Mental health professionals working with first responders (law enforcement officers [LEOs], firefighters [FFs], and emergency medical technicians [EMTs]) should target affective depression over somatic depression symptoms early in treatment if they want to buffer against suicidality.

Emergency medical service (EMS) professionals have a stressful vocation, inarguably worsened by the COVID-19 pandemic, which affects their mental health and makes them a vulnerable population warranting further study. However, to date, no published research has compared non-treatment and treatment-seeking EMS professionals in the same greater metropolitan area. In this study, we examined differences and similarities among the non-treatment-seeking EMS professionals (<em>n </em>= 57) from a local EMS agency and treatment-seeking EMS personnel (<em>n </em>= 53) from a non-profit community treatment center on six assessment instruments that measure attachment avoidance, attachment anxiety, resilience, depression, generalized anxiety, posttraumatic stress disorder (PTSD), and suicidality. The Mann-Whitney U test revealed attachment avoidance, attachment anxiety, depression, generalized anxiety, and posttraumatic stress disorder (PTSD) were significantly higher in the treatment-seeking sample compared to the non-treatment-seeking group. Resilience and suicide did not significantly differ. Correlational analyses revealed that the most consistent findings for both samples were PTSD, depression, and generalized anxiety. Findings suggest that negative affect may underlie these three constructs, regardless of whether the individual is treatment-seeking or not. These findings are conceptualized through three different theoretical frameworks: attachment, resilience, and negative affect. We also make recommendations for EMS agencies and suggest future scholarship based on these preliminary findings.

Explain to clients in their clinical practice why identifying their personal attachment style is an important therapeutic step and how therapy could eventually modify attachment styles and subsequently improve mental health.