Psychological Resilience of Emergency Responders

Five years after much of the world was becoming used to various forms of lockdown to counter the COVID-19 pandemic, we continue to learn lessons, hoping they will be applied in the future. I have been working with a team in Bergen, Norway, and London, UK, to understand better how emergency responders psychologically coped with the virus and lockdowns in order to support their mental and physical health and well-being during future pandemics.

We have just had a paper published in the scientific journal Disasters comparing the two cities. The results come from analyzing semi-structured interviews with nine experienced emergency responders in Bergen and nine in London. The focus was on their positive and negative experiences, including distress and mental strain alongside coping mechanisms.

The study’s results

The study is fairly unique, given the comparison across two cities with different languages, cultures, and governance systems. Four main themes emerged from the interviews, with commonalities in both locations.

First was the emotional toll exacted by being an emergency responder during a pandemic when most of the rest of the population had to stay at home. There were many unknowns and uncertainties about the virus, the disease, and the safety of exiting lockdowns. The first weeks were marked by the surrealness of responding through empty streets while worrying if, after their shifts, they would bring the virus back to their families.

The second theme covered psychological difficulties and psychological resilience in maintaining readiness. Adaptability was key. Training and meetings went online when possible, helping responders to feel safer but instilling a sense of disconnect from the usual camaraderie.

Third was an increased sense of service to the community, supporting mental health and well-being through continuing to work. Recognizing how essential their jobs were—because of rather than despite lockdowns—renewed their sense of duty and their commitment to placing communities first. It puts the emergency responders and their families at risk of COVID-19, but taking risks for others is part of what their career offers their cities.

Finally, psychological resilience was built through professionalism and learning when moving forward from the lockdowns and the pandemic. Positive new work procedures were retained, especially using technology to its fullest potential and improving how their organizations functioned.

Moving forward to do better

Leadership was key, making a good or bad difference in individual and organizational resilience. In both cities, emergency responders commended their direct leaders for their sympathy, support, and flexibility. In the UK, national leadership failed by not providing appropriate or enough personal protective equipment, compounding mental stress due to the emergency responders’ concerns that they might get sick or bring the virus back to their families.

Mental and physical readiness and resilience thus need to better combine emotions, psychology, thinking, training, readiness, and high-level support. For instance, firefighters do much more than preventing and fighting fires. In London during COVID-19, they drove ambulances to emergency calls and managed bodies of COVID-19 fatalities. Experienced emergency responders and recent joiners must be mentally and physically ready while being trained and having the equipment for all the tasks that could be required of them.

Mental stress was augmented by perceptions of the pandemic and responses to it being unprecedented, surprising, and unpredictable. This was despite the previous coronavirus pandemic having been Severe Acute Respiratory Syndrome (SARS) from 2002 to 2004. The UK government even ran a large-scale pandemic exercise in 2016, revealing that the country was woefully unprepared, and yet did little to alleviate the identified problems.

More positively, both sets of interviewees highlighted how the culture within emergency response is changing to permit open discussion about and redressing work-related mental health and well-being challenges. Post-traumatic stress disorder (PTSD) was emphasized. Disconnect and isolation—notably from their own families, although from colleagues as well—leading to mental trauma were an important component. Workplace compassion and support are improving.

These similarities between Bergen and London indicate the importance of exchanging and connecting among emergency responders in different jurisdictions, irrespective of differences. Plenty can be learned from each other while boosting mental health and well-being through empathy, mutual understanding, and caring for each other across cultures.