Behind the uniform: first responder mental health challenges - Salish Current
December 5, 2023
Behind the uniform: first responder mental health challenges
Aria Nguyen

Doug and Karen Monda (center) stand with the other Survive First board of directors members at the 2023 FBI National Academy Associates conference in Denver last summer. Monda wears a shirt reminding people to remove the stigma from discussions of first responder’s mental health. (Photo courtesy of Karen Monda)

December 5, 2023
Behind the uniform: first responder mental health challenges
Aria Nguyen


Content warning: Explicit language, discussions of death and suicide.

Doug Monda sat on his couch. For the first time during his career in the military and law enforcement, he could reflect on everything leading up to the very moment that changed his life. 

“I had all day long to think about all the horrible shit that I saw in my career,” he said. “And it started messing with my emotions.”

Monda is a retired narcotics agent who joined law enforcement after realizing he would not be a professional athlete. His father was a colonel in the military for 30 years, and his whole family came from a military background. 

“I always wanted to be a SWAT [Special Weapons and Tactics] guy,” he said. “And my parents knew that because when I was a little kid, in the ’70s, there was a show called ‘S.W.A.T.’ I absolutely worshiped it, and I always wanted to be on the SWAT team.”

Monda was recruited in the police academy for a SWAT team where he became a sniper. He was recruited again to go through the Marine Corps Scout Sniper Program by Blackwater, a Department of Defense military contractor. For 20 years, he worked undercover as a narcotics agent. 

One day a call came through.  A reckless driver was aiming at women and children in a residential neighborhood. This was not a typical call for Monda, but he responded and arrived on scene. 

Monda was struck by the vehicle.

“He hit me with the truck. His truck, the cop car and me [were rammed] into an oak tree. When I hit the oak tree, I sustained a severe brain injury, a traumatic brain injury, and I broke my back. I had a bone fragment go into my spinal cord,” Monda said. 

Three days after the accident Monda woke up in a wheelchair and with a walker beside him. His whole life had changed. He was about to lose his job and his physical health, and was getting divorced after 17 years of marriage. Being alone with the emotional and physical pain was too much for Monda to bear.

“My whole life has just disappeared in front of me,” he said.

He attempted to take his life, but the gun did not fire.

“One in a million times, it doesn’t work — and fortunately for me, that day it didn’t work,” Monda said.  

Not the only one

Monda was not alone in his experience. 

The Centers for Disease Control and Prevention (CDC) report that first responders are more likely to die by suicide than in the line of duty.

First responders have an elevated risk for mental health challenges due to the nature of their jobs, which involve repeated exposure to stressful situations and traumatic events or incidents. 

Kira Mauseth at Seattle University is a clinical psychologist specializing in behavioral health and preparation response and recovery from small- to large-scale critical incidents, emergencies and disasters.

Mauseth said the Western perspective of trauma is often event- or incident-based, referring to individual experience of events. The definition, she said, is growing and expanding to include factors such as intergenerational and epigenetic — responses to experience that affect genetically related behavior — stressors that can still influence behavior, emotion and cognition. 

Mauseth said data show that people who do emergency work generally have a higher baseline resilience than the general population. But there is another side of the coin.

“If you’re in that role, you are much more frequently exposed than a member of the general population to highly traumatic and sometimes very horrific kinds of events,” she said. “What you end up with in the long run is still higher rates of PTSD [post-traumatic stress disorder], higher rates of risk of suicide.” 

Repeated exposure to traumatic events and incidents can contribute to the development of mental health trauma for first responders. The trauma is coupled with stigmas and cultural issues around talking about these experiences. 

The stigma of ‘weakness’

“The perception of weakness is the biggest stigma associated with mental health and illness for people who are in the job of ‘rescuing others,”’ Mauseth said.

That was the case for Monda. 

“I thought if I told anybody I was struggling, that they would take my job and my life,” he said. “They would take everything from me, and I would be considered a weak person.”

Michelle Doran, What-COMM 911 dispatch supervisor, echoed this same concern.

“We take a psychological evaluation to be hired and it can disqualify people from being hired,” she said. “So I do think that there’s a concern that people will be found unfit for duty.”

Alysn Everbeck, deputy director of What-COMM 911, said the people who do this work feel like they have to be “badasses.”

“And they are,” Everbeck said. “It’s not something that everybody can do, and admitting that you’re struggling or that you need help, it’s really hard for people who have to be strong and decisive all day long. But it doesn’t mean they’re weak, broken, or not cut out for the work.”

First to respond, first to be forgotten

Despite being the first to receive and respond to emergency calls, 911 dispatchers like Doran and her coworkers often go unnoticed.

“We’re invisible,” Doran said. “You don’t see us on the scene of crimes so you don’t really know what we’re exposed to.”

Washington state passed a law in 2022 acknowledging telecommunicators as first responders. Doran said prior to this change, historically dispatching was considered a clerical position. “I think when you think of someone as a clerk, you’re not necessarily thinking of them experiencing trauma,” she said. 

2013 study of telecommunicators showed that repeated calls received by dispatchers can produce feelings of intense fear, hopelessness or horror. 

“Routine calls,” according to Doran, include traffic calls with minor or no injuries. Even domestic calls can be routine when the situation is calm, but outside mediation may be needed to prevent escalation.

The severity of calls — the very nature of them — can change at any moment. “It’s everything from ‘my neighbors put their garbage out too early,’ cars illegally parked, or people take calls when people end their lives on the phone with them, and everything in between,” she said.

“We’ve had calls that impact the whole community.  We had an incident in North Bellingham where multiple students were hit by a car. It was traumatic for everyone, the community, the call takers,” she said.  “That was a call that was at the front of my mind for a while.”

Another of Doran’s memorable calls was being on the line with someone experiencing abuse. Telecommunicators or dispatchers must stay on the line to get the information they need to aid those in danger — sitting, listening and finding the appropriate means to react and respond. Eight to 12 hours a day, they hear people on the worst days of their lives.

Despite the impacts to mental health, Doran said the work dispatchers do as highly trained professionals is important — lives are saved.

Being the change

In the moments leading up to his suicide attempt, Monda believed he was alone, unable to serve, unable to take care of his five kids. But things changed. 

With extensive physical and mental care, he was able to return to work after a year and a half of rehabilitation. Since 2011 he has been in the rehabilitation state of his recovery but for the most part is back to normal functioning such as running, swimming and more. 

“My chief and my partner, they believed in me,” Monda said. “My agency didn’t turn their back on me, and they got me help. They got me such good help that I was able to return to work and when I went back to work, I realized that the system was broken for law enforcement.”

Taking a good look around on his first day back, Monda realized that many people he knew were suffering in silence.

“I’m not the only one struggling, all my brothers are struggling,” he said. “ I had 13 guys on my team who were all involved in the same things I was involved in, and I could see the pain in their eyes.”

In 2018, Monda, with a police chief and mentor, started Survive First, an organization dedicated to reducing first responder suicide by eliminating the stigma associated with seeking mental health and bringing  support and awareness to the mental health challenges first responders may face. 

Doran said she was 10 years into her career before someone offered time away from her desk after a bad call. She said now the work environment and discussions of mental health in the call center are changing. 

Enough people have started in the field who wanted to work in something other than an environment where support was not offered, Doran said. Now, more people are open to discussing difficult calls and mental health. There is also a celebration committee and fundraising for families going through a tragedy. Peer support and the culture are changing, she said.  

Resources and treatment 

In addition to national groups such as Survive First, Everbeck said there are resources for first responders who are experiencing difficulties. Through the City of Bellingham, there is an Employee Assistance Program, and employee medical benefits allow dispatchers to access counseling services outside of the job. A peer support program is also offered through the Bellingham Police Department. 

Kristen Lindgren, professor at the University of Washington School of Medicine in the Department of Psychiatry and Behavioral Sciences and clinical psychologist by training, said there are top-of-the-line treatments available. 

Lindgren said the International Society for Traumatic Stress Studies can offer detailed information about treatments available. 

“There’s a notion that’s out there that once you’ve got PTSD, you always have PTSD or are broken for life on that end,” she said. “What we’re seeing from the standpoint of treatment and treatment research is that people really can recover and return to functioning.”

Doran said she worries about her coworkers who have worked hard for 20 to 25 years in the industry.

“I just think that they deserve more at the end of their career than heart health issues and suicides,” she said. “We owe first responders the chance to have a life after this work.”

— Reported by Aria Nguyen


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