By Jasper Kenzo Sundeen
Yakima Herald-Republic
Yakima County, Wash. 鈥� TJ Martin started working as a volunteer firefighter in Ferndale in 2001. She moved to the Yakima Valley a dozen years later, where she started working as an EMT.
She spent two decades working as a first responder. Martin did it because she wanted to help people.
鈥淲e all want to help,鈥� she said, sitting in her home just outside of Zillah and looking out the window, where a group of goats and a black Lab wandered around her backyard.
Martin doesn鈥檛 work as an EMT anymore, though. She can鈥檛.
鈥淭wo calls were the beginning of the end for me,鈥� Martin said.
She remembers responding to a call in which a victim died of a gunshot wound. In the midst of the panic and anguish, the victim鈥檚 8-year-old sister tugged on Martin鈥檚 sleeve to ask what was happening.
鈥淎ll the adults had failed her. There was no one to care for her,鈥� Martin said.
She recalled responding to a juvenile detention center, where a 15-year-old just found out their father died by suicide. The teen was curled into a ball, completely wracked with pain, Martin said.
鈥淚t was watching the worst of the worst in human emotion in a 15-year-old kid,鈥� she said.
You can鈥檛 not feel that, she said. She took two weeks off to do some research about mental health and getting help.
鈥淚 worked for a number of years and then stopped,鈥� Martin said. 鈥淚 can鈥檛.鈥�
Martin is one of hundreds of first responders in the Yakima Valley and across the country who experience challenges with mental health and post-traumatic stress disorder (PTSD).
Paramedics, EMTs, firefighters, coroners, law enforcement officers and other first responders often interact with people in their worst moments and deal with stress from those situations.
The discussion has taken on heightened interest in Yakima County lately. Yakima County Coroner Jim Curtice has been on leave and is facing criminal charges and a possible recall over allegations of substance abuse at work this fall. PTSD was cited as a factor in the incident, along with a previous incident in 2023.
鈥榃e burn out quickly鈥�
Pyper Thaller, a licensed mental health counselor who specializes in treating first responders and substance abuse issues in Washington, Oregon and Alaska, said first responders witness terrible accidents and 鈥渢he most horrific things that humanity can do to ourselves and each other on a daily basis.鈥�
鈥淲hen something like that happens in your own life, you don鈥檛 forget it,鈥� Thaller said. 鈥淲hen it happens repeatedly day in and day out for officers every day of the week, how do you forget it and how do you make sense of it in a way that helps you to be able to move forward and live a healthy life?鈥�
If stress and trauma aren鈥檛 dealt with, they can have devastating consequences for people, Thaller said.
鈥淲e burn out quickly in this field. The average shelf life of first responders in general that are involved in trauma exposure is five years or less,鈥� Thaller said. 鈥淔or a lot of folks, there is a shorter shelf than that, and it鈥檚 because the work is so difficult. And if we don鈥檛 get a handle on that trauma and stress, we can burn out and we lose so many valuable, beautiful people.鈥�
A 2022 study from the National Institute of Health estimated that 10% of first responders report post-traumatic stress disorder. First responders鈥� symptoms can be different from civilians, the study adds.
First responders reported greater rates of diminished interest, emotional numbing and social detachment, and less psychological reactivity and avoidance of situations than civilians with PTSD, reads a summary of the results. They also reported more severe levels of depression and suppressed anger.
Those issues can have tragic results.
Thaller said some people end up with substance abuse issues as they try to cope with trauma.
In 2021, the Center for Disease Control published a call to action noting increased rates of suicide among first responders compared with the general population.
鈥淟aw enforcement officers and firefighters are more likely to die by suicide than in the line of duty,鈥� the article noted.
That鈥檚 why access to resources and help is important, Martin said, and it鈥檚 why she shares her story and advocates for change.
She鈥檚 not the only one. Quality mental health resources and support for first responders can be difficult to find in Central Washington, but local firefighters and law enforcement agencies are taking steps to make first responders healthier.
Ending the stigma
Yakima County Sheriff鈥檚 Office Sgts. Derrick Perez and Caleb Johnson have spent a lot of time thinking about how to get law enforcement personnel mental health resources. They organize the peer support program at the Sheriff鈥檚 Office.
It鈥檚 about shifting culture, Perez said. One of the greatest challenges among first responders is the cultural stigma around seeking help.
鈥淚t would cause such a problem because you鈥檙e worried about what your peers think,鈥� Perez said.
Johnson said the stigma around discussing mental health can keep officers from talking to each other or their own families.
Police officers and other law enforcement officers see grisly details of investigations and are often tasked with being involved in dangerous, stressful situations. But there鈥檚 a culture of keeping struggles to yourself, Perez said.
That鈥檚 not healthy, Perez and Johnson said. It鈥檚 not good for first responders鈥� mental health, and by extension their personal relationships and quality of work.
鈥淲hat good are they at the next incident if their head is in the last one?鈥� Johnson asked.
Perez said part of his and Johnson鈥檚 goal is to shift the mentality between generations and get younger officers on board with better mental health care early on.
鈥淚 can do the job, be good at it, be safe at it and enjoy my home life and be a good dad,鈥� Johnson said.
It鈥檚 a problem that other first responders deal with, not just law enforcement.
Ken Shipman, the chief of Yakima County Fire District 5 in the Lower Yakima Valley, said firefighters often kept things to themselves, and it was a sign of being tough.
鈥淏ut the reality is that (mental health challenges) were still happening, just behind closed doors,鈥� he said.
Shipman also is hoping to change the experiences for new recruits from the start through cultural shifts and training to reinforce the importance of mental health. There鈥檚 still a long way to go, he said.
Martin said that initial skepticism made it hard for her to step back and seek help. It鈥檚 something she still thinks about. Martin has to work not to feel guilty for stepping back.
鈥淓ven today, I have to remember it鈥檚 not an embarrassing thing,鈥� she said.
First responders want to help people and be strong for the community around them, said one of Martin鈥檚 former coworkers, retired EMT Darren King.
鈥淚t鈥檚 people鈥檚 lives out there. You feel an obligation to keep going,鈥� King said.
King found himself thinking that if he stopped, a shift could be shorthanded or an ambulance could stop running, he said. He did not want to put more work on his colleagues or take resources away from the community he wanted to help, but there is a time when first responders need to take care of themselves.
鈥淭here鈥檚 a fine line between patching up a person to get back in the game and doing what鈥檚 right for that person,鈥� King said. 鈥淵ou can only be a tough guy up to a point.鈥�
Getting help helps
Taking that first step to get help is critical. Perez and Johnson said building a culture in which people feel comfortable sharing their emotions and their needs is important.
Better support for employees in any industry results in better work, Perez said, and law enforcement is no different. He added that the Sheriff鈥檚 Office tries to implement peer-support practices within three days of an incident.
鈥淲hen we get these events and these things that happen, we want to get in there,鈥� he said.
Processing typically involves inviting personnel together to talk about and, sometimes, cry about incidents. Perez and Johnson said that gives people a better understanding of what happened and how what they experience fits into the larger picture.
Those meetings, called critical incident stress management (CISM), are common among first responder groups.
Paul Nagle-McNaughton, senior director at Comprehensive Healthcare, said in a 2023 interview with the Herald-Republic that Comprehensive helps conduct critical incident stress debriefings after traumatic incidents for first responders.
He said it is expected that those who have to deal with a critical incident, such as when a semi crossed into oncoming traffic and killed people in a car, will have a stress response, such as aches, headaches, loss of appetite and numbed thought processes, and being able to have a debriefing about the event is helpful.
鈥淗aving an abnormal response to an abnormal situation is normal,鈥� Nagle-McNaughton said.
The debriefing is a chance for those involved to talk through the incident, with the participants sharing what they saw and how they are doing.
How those meetings are run is critical. Martin and King said it can be difficult to be frank when there are a lot of other first responders in the room.
The Sheriff鈥檚 Office is working to create a culture in which there is more emotional vulnerability and connection.
Johnson said communication, critical thinking and empathy skills they learn when working on mental health can also make officers better at their job.
When dealing with incidents in their day-to-day work, officers can be more empathetic and solution-oriented, Johnson said.
Perez said he now pays attention to the traumas of individuals he interacts with and tries to be a better listener and relationship builder when working in the community.
Shipman said he鈥檚 put a lot of effort into creating that kind of culture at Fire District 5 to better serve firefighters, ambulance personnel and 911 dispatchers.
鈥淢y goal is to never lose anyone to PTSD,鈥� he said. 鈥淔irefighter suicide is at an all-time high and there鈥檚 so much we can do to prevent that.鈥�
After a difficult call, personnel will come together to discuss it.
鈥淓verybody gets a chance to speak and to understand what the roles of all the other first responders were,鈥� he said.
At those meetings, firefighters go off service, turn off their phones and take a break to focus on mental health.
鈥淲e isolate them so they can turn all the outside noise off,鈥� Shipman said.
Fire District 5 coordinates with other local departments to provide coverage while personnel are in the meetings. In turn, Fire District 5 covers for those other departments when they need it.
Going a step further
Some people need more than a CISM meeting. Fire District 5 and the Sheriff鈥檚 Office both have policies to get their personnel the help they need.
Shipman said Fire District 5 has a mental health professional on standby 24 hours a day for one-on-one support. There is also a chaplain for religious assistance for fire district personnel and community members.
鈥淲e have a lot of different layers of support that are available,鈥� Shipman said.
Thaller said that first responders can get stuck in fight-or-flight mode. It鈥檚 a natural response to trauma, she said, but if you get stuck there, it can be detrimental.
Thaller used an example of a bear approaching a campsite.
鈥淲e talk a lot about how anytime we go through too much fight-or-flight response, we all have maladaptive ways of coping,鈥� she said. 鈥淭hat part of our fight-or-flight brain doesn鈥檛 timestamp. So it doesn鈥檛 hear about consequences because it just says, 鈥極h my gosh, there鈥檚 a bear coming to our campground. Who cares what we鈥檙e going to eat for dinner tomorrow? We鈥檙e going to die today.鈥欌��
Your brain responds immediately, Thaller said, and that response can continue anytime you see that trigger, even if it鈥檚 on a computer or on television.
鈥淵our brain at fight or flight goes, 鈥極h, there鈥檚 a bear. They鈥檙e always bad. They鈥檙e always scary. Always hurt us. Watch out for that bear,鈥� 鈥� she said. 鈥淪o we have a false sense of not being safe in the world, but it鈥檚 our primitive brain trying to keep us safe in the world. We short circuit ourselves.鈥�
King said that, for first responders, that can be particularly difficult because they live in the community they work in.
鈥淎s I鈥檓 headed to work, I鈥檓 passing houses, intersections, mileposts where things have happened. I do that twice a day,鈥� he said.
鈥淵ou鈥檙e not removed from the scenes, the memories,鈥� he continued. 鈥淚t can be exhausting, depressing. It drains you. It really drains you. What you鈥檙e left with is anger, resentment, a lot of ugly feelings. That鈥檚 what your family gets to deal with.鈥�
Thaller works with mindfulness-based cognitive therapy and evidence-based practices like eye movement desensitization and reprocessing (EMDR) to get out of that fight-or-flight mode.
She wants to give the people she works with the tools to work through that in their daily lives.
鈥淚t gives you breathing space around some of the triggers or trauma activation that can occur 鈥� when we see or experience something that reminds us of a trauma that we鈥檝e been through in the past 鈥� and that gives people room to breathe,鈥� Thaller said.
In cases where intensive treatment is required, first responders are increasingly utilizing services like Deer Hollow, a mental health treatment center in Draper, Utah . Martin attended the facility and said it helped her.
It鈥檚 become a frequent destination for Washington first responders who need that mental health treatment.
Perez said he eventually sought treatment after a fellow officer was shot. His colleagues encouraged him to go to Deer Hollow.
It made an enormous difference, he said, but it wasn鈥檛 easy. There is almost no communication with the outside world, and Perez said he spent 12 hours a day going through counseling work.
鈥淵ou will cram in two and a half years of counseling into 35 days,鈥� he said. 鈥淗ands down, it is the hardest thing I鈥檝e ever done.鈥�
Perez said he tries to encourage officers to go to treatment when they need to. In urgent cases, officers can leave to get treatment within 24 hours.
A lack of resources
It can be difficult to find trained mental health professionals locally. That鈥檚 true for most people who want some form of therapy or counseling, and first responders often need mental health professionals with a deeper understanding of their work.
鈥淚t is very difficult to find that mental health professional in Yakima County ,鈥� Shipman said.
Finding someone with those qualifications who also has availability and fits health care plans is incredibly hard.
鈥淭hey tend to be booked up for a very long time,鈥� Shipman said.
It鈥檚 part of the reason Fire District 5 has contracted with an in-house mental health professional.
Thaller acknowledged that challenge. She noticed that some of her clients were driving up to four hours to see her for one-hour appointments.
She moved much of her practice online to help people better access care.
Martin said having someone who knows about symptoms, can recognize them and organize help is important. Professionals who are accessible, can make resources accessible and help people quietly but safely get help would make a difference, Martin said.
鈥淲hat is needed, in my opinion, is peer-to-peer support,鈥� Martin said. 鈥淲e need someone at every station, at every shift, who is trained to look out for this stuff.鈥�
This could be former first responders who have the experience that allows them to relate to their peers. Martin said training and schooling could improve that.
Martin also noted that treatment centers where people can go are few and far between. One of the reasons so many Washington first responders go to Utah for treatment is that the same resources do not exist locally.
Martin said less travel would make treatment more accessible. However, other first responders said the isolating effect of being several states away was helpful.
Other positions
Not all first responders have the same access to mental health resources and services.
Martin said EMTs who work for private ambulance services can have less support through insurance than firefighters or police officers in government positions.
Social workers, attorneys, coroners and judges also deal with parts of the criminal justice system, where they must handle stressful or traumatic cases.
They are not immune to PTSD, said Washington Association of Coroners and Medical Examiners President Hayley Thompson .
鈥淚t is more common than you would think,鈥� said Thompson, who is also the Skagit County coroner.
While paramedics and emergency medical technicians deal with a case for a day, coroners may be working on the case until an investigation is closed, Thompson said, a process that could go on for months, or even years.
While there are programs to help police, firefighters, medics and other first responders with PTSD, there鈥檚 no formal programs to help coroners cope with their traumatic responses.
鈥淲e are not recognized as a first responder,鈥� Thompson said. 鈥淲e are dealing with the same things other first responders do.鈥�
Last year, the coroner鈥檚 association worked with the Legislature to include coroners in a bill on first responders and PTSD, but lawmakers wanted to look at the program before adding coroners to the list. It is something Thompson plans to take up in the 2025 session.
Thompson believes there are forensic investigators who have left their jobs because of the stress.
A decade ago, Thompson said, the attitude among coroners and medical examiners was to suck it up and keep going. Now, she said, some coroners鈥� offices are employing therapy animals and other techniques.
Seeing the way forward
There is near-universal acknowledgement that barriers to mental health treatment remain for first responders. Shipman, Perez, Johnson and Martin all noted that in interviews for this story.
鈥淭his goes beyond 鈥楬ow can YSO change,鈥欌�� Johnson said. 鈥淭his goes into the community.鈥�
鈥淗opefully, today we鈥檙e taking big steps instead of little steps,鈥� Shipman said.
First responders are asking for community understanding while they invest in solutions. Creating better mental health outcomes for first responders can better their life expectancies, career length and quality of work, said Johnson and Perez.
The Sheriff鈥檚 Office received a grant this year for officer wellness and is using it to gather data on what support services are most helpful. They鈥檙e open to having conversations with community members about that, Perez said.
He added that when they鈥檙e asking for changes, there鈥檚 a reason for them. Some of those changes, like adding wellness rooms or gym equipment, can seem frivolous, but they are proven ways of dealing with stress. Perez noted strategies like cold plunges, red light therapy and saunas can all help a person level out and process stress.
鈥淛ust those little things like that, it鈥檚 going to help with longevity, with retention, with team building,鈥� Perez said.
There are other resources out there for first responders. Martin noted the Code Green Campaign, a nationwide nonprofit that started in Spokane and has a crisis helpline and resource guides for first responders who need aid.
鈥淎t the end of the day, the coolest part is there is help,鈥� Martin said. 鈥淭here鈥檚 hope at the end. I鈥檓 still here, my husband is here.鈥�
Martin is happy and hopeful. She loves herself, but it鈥檚 taken hard work to get there.
Martin reached for a small sculpture on a side table. It鈥檚 a funny little thing she bought online, she said, and it matches nothing in her house.
It鈥檚 a dinosaur swarmed with a load of ridiculous, pointed-hat-wearing gnomes. The dinosaur has a brightly dressed one in its mouth. The other gnomes clamber over its body. This is one of the ways Martin thinks about her trauma.
鈥淭hat鈥檚 kind of how you live with PTSD. You鈥檙e in this chaos that didn鈥檛 really need to be here,鈥� she said. 鈥淚t鈥檚 a poignant reminder that I don鈥檛 need to fight off the gnomes. You really don鈥檛 need to.鈥�
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