The nature of the work that EMS clinicians do—regularly facing high-stress, life-and-death situations, witnessing trauma, and working long, irregular hours—significantly contributes to mental health challenges such as anxiety, depression, and PTSD. The cumulative impact of these stressors also makes them more susceptible to burnout and increases the risk of suicide compared to the general population.
There is help!
Efforts to address these issues include promoting mental health awareness, providing access to counseling and peer support programs, and implementing organizational changes to reduce burnout.
EMS Provider Health and Wellness
“It’s okay, to not be okay….”
Emergency medical services (EMS) workers face significant mental, physical, and emotional stress with every shift. This demanding profession is associated with high levels of stress, an increased risk of post-traumatic stress disorder (PTSD), and a high incidence of work-related injuries. These challenges contribute to elevated rates of suicide, burnout, clinical depression, and physical health issues that may eventually prevent EMS personnel from continuing fieldwork. Maintaining personal health and overall wellness—physical, emotional, and mental—is essential for sustaining long-term careers in EMS.
EMS providers are highly trained medical professionals who support or operate as extensions of physicians, primarily in pre-hospital settings. The modern EMS system was established following the National Research Council’s 1966 White Paper, Accidental Death and Disability: The Neglected Disease of Modern Society. This report revealed high accidental death rates in the United States and emphasized the need for national, standardized, and advanced medical training, leading to the development of the National Standard Paramedic Curriculum.
According to the U.S. Department of Labor’s Bureau of Labor Statistics, there were approximately 241,200 paramedic positions in 2014, with an anticipated job growth rate of 24% over the next eight years. Since its inception, EMS professionals have been recognized for their capability to assist patients in extreme situations, whether on busy highways in scorching heat, in remote farmlands during freezing temperatures, or in high-crime urban areas.
The demanding environments, combined with high patient acuity and the adrenaline rush experienced while responding to emergencies with lights and sirens, have contributed to the perception of EMS workers as “adrenaline junkies.” These job characteristics often attract individuals with specific personality traits. Dr. Jeffery Mitchell identified common traits among emergency personnel, including a need for control, obsessive-compulsive tendencies, high internal motivation, action-oriented behavior, a need for stimulation and immediate gratification, susceptibility to boredom, risk-taking, a “rescue personality,” strong dedication, and a deep need to feel needed. These traits often drive EMS providers to continue working despite personal risk or harm.
In addition to the psychological and emotional demands, EMS work is physically taxing. It is not uncommon for providers to be awakened suddenly and required to lift or move a 300-pound (136 kg) patient within minutes, without adequate time for stretching or warming up. Historically, many EMS agencies scheduled employees for 24-hour shifts, which, combined with low wages and the necessity of working multiple jobs, has led to significant sleep debt. Sleep debt is the gap between the amount of sleep an individual gets and the amount needed to avoid severe fatigue. More than half of EMS workers report insufficient sleep, poor sleep quality, and inadequate recovery between shifts.
Addressing these challenges requires a comprehensive approach to health and wellness, focusing on mental health support, physical fitness, and adequate rest to ensure EMS workers can safely and effectively perform their critical roles.
Stitches of My Heart 