Walking through the halls of the Louisville Fire Station, it’s hard to miss the red note cards pinned on the wall. They’re adorned with drawings and words of encouragement from local children hoping to put a smile on the faces of passing first responders.

“Seeing these positive affirmations, day after day, makes us feel valued, loved, and like what we’re doing is important and meaningful,” says Shawn Stark, a 53-year-old emergency medical service (EMS) captain with the Louisville Fire Protection District.  

Red note cards show thanks to the Louisville Fire Station. Credit: Sophie Crawford

That’s no small detail for emergency response workers like Stark, who dedicate their lives to a profession that can take a big toll on mental wellness. About 30% of first responders develop behavioral health conditions — including depression and post-traumatic stress disorder — due to their jobs, compared with 20% of the general population, according to the federal Substance Abuse and Mental Health Services Administration

“We’re not robots,” Stark says. “Even though we might not express or feel that emotion at the time of the emergency, it doesn’t mean it’s not there.”

In Boulder County, there’s been no shortage of devastating emergencies in recent years — the most recent, the 2021 Marshall Fire, destroyed more than a thousand homes and upended so many lives. “The Marshall Fire was a huge traumatic event for first responders,” Stark says. But “for those people that lost houses, the trauma isn’t even comparable.”

Part of the reason for the higher rates of mental distress in first responders is that second-hand trauma often experienced on the job. And some emergency response workers say the stigma surrounding mental health support, along with a lack of resources, has made matters worse. 

At the Louisville Fire Protection District, one EMS provider compared the second-hand trauma to a cabinet overstuffed with files. As responders continue to file away those feelings, it eventually gets too full and spills out.

Stark (far right) with her colleagues at the Louisville Protection Fire District. Photo courtesy of Shawn Stark

Organizations in Colorado are responding by trying to fill the gaps and normalize mental health treatment for people in the profession who carry the heavy burden of supporting those in crisis. But most experts and responders say it’s not enough. 

“I think first responders are on the cusp of having a huge mental health crisis,” says Tyler Avischious, a 37-year-old firefighter and paramedic in Arvada who helps run Revital, a nonprofit focused on first responder mental health. “Mental health in the fire service is 10 years behind where it should be.” 

The stakes are high, Avischious says. “If your parent is sick or your kid is sick, you want to know that the person showing up [to help] will perform in the best way possible,” he says. “But if they’re sleep deprived, having problems with their marriage, and their car is broken down, then they have a lot on their mind.”

Second-hand trauma can lead to harmful habits if left untreated, including sleep deprivation and substance abuse, according to Avischious. “Because we’re giving so much to other people, there’s nothing left to replenish and refuel.”

Revital takes first responders on outdoor adventures and later surveys them to find out how they’re doing in certain aspects of their life. Depending on the answers, the organization will provide them with resources to help with their struggles. The group, founded in 2020, is funded by donors including Martinez Fire Protection in Arvada, Allstate and PSTrax, a software company for first responders. Its programs are free.

“We take guys and gals from the fire service and try to get them away from the stress that they experience,” Avischious says. He believes the first step for first responders is to admit they need help and for managers to create a work environment that normalizes talking about mental health.

“Sometimes it takes someone advocating for you, to advocate for yourself,” he says. “I just don’t want people to suffer the way I did. There were times when I would come home from work and drink a couple of beers and take muscle relaxants just to sleep.” 

Revital participants on an excursion. Revital has connected dozens of people in Boulder County to mental health services, and the goal is to expand across the Front Range, Tyler Avischious, the group’s follow-up care coordinator, says. “I truly believe that Revital can change the face of mental health for first responders.” Photo courtesy of Revital

‘Until you see, absorb, and smell it, you can’t understand the job’

Cole Lathrop, a 54-year-old retired career firefighter with Mountain View Fire Rescue in Niwot, is also no stranger to the rigors and risks of working in fire stations.

He grew up around the Cherryvale Fire Department in Boulder County, where his dad was a volunteer firefighter. Lathrop started his own journey down that path when he was 16, and got his Emergency Medical Technician (EMT) two years later. He continued as a volunteer for 17 years and a paramedic in Longmont for three years, before being hired as a career firefighter at Mountain View in 1993, where he stayed for 23 years. 

Lathrop says the job has exposed him to horrors that have been hard to shake.

“At 16, I was assigned to a car accident with a group of kids that were all my age. I did CPR on one of them who died,” Lathrop says. “That right there almost pushed me out of the career.”

Cole Lathrop (center) responding to a fire. Photo courtesy of Cole Lathrop

He says the calls he received involving kids took the biggest toll over the years and still affect him today.  “It’s been over 30 years, and I can still see that kid’s face as if it’s happening right now.”

“Until you see, absorb, and smell it, you can’t understand the job,” Lathrop says. “It affects all of your senses.” 

Access to treatment is still lacking, he laments.

“There were plenty of situations throughout my career where we would see so many horrific incidents and sometimes have a debriefing with counselors, but that was very far and few.”

According to the Centers for Disease Control and Prevention (CDC), firefighters and law enforcement officers are more likely to die by suicide than in the line of duty; and EMS clinicians are more likely to take their life than members of the general public.

“It’s a huge problem,” he adds. “Suicide of first responders has not slowed down.”

Boulder Fire-Rescue chief, Michael Calderazzo, raised these concerns during a Boulder City Council meeting this month.

“Mental health is big for the [Boulder] community, but it’s also big for our own team, and making sure they’re taken care of,” he said. “It’s unfortunate that the highest cause of death among firefighters is actually self-inflicted — as opposed to the job itself.” 

There’s definitely a stigma,’ as younger responders lead charge for change

While the mental health struggles of first responders are becoming more commonly discussed in the field, a hurdle remains: The stigma surrounding the topic remains a tough one to broach for many who are suffering.  

“Mental health has only been a buzzword for about two years now,” says Nicki Coghill, executive director of Denver-based Building Warriors, a nonprofit that started in 2016 to provide mental health support for first responders, as well as peer support, education and counseling services. “There’s definitely a stigma within the first responder world.”

Before joining Building Warriors, Coghill was a first responder for three years at Timberline Fire Protection District.

Nicki Coghill receives a donation for Building Warriors in March 2022. Photo courtesy of Building Warriors

“It became very clear to me very quickly that the day-in and day-out sleep deprivation and trauma was going to really throw me over the edge,” Coghill says. “It’s not normal for a person to see death and destruction all day, every day.” She later spent several years in education and corporate wellness.

When Coghill came on board last year, the organization was having a hard time keeping up with demand. “It’s been a pretty severely underfunded and under-resourced organization,” Coghill says. “That is what I am trying to resolve, because it doesn’t need to be.”

Building Warriors, which partners with Revital, provides clinical oversight for “peer leads,” firefighters trained in helping their coworkers with their mental health. The group provides monthly courses for the leads so they know they’re supported too. 

“The support has to come from the inside as well. That’s why we focus so much on peer support,” Coghill says. “Our big goal is to normalize mental health support.” 

“It’s not normal for a person to see death and destruction all day, every day.” 

Nicki Coghill of Building warriors

Tyler Capron, 37, a peer lead and firefighter lieutenant for Boulder Fire-Rescue, helps run a weekly support group. The goal is to do emotional check-ins, provide support resources and explain how to balance “toughness” with vulnerability, he says.

“This job changes you,” Capron says. “You have to have a thicker skin, but also healthy outlets.”

According to Capron, it’s younger first responders who are pushing for a change within the culture of the profession when it comes to conversations surrounding mental health. 

Coghill agrees. 

“The younger generation has come in and said, ‘We want to take care of ourselves and we’re not going to settle for anything less.’” 

I'm a student journalist and junior at the University of Colorado Boulder studying journalism and psychology.

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1 Comment

  1. Wow this is a terrific article! This subject is very under-reported and most people are not aware of the depth of the problems. The article is based on solid research and great interviews/quotes, and the pictures are sharp and add interest. Super job, Sophie!

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