The Call We Don't Answer

We Need to Be Better at Taking Care of Our Own

There is a phrase that gets thrown around a lot in the fire service and EMS.

"We're family."

It's a great saying. But if we're going to say it, we have to mean it.

Mental health has become one of the biggest conversations in first responder culture, and rightfully so. We spend our careers walking into situations that most people will never experience. We hold dying patients' hands. We tell parents their child is dead. We watch families lose everything in a house fire. We work cardiac arrests, suicides, fatal wrecks, abused children, overdoses, violence, and tragedy over and over again.

Then we're expected to reset, grab dinner, laugh at the kitchen table, and catch the next call.

We know that is just part of the job. After enough years, though, you realize that none of those experiences really disappear. They become part of you. Over time, they slowly occupy space in your mind. Most days you don't notice they're there. Other days, they all seem to arrive at once.

I've had my share of those days.

I've experienced the deaths of young children. I've experienced the deaths of parents before transporting the child screaming for mommy and daddy. I've lost someone in my family who meant everything to me. I've buried brothers. I've had the mother smack by back and cry out to their lifeless son while work on his bluish, limp, wet body. I've spent decades seeing trauma that most people can't imagine. None of those experiences define who I am, but every single one of them has real estate in my grey matter.

I’ve learned that with some people the worst pain is hidden. 

When I think back on the people I've known who died by suicide, very few of them were the people everyone thought were struggling. Most carried it quietly. Looking back, there were small clues, but almost never the dramatic warning signs we expect to see. That is part of what makes this a difficult issue.

The people who need help the most are often the least likely to ask for it. I know that because I've been there. When I was in some of the lowest places in my life, the last thing I wanted to do was tell someone. I didn't want to burden anyone else. I didn't want people to think I couldn't handle the job. I convinced myself I could deal with it alone. Often, hurting people begin to feel that others don’t care about them either. 

That's why I think we need to stop putting all of our hope into telling people, "Reach out if you need anything."

Support systems are incredibly important. Families matter. Friends matter. Crews matter. But a support system only works if someone is willing to use it. The people in the deepest pain often aren't.

So maybe the answer isn't waiting for someone to ask. Maybe it's building departments where checking on each other becomes as routine as checking our apparatus before shift. Maybe it's creating crews that know each other well enough to recognize when someone just isn't themselves. Maybe it's annual or semiannual conversations with a chaplain or mental health professional who understands first responder culture, not because someone is "broken," but because maintaining mental health should be treated no differently than maintaining physical health. Maybe it's simple crew check-ins after particularly difficult calls. Maybe it's supervisors who know their people beyond their certification level and badge number. Maybe it's giving one another permission to be honest without fearing judgment.

I don't know exactly what the perfect answer looks like, and I don't think anyone does. I do know that serving the public is only possible if we also serve each other. Looking after your crew shouldn't begin when someone is already in crisis. It should happen every single shift, in small ways that build trust long before anyone needs to say, "I'm not OK.”

We pride ourselves on recognizing subtle changes in our patients.

We notice skin color. We notice respiratory effort. We notice changes in speech, posture, gait, and mental status.

We should become just as good at noticing those changes in each other.

Not because we'll catch every person who is struggling. We won't. But because of every conversation, every check-in, every meal shared, every phone call after a difficult shift, and every genuine "How are you really doing?" increases the chance that someone feels less alone. And sometimes, less alone is enough to make it through one more day.

I'd like to hear from other first responders.

What does a healthy crew actually look like?

How do we intentionally build a culture where people are known, valued, and looked after before they reach a breaking point?

Because I don't think the answer is another policy.

I think it's people who decide that taking care of one another is just as much a part of the job as taking care of our patients.

Maybe it's creating new national standards that go beyond what we currently teach. We spend countless hours teaching first responders how to care for everyone else, but comparatively little time teaching leaders how to care for their people. Things like FTEP, EFOP, and other courses have laid important foundations, but perhaps it's time to expand what leadership education looks like. Not just leadership in the operational sense, but leadership in the human sense.

What if every officer was taught how to build connected crews? How to recognize changes in behavior before they become crises? How to create an environment where asking for help is seen as a sign of trust instead of weakness? What if leadership courses spent as much time discussing psychological health, purpose, and belonging as they do accountability, tactics, and policy?

I don't believe we can eliminate depression, grief, or trauma. Those are part of being human, and they are certainly part of being a first responder. But I do believe we can build organizations that help people weather those storms.

One thing I've come to believe is that purpose matters.

Feelings are temporary. They rise and fall. Some days we feel motivated, confident, and fulfilled. Other days we don't. If our reason for living depends solely on how we feel in a given moment, we're standing on unstable ground.

Purpose is different.

Purpose gives us something to move toward even when we don't feel like moving. It reminds us that people depend on us, that our work matters, that our family matters, that our crew matters, and that our life has value beyond today's emotions. It gives us an obligation to keep going. We need that. 

As leaders, maybe one of our greatest responsibilities isn't simply making better firefighters or better paramedics. Maybe it's helping build better human beings who understand that their value isn't measured by the last call they ran or the mistakes they've made, but by the impact they continue to have on the people around them.

I don't know exactly what that training should look like. Maybe it's leadership courses. Maybe it's peer support education. Maybe it's annual resilience workshops. Maybe it's mentorship programs that intentionally connect younger members with experienced ones. Maybe it's all of those things.

What I do know is this: if we're willing to invest thousands of hours training someone to save a stranger's life, we should be willing to invest time teaching our leaders how to protect the lives of the people serving beside them.

Let me know your thoughts.