we ask for help, we become one of them; as a result, many EMS providers continue to suffer with symptoms in silence.

Compare how we view mental illness to other medical conditions. There is no stigma about seeking medical care for acute physical pain and there is no fear of job loss if diagnosed with diabetes. We cheer co-workers on as they recover from cancer and no one considers migraine medication a crutch for a character flaw. Moreover, we don’t joke about patients with these conditions.

Workplace culture has a significant impact on our mental health. A 2016 NAEMT survey reported that stigma and fear of reprimand were barriers to seeking help for mental health problems and that only half of respondents reported that they felt comfortable sharing about mental health issues with a co-worker [2].

The Fitch report found that the rate of suicidal thoughts and attempts were more prevalent among survey respondents who work in a culture unsupportive of mental health. Respondents working in unsupportive environments were also less likely to seek help for critical stress and those who did were less likely to find help beneficial. On the other hand, survey respondents from environments they described as supportive were more likely to seek help for critical stress and were more satisfied with the help they received [1].

There is hope with mental health treatment, but it can take time

Persistent anxiety and depression should not be accepted as normal feelings, and seeking treatment is nothing to be ashamed of. Any concerns about your mental health deserve prompt attention. You may be suffering from a mental illness or short-term stress that impacts your daily functioning and happiness. Either way, mental and physical symptoms demand that we seek quality treatment and be active participants in our well-being.

Mental health treatment may include talk therapy from a counselor, medications from a prescriber or a combination of both. Additionally, treatment can include outpatient, intensive outpatient or inpatient care, depending on your diagnosis and severity of symptoms. There are numerous medications and talk therapy approaches available to treat mental health diagnoses.

Unfortunately, it may take time to find the best treatment regimen, which may mean seeing more than one therapist or physician until you find the best fit. Be an advocate for yourself and be honest with your providers. It is important to be clear about what you feel is unusual for you or what you want to change. Before deciding that all mental health treatment does not work, consider that only this therapy approach or this medication may not, and keep looking for a treatment or practitioner that is effective. While there is no cure for mental illness, they are treatable, and people are able to live full and happier lives once the right combination of treatment is found.

Please don’t die

Thom Dick wrote these words in his book “People Care,” which he offers as advice to say to patients who are suicidal. Please heed his advice if you are having thoughts about hurting yourself and reach out for help.

If you believe you are suffering with a mental illness, please do not let the stigma stop you from asking for help. There is effective treatment available and there is hope after finding it.

About the authors
Shauna Sullivan, LCSW, LLC, is a licensed clinical social worker providing therapy to individuals and families. She has special interest in eradicating stigma and advocating for those affected by mental illness. Shauna owns a private practice in Wilmington, Del., and can be reached at her blog, Take on Mental Health.

Bob Sullivan, MS, NRP, is a paramedic instructor at Delaware Technical Community College. He has been in EMS since 1999 and has worked as a paramedic in private, fire-based, volunteer and municipal EMS services. Contact Bob at his blog,

1. Abbott C, Barber E, Burke B, Harvey J, Newland C, Rose M, Young A. (2015 April 21) What’s killing our medics? Ambulance Service Manager Program. Reviving Responders.

2. 2016 NAEMT National Survey on Mental Health Services, retrieved from:

Bob Sullivan, MS, NRP, is a paramedic instructor at Delaware Technical Community College and works as a field provider in the Wilmington, Del. area. He has been in EMS since 1999, and has worked as a paramedic in private, fire-based, volunteer and municipal EMS services. Contact Bob at his blog, EMS Theory to Practice.