Letter advocating for a member of the House to support mental health stipends for some first responder professions

 19th March 2025

Nikki Budzinki

113 South 4th Street

Springfield, IL 62701

Dear Nikki Budzinki,

I am a full time social work student at the University of Illinois in Springfield. I have also been a Certified Nursing Assistant for ten years. As such, I know that taking care of other people, especially in understaffed conditions, can be extremely stressful and lead to burnout, causing people to leave the profession. Mental health services need to be included as a stipend upon the enactment of the hiring process for workers that deal with traumatic events on a regular basis, these include firefighters, paramedics, police officers, and other first responders.

Emergency first responders deal with critical situations on a daily basis and this affects not only their mental wellness, but also their relationships with coworkers and family, as well as their productivity in the workplace setting. Communication efforts take a backseat as details get lost in translation. The need for privacy and confidentiality regarding the nature of their work and the clients they face ensure that certain topics causing secondary trauma remain unspoken about. The lack of recognition, understaffing, long hours and low pay among these professions can lead to resentment and cause people to want to leave the field. Personally, I know of at least ten people that have left the medical field for all of these conditions combined, and even more that want to but won’t because they know that they are making a slight difference. 

One of the major problems that we see today is burnout, which is caused by long-term exposures to uncontrolled demanding work situations. Burnout is multi-faceted and is characterized by emotional exhaustion, depersonalization, and cynicism (ten Brummelhuis et al., 2011). When workers are over-exerted, they tend to forgo important safety measures put in place to protect not only them but their clients and communities. Burnout has been linked to error, fatigue, cognitive weariness, reduced safety performance, and injury (Smith, DeJoy, Dyal, & Huang, 2019). Additionally, burnout has been linked to safety behavior deviations and violations such as personal protective equipment compliance, adherence to safe work practices, and safety reporting and communication (Smith, Hughes, DeJoy, & Dyal, 2018). In order to combat burnout, employers need to meet their workers halfway. New policies need to be implemented to promote mental wellness in the workplace. By implementing wellness stipends to these more stressful workforces, we will enhance communication, job satisfaction and provide an outlet to talk about any secondary trauma that otherwise goes ignored. 

Another key factor hindering the workplace environment and stimulating the need for mental wellness stipends is secondary traumatization. In a study by Alexander and Klein (2001), more than 80% of paramedics reported having experienced an ‘extraordinarily disturbing incident’ in the past 6 months. As a result, stress levels are raised. This elevated stress level may lead to mental and physical changes (Herman, 1997), such as emotional exhaustion, irritability, sleep disturbances, fatigue, problems with interpersonal relationships (Mahoney, 1997; Thoreson, Miller, & Krauskopf, 1989), concerns for individual safety (Eriksson, Kemp, Gorsuch, Hoke, & Foy, 2001), and even intrusive images (Burns, Morley, Bradshaw, & Domene, 2008). It is an increasing problem that needs to be addressed. Part of the issue is the stigma around it, people don’t always understand that the event doesn’t have to happen to you in order to be traumatic. There is also a mentality among many first responders that you have to block everything out or failing that, find different coping mechanisms for the trauma instead of dealing with the issue directly. As such, it can lead to people feeling uncomfortable talking to their coworkers and especially, people who don’t understand the situation at all.The wrong outlets can cause issues as well. So, my proposal once again, is a wellness stipend upon hire that can be used at any time on mental health apps, gyms, yoga, meditation and counseling. 

Wellness stipends are taxable and can range anywhere from 150 dollars annually to 2,000 dollars annually per employee for bigger, wealthier corporations. While this may seem like a lot, the average company spends approximately 4,700 dollars for every new employee hired by the time you calculate recruitment costs, onboard training, and paperwork (Navarra,2022). Annually, companies spend approximately anywhere from 660,000 to 2.6 million dollars replacing employees (Prokopets, 2024). So when you compare that amount to what it would cost for wellness stipends to be implemented upon hire, you are losing less money by adding the stipend as it will likely increase longevity and overall satisfaction in the workplace, calling for less turnover.

Thank you so much for your consideration on this matter. I look forward to hearing from you. 

Sincerely,

[Student's name]

Paramedics are shockingly underpaid, as are some types of healthcare professionals, but emergency medicine doctors, firefighters, and police officers in Illinois are fairly well-paid, as are most social workers who do therapeutic work. If your argument is that these emergency first responders need mental health care, but can't afford it, that is a good argument for the paramedics and some types of nurses or nurse-aides in medical settings. 

I would suggest that one of the best arguments to make for this sort of policy is to suggest that emergency first responders should be given physical medical examinations and mental health check-ups at least once every twelve months (or, you could argue for every six months).  There are ethical reasons why social workers cannot provide services to a client who does not want services and is not exhibiting any problem emotions or behaviors, but if we conceive of this as an opportunity for an annual mental health examination where professionals are assessed for mental wellness and burnout, and then are given further services as warranted if needed, then we have a situation that could be ethical.

You have a policy idea for some sort of state regulation of standards for certain types of professions.  You have addressed your letter to a member of the U.S. House of Representatives.  Your specific request from Representative Budzinski could be to use her position in Washington to raise awareness of the need for mental health screening and wellness care for certain professions in general, perhaps holding hearings at the federal level and perhaps establishing a Department of Justice grant program to help states implement this sort of program.  Or, you might be asking her to act as a prominent leader within the state's Democratic party to push this sort of policy among her friends in the state Democratic Party, since legislation to require the mental wellness stipends would almost certainly come at the state or local level.

I think you also could have mentioned three local cases of recent years that have illustrated the dangers of having stressed and psychologically damaged persons in first responder positions. The emergency medical workers who killed Earl Moore Jr., and the police officers who stood by and recorded the events leading to his death on their cameras, all showed signs of burnout and lack of empathy. The Sheriff Deputy who murdered Sonya Massey was clearly a person with psychological problems, and he should have been noticed and helped before he went into the field and murdered an innocent woman. We also had that disturbed neo-nazi on the Springfield police force (the one who resigned in April 2022).  And, there was the case of Samuel Rosario, who was suffering from PTSD related to his service in Iraq, and the February 2017 misconduct recorded on his body cam that led to his being kicked off the force. Just Sangamon county provides these several examples of mental instability in first responders.  I think we could also make a case for some care and screening of people who work in the County Jail, based on some of the deaths that have occurred in there, and what I've heard about how people behave in there.  

Student wants Mental Health Crisis Training for First Responders

  I believe that first responders should undergo mental health crisis training. I believe this because there are so many circumstances in which this training could be crucial. Police officers in particular are faced with situations such as potential suicide attempts and/or people who could be having mental health episodes. They need someone who is going to be understanding and well trained on how to handle such situations. If first responders are not well-educated on how to handle persons who are experiencing suicidal or psychotic episodes, the resulting interactions could be traumatic for all parties involved. 

Unfortunately, people struggle with mental health on a daily basis. Sometimes, even those with proper training cannot prevent a suicide attempt. So, those who are going to be responding first should definitely have adequate training to mitigate the chances of violence or suicide from being higher in an encounter with a distraught or disoriented person in crisis. It is almost impossible for there not to be trauma and guilt associated with every suicide committed. If every first responder is well educated on how to respond well, they can at least have the comfort of knowing that they did everything in their power to prevent it. 

It would be a protection for everyone involved, and since it is a training that has already been established, it would not be hard to implement it in the police and first responder’s training. I also think that police officers and first responders need to be frequently checked up on especially after traumatic events happen to make sure they are mentally stable. They do not have to maintain a tough exterior. Time taken off and therapy should be a given after experiencing severe situations, especially one as severe as a successful suicide. 

Most police departments, sheriff departments, and fire departments in Illinois have serious training requirements, and have all their staff engage in on-going training to keep up their skills and build their expertise. Suggesting that professionals in these occupations have a certain number of hours of theory and simulation practice to enhance their ability in handling people who are suicidal or suffering a mental health crisis makes sense. That training would not be too difficult to implement, in the sense that this sort of training could be incorporated into existing training programs.  After the two deaths in 2022 where emergency medical technicians essentially killed persons they were supposed to help (Leonardo Guerrero killed in Chicago on August 31st and Earl Moore Jr. killed in Springfield on December 18th) I looked into the training that EMS workers must have, and I read the minutes and agendas of the advisory board that advises the Department of Public Health on certification of EMS staff and ambulance services in Illinois (there is an administrative code for emergency services and it dictates the level and scope of training for EMT and EMS system professionals). I had my students join me in sending letters to the members of the Emergency Medical Services Advisory Council urging them to mandate training that would help EMS workers avoid the sort of burn-out and demoralization where they would become abusive against people in mental health crisis or intoxicated people.  I spoke with people who worked as first responders, including Kainan Rinaberger (president of Springfield Firefighter Local 37) about the issue. 

Leo Guerrero and Earl Moore Jr. both had problems with mental illness and substance addiction. Police and EMT workers who encountered them did not treat them as they should have done. I can think of other examples. Greg Small, Jr. (of Chatham, Illinois) was suffering a mental break-down related to schizophrenia, and he had a knife in his hand, so his mom called for help, but officer Adam Hahn saw that Greg had a knife and would not drop the knife when ordered to do so, so when Greg approached Hahn, Hahn shot him several times. The Sangamon County State's Attorney Dan Wright charged Greg Small, Jr. with aggravated assault for approaching Officer Hahn with a knife in his hand, but Greg was found not guilty by reason of insanity. The fact that Officer Hahn hadn't received specialized training in dealing with a person in a psychotic crisis holding a weapon led to Greg Small suffering four gunshot wounds and Officer Hahn becoming a public example of incompetence. Dan Wright said he had to bring charges so that the courts could order Greg to get mental health treatment he needs.  

Generally, what I gather is that first responders are, as you suggest, traumatized through their work.  I’m told firefighters tend to encounter two or three dead persons each month, and I suppose the EMT workers and police would see a similar number.  Any encounter with a victim of an accidental death, a suicide, or homicide, or even just a natural death can be traumatic, but imagine encountering such situations on nearly a weekly basis!  And a significant number (although a small minority of all cases) of persons who need emergency medical or police protection will be hostile, abusive, or even violent against their rescuers and helpers. It can wear down people.  In Springfield, the police and firefighters are well-trained, and I think that some of them would accept referrals to professional counseling as a way to help them cope with the stresses of their jobs. As for the EMT staff in the private ambulance services, that is often a transitional job for young people who aren’t old enough to become firefighters or police, and the pay is very low, the training requires dedication, and the job can be dangerous and stressful.  

It seems to me that law enforcement professionals facing the anti-police bias widespread in the community (and sometimes well-founded on experiences with unprofessional or brutal/corrupt police) and dealing with regular exposure to traumatic situations and people engaged in anti-social or threatening behaviors could easily turn some fraction of the workforce into an us-versus-them mentality where suspicion and contempt would inform their interactions with the public.  Not only do police, firefighters, and EMT professionals need help dealing with the traumas and stresses of their job, they need idealistic rituals or processes to help them commit themselves to their missions. They need help feeling the support that comes from actually committing to service to others, and respect for human rights. 

Without help and training, first responders may easily dehumanize difficult patients and members of the public (e.g., persons freaking out and having a suicidal attempt, or just generally disrupting the community as they suffer from severe intoxication or a florid psychotic episode). What do we do with people who wander around in a busy area during a community event screaming and shouting threats and obscenities and generally making a nuisance of themselves as they act in a disorganized fashion?  The impulse to treat such people harshly, locking them up and removing them from the community, may appeal, but harsh treatment can exacerbate the problem. You can see how mental health professionals help the angry and violent man (Todd) threatening the doctor in the documentary "Bedlam" (you'll watch it later this semester).