A Multifaceted Approach to First Responder Health & Wellness


Miriam Childs

In public safety, the age-old adage “our people are our greatest asset” is commonplace. If we really hold this to be true, it’s important for us to consider: Are we really treating our people as though they are our greatest asset? This goes beyond good salary and benefits – it involves an integrated approach to overall health and wellness for our dedicated first responders. As Gordon Graham says, if we aren’t taking our approach to wellness seriously, “that’s a problem lying in wait.”

When first responders enter law enforcement, the fire service or EMS, they are a picture of strong, resilient, and mentally and physically healthy individuals. But, over the course of a 20- to 25-year career, these individuals experience a higher rate of heart attacks, increased instances of mental health problems and a lower life expectancy than the general population. Why is this the case? What can agency leaders and first responders do to overcome the challenges and effects of such a physically and mentally taxing career?

Experts Dr. Jon Sheinberg, Dr. Lois James and Dr. David Black answer these questions in a recent Lexipol webinar from three key perspectives: physical health, sleep health and mental health.

Physical Wellness

Hypertension, obesity, diabetes and heart attacks are frequent causes of illness and even death for law enforcement professionals and firefighters. Many of these physical wellness issues are tied to physical fitness, nutrition, stress levels and more – all of which can and should be addressed within public safety agencies. Physical wellness involves more than just tactical combat casualty care (TCCC). Effectively caring for line-of-duty injuries is crucial, but it’s not where the story of physical wellness ends.

Heart health is a critical component of physical wellness. First responders suffer from heart attacks at a younger age and higher rate than the rest of the population, but this is a detectable and treatable problem. Dr. Sheinberg suggests two cardiac tests to catch plaque build-up early:

These two tests are indicators of the presence of plaque where it is vulnerable to rupture. While both tests determine the same thing, most individuals present only one of these detectable abnormalities, so both are vital for public safety professionals. How can you get these tests done? “As patients, you have to advocate for yourselves,” Dr. Sheinberg explains. “Ask your personal physicians if they have the ability to offer this type of testing.” Most mid-size labs will be able to conduct these tests, but your doctor may not initially suggest them to you. Many times, the responsibility will fall to you to request the tests to catch potential issues early on. Dr. Sheinberg’s company, Sigma Tactical Wellness, also offers on-site testing to public safety agencies.

Sleep Hygiene

Sleep is inextricably intertwined with other aspects of wellness, including risk of disease, mental health and performance-based metrics. Often, it can seem as though sleep is a largely ignored component of first responder wellness – feeling tired is simply a “normal” part of the job. Shift work, long hours and the potential for overtime only contribute to an already exacerbated issue.

Fatigue limits cognitive capacity and negatively affects individuals’ decision-making skills. In the high-risk world of public safety, sleep deprivation creates situations that are ripe for tragedy. While it may be possible to get by on less-than-enough sleep for a short amount of time, it is not a long-term or optimal solution. With four hours of sleep, our cognitive capacity is roughly 70% of what it is when adequately rested. For many industries, this may be sufficient. “But is public safety a 70% profession?” Dr. James asks. “Is that what we expect from these people? I would argue it’s a 100% profession.”

If public safety is a 100% profession, we ought to be sleeping like it is! One way to do so is to focus on having good sleep hygiene. Dr. James explains, “Everyone needs to make the most of the sleep opportunity they have, even if the sleep opportunity is not long enough.” Sleep hygiene is the simple act of creating an optimal sleep environment to make the most of those opportunities. This includes ensuring your environment is dark, quiet and at a comfortable temperature.

Remember: Sleep affects virtually every part of your body and life. Take sleep seriously and don’t underestimate the power of good rest.

Mental Health

The people who enter public safety are some of the strongest and most resilient people in our nation. Because they are surrounded by people who are “cut from the same cloth,” this perpetuates an overflowing culture of strength. While this can be positive, it has led to a deep-seated stigma regarding mental health support. First responders overwhelmingly say they will not seek help due to fear of appearing weak, being seen as unfit for the job or retaliation.

Dr. Black explains that it’s important for first responders to realize “your resilience can kill you.” On average, law enforcement officers experience 188 critical incidents throughout the course of their career, while an average individual sees a small fraction of that. Critical incidents, by definition, overwhelm a person’s ability to cope. Because first responders are more resilient, they will continue on under the psychological pressure of coping with these incidents. As the pressure builds over time, public safety professionals experience higher rates of PTSD, depression and suicidal ideation. But this does not have to be the case.

How can leaders work to support their personnel amidst these and other mental health struggles? Providing consistent and confidential 24/7 access to high-quality resources is critical. Peer support, vetted therapists and other mental health resources, along with working to shift the culture of public safety and destigmatize seeking mental health help, can make a big difference in first responders’ wellness. “We want people getting in earlier and earlier,” Dr. Black shares. “I don’t want the nation’s heroes waiting until they’re about to break – I want them getting in as early as possible and getting help before too much suffering occurs.”

An Integrated Approach

All aspects of wellness are intertwined, making a multifaceted approach the best option for first responders to see health, happiness and success. One of the most important things that leaders in public safety can do to support the wellness of those in their agency is to provide an integrated approach that emphasizes physical wellness, mental health support and proper sleep.

To learn more about first responder health and wellness relating to physical fitness, heart health, mental health and fatigue management, view the on-demand webinar, “The Ready Responder: How Physical and Mental Wellbeing Affects Performance.”

About Miriam Childs

Miriam Childs is the marketing coordinator at Lexipol, which offers wellness solutions through Cordico.