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Saving Those Who Save Others


By Marci Foster

Bravely rushing into a burning building. Defending the defenseless. Standing strong when others might back down. Not hesitating when a life is at stake.

First responders are trained to put their lives on the line to protect the communities they serve. But for these exceptional men and women—police, firefighters, corrections officers, emergency medical responders, and military personnel—functioning at such a heightened state of alertness can take its toll on physical and emotional health, potentially resulting in increased incidence of anxiety, stress, depression, isolation, and anger. Left unidentified and untreated, these conditions can lead to a host of personal and professional issues.

“In addition to physical trauma, first responders may experience or witness horrific circumstances that can overwhelm their capacity to endure,” explains Michael Bizzarro, PhD, LCSW, director of Clinical Services for First Responders at Penn Medicine Princeton House Behavioral Health, and a former police officer. “The wounds sustained by first responders are often invisible. And more often than not, they experience traumatic events several times; and repeated exposure can have a cumulative effect.”

According to the national Substance Abuse and Mental Health Services Administration (SAMHSA), an estimated 30 percent of first responders develop behavioral health conditions such as depression, anxiety and post-traumatic stress disorder (PTSD), as compared to 20 percent of the general population. Addressing this disparity is the goal of Princeton House Behavioral Health’s First Responder Treatment Services program, the first and only program of its kind in New Jersey.

“As we approach the holidays—which can be an emotionally difficult time —the training we are conducting … will mean that each police department across New Jersey will have a trained officer who is prepared to throw a lifeline to officers in need and who will ultimately be trained to teach resiliency to every officer,” Attorney General Gurbir S. Grewal said last month in an announcement of a two-day Resiliency Summit for all law enforcement agencies in the state. “This is a turning point for law enforcement in New Jersey.”

The Princeton House First Responder Treatment Team in their headquarters: Shannon Paskaris, clinical social worker; Jim Schneider, peer support specialist; Dr. Michael Bizzarro, director; Iris Perlstein, clinical specialist; Ken Burkert, senior outreach coordinator.

To shape the resiliency training effort, nearly a decade ago the state of New Jersey created a task force to determine effective ways of providing more mental health and substance use disorder services in the state.

“As part of the task force’s efforts, law enforcement leaders met with Princeton House, and our program was born,” Dr. Bizzarro said. Since we began the program in 2013, we have helped about 1,200 first responders through the inpatient program. In the past year alone, we have also provided training to roughly 2,000 first responders, giving them a toolkit to significantly reduce their sense of isolation and work toward developing resilience.”

Police and fire departments, as well as departments of correction and other first responder groups can arrange for training sessions to help personnel recognize stressors and learn coping skills, including feeling safe to reach out for support when needed. 

“First responders are trained to be protectors, so for some, seeking treatment goes against the pride they feel in being able to handle anything life sends their way,” Dr. Bizzarro said. “For some, treatment is surrender. But for many, for the first time in their lives, this type of surrender can be a life-long victory.”

The program provides inpatient addiction and mental health services to address the unique behavioral health needs of police and corrections officers, military personnel, firefighters, paramedics, and EMTs.

Care is directed and provided by clinicians who have had law enforcement, military, and first responder experience. Treatment includes many facets such as individual and group therapy, family therapy and psychotherapy, medication management, nutrition counseling, expressive therapies, and a fitness gym.

For some, participation in this program is the first time they have been able to identify the wounds of the past and connect with behavioral health professionals who teach them coping skills and resiliency.

Dr. Bizzarro notes that a first responder who is having difficulty after a traumatic event may start behaving in ways that are inconsistent with their normal personality. Physical changes may include trouble sleeping or exhaustion, no matter how much sleep they get. Behavioral changes could include irritability, angry outbursts, or panic attacks.

For many first responders, often a significant amount of time passes before they seek help. “It is extremely important for first responders to realize they need to pull another individual into the equation to help them cope with the pressures that are inherent in their roles as protectors,” he said. “They need to be able to share the burden with someone they can trust, and we are here to be that someone.”

To learn more about Princeton House Behavioral Health’s First Responder Treatment Services, visit

If you or someone you know is experiencing suicidal thoughts, contact a mental health professional. The National Suicide Prevention Lifeline is confidential and available 24 hours per day, 7 days per week to provide support, information, and local resources. Call 1-800-273-8255. The free crisis text line is also available for those in crisis to connect with a trained crisis counselor via text message at 741-741. Text HOME to 741-741 from anywhere in the United States support.

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Views expressed are those of the author or other attributed individual and do not necessarily represent the official opinion of the related Department(s), University of Pennsylvania Health System (Penn Medicine), or the University of Pennsylvania, unless explicitly stated with the authority to do so.

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