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Mental Health Training for First Responders

By Anna Reinalda | January 19, 2022

The first images that come to mind when one thinks of emergency first responders are ambulances, fire trucks, sirens, and commotion. But some of the most important life-saving skills are much more subtle. The ability to recognize when somebody is having a mental health crisis is often difficult, but critically important.

This is why Barbara Vaning, a program associate for Penn Medicine Princeton, works hard to schedule, design, and implement programs to promote community health and wellbeing.

Vaning, a Skillman resident for more than two decades, has been involved in EMS work for 43 years. After losing her mother at age 12, Vaning was compelled to learn life-saving skills, and to teach those skills to her community.

“When my mother died, her best friend was next to her,” Vaning said. “She took a breath, and then collapsed to the ground. Her friend stood there and didn’t know what to do.”

Taking a personal vow to always know what to do, Vaning signed up for her local first aid squad at age 16. “I didn’t want some other little girl to come home and find out that her mom had died because somebody didn’t know what to do.”

In Vaning’s early EMS days, she said CPR and paramedics were relatively new in the medical world. She evolved alongside first response practices, constantly developing her skills to serve her community. With research and awareness of mental illness and addiction now on the rise, Vaning and her team have brought mental health to the forefront of their practice.

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Through Penn Medicine Princeton, Vaning's Mental Health First Aid classes are available both for the general public, and as a specialized course for first responders. The class is taught by five instructors, three of whom are EMS responders, and one of whom is a retired police officer.

“In 2017, 103 firefighters died by suicide, and more than 93 firefighters died in the line of duty,” Vaning said.

With trauma being implicit to the work of first responders, Vaning explained that their mental health takes a toll.

"First responders often deal with tragic situations where yellow caution tape denotes an accident, violence, a fire, or death. When they internalize and carry this trauma with them, it’s like wrapping caution tape around themselves—preventing them from dealing with the emotional impact of their experiences," according to Princeton House Behavioral Health Today.

Iris Perlstein, Trauma Specialist for First Responder Treatment Services at Penn Medicine Princeton House, told PHBH Today that she sees time and again how difficult it is for first responders to retell and process horrific work experiences.

"But when this echo of trauma is not dealt with, it can lead to anger, anxiety, depression, addiction, a disconnect from relationships, a loss of self, and other adverse effects," Perlstein said. “As behavioral health professionals, we may experience compassion fatigue or vicarious trauma from repeatedly hearing about trauma experiences from our patients. For first responders, it is more all-encompassing, because it integrates all of their senses. They see, hear, and even smell trauma on an ongoing basis, and it stays with them longer on a deeper, more visceral level.”

"Compounding the issue is the inner voice of those who serve and protect society, which may be whispering, 'Asking for help could be viewed as weakness,'" Perlstein said.

Recognizing Mental Health Issues in Patients

Students in Vaning's class learn how to keep their antennas up for mental health issues during a crisis.

“We are what my partners call ‘expert noticers,’” Vaning said. “We don’t diagnose anything, but we do … guide [people] towards resources.”

The course covers many topics, including: "What are mental health disorders," prevalence, self harm, and signs of substance abuse, to name a few. Students learn about a myriad of mental health symptoms, and what to look for.

Totaling eight hours of instructor-led class time, there are one-day, two-day, four-day, or virtual options, allowing students to choose the option which best fits their schedule. Need-based scholarships are also available.

One thing is nearly omni-present in class: Stigma.

“Mental health has a stigma — people don’t want to talk about it,” Vaning said. “But I tell people: ‘If somebody is a diabetic, do you laugh at them? If somebody has a heart condition, do you laugh at them? It’s all part of your body, including your brain.”

Working to break down that stigma both in and out of the classroom, Vaning says a lot of it comes down to being deliberate in the way she talks about mental health. “I never say somebody ‘committed’ suicide,” she explained. “‘Committed’ sounds almost like a crime. Saying ‘died by suicide,’ removes fault and blame.”

Vaning says mental health training has had positive impacts in the field. Using a method called "Five Minutes to Health," Vaning says EMTs now spend five minutes with a Narcan recipient to discuss treatment options for substance addiction when they respond to an overdose call.

“We teach people that we’re not trying to change them overnight, but we want to put a seed in their brain,” Vaning said. “Every time we interact with that person, we can water that seed. Maybe one day they’ll say, ‘Today’s the day.’”

To register for the Mental Health First Aid class, go to, or call 888.897.8979.

Upcoming classes:


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