What Is Psychological First Aid? And Why Every Fire and Law Enforcement Agency Should Be Trained in It

Let’s be honest—as first responders, performance expectation are high. But day after day, shift after shift, we see trauma that stacks up in ways we don’t always recognize until it breaks us down. That’s where Psychological First Aid (PFA) comes in.

PFA isn’t therapy. It’s not a mental health intervention with a couch and a clipboard. It’s a field-ready, boots-on-the-ground strategy designed to help stabilize someone after a crisis—something every fire department, police station, and emergency crew should have in their toolkit.

This method, backed by research and field-tested across fire, police, and even military units, gives us a better way to take care of our people—before it becomes a crisis.

What Is Psychological First Aid? (And Where Did It Come From?)

Psychological First Aid was developed by the National Center for PTSD and the National Child Traumatic Stress Network back in 2006. It was created to help people right after they go through something traumatic—whether that’s a house fire, a shooting, or witnessing a line-of-duty death.

Dr. George Everly from Johns Hopkins University built out a system called the RAPID model, specifically for responders. That’s:

• R: Reflective Listening

• A: Assessment of needs

• P: Prioritization of those needs

• I: Intervention (calming, reframing, or problem-solving)

• D: Disposition—meaning, where do they go from here

Source: Everly et al. (2014), Johns Hopkins RAPID Psychological First Aid Model

This model has been taught to firefighters, medics, cops, and even military units. It’s designed to be peer-to-peer, simple, and effective in the moments that matter.

So, Does It Work? Here’s What the Research Says

This isn’t just feel-good fluff. PFA has been tested—and it’s showing real-world results.

 

Police Officers Who Took PFA Training Got Better at Handling Crisis

A randomized controlled study in the Philippines trained over 100 police officers in Psychological First Aid. The officers who received the training showed increased confidence and real improvements in crisis communication skills, compared to those who didn’t.

Source: Espiritu, J. et al., 2022 – PubMed PMID: 35755941

Translation? When officers know how to spot stress reactions and apply PFA on the spot, they’re better prepared to support their team and the community—without freezing up or making it worse

 

When Supervisors Use PFA in Police Departments, It Changes Culture

In Québec, supervisors in police departments were trained to deliver PFA after critical incidents. Officers said it made them feel supported, helped reduce mental health stigma, and gave them hope after tough calls.

Source: Généreux et al., 2023 – PMC10040866

Let’s face it—when your boss gives a damn and actually knows how to handle someone in crisis, it sets the tone for the entire department.

Fire Departments Are Getting Results with Stress First Aid (SFA)

SFA is built on the same bones as PFA. A recent study in fire departments found that crews who got this training saw a boost in mental health awareness, peer communication, and trust in their leadership to respond to behavioral health needs.

Source: Petrie et al., 2023 – PubMed PMID: 37998298

This is huge. Fire crews don’t just want policies—they want tools that work in the real world, where trauma is part of the job.

What About Military, Health Care, and Victim Services? Same Results.

 

Crime Victim Study: Global Functioning Improved

Paraprofessionals using PFA with crime victims helped improve the person’s ability to function day to day, even if their PTSD or depression symptoms didn’t fully disappear.

Source: Lusk et al., 2020 – PubMed PMID: 32700952 

Simulation Training in Health Care Increased Confidence

PFA training in simulated disasters led to better confidence, skills, and response readiness among health care responders.

Source: Everly et al., 2020 – PubMed PMID: 32792033

The Big Picture: What the Systematic Reviews Are Saying

The 2022 systematic review by Kitchiner et al. looked at 136 different studies on early mental health support for first responders. The conclusion?

PFA, peer support, and early interventions improve functioning and help-seeking. They also increase return-to-duty rates. PTSD symptom reduction is still hard to pin down—but the practical impact is real.

Source: Kitchiner et al., 2022 – PubMed PMID: 35837521

So no, PFA isn’t a magic bullet. But it’s a powerful tool when used right after trauma, by the people who are already there.

Why Your Department Needs Psychological First Aid Training

1. Because We’re Not OK.

   Firefighters, EMTs, and cops are 4–5x more likely to develop PTSD than civilians. The trauma we absorb doesn’t just go away on its own. It festers—and it kills careers, families, and lives.

2. Because This Stuff Actually Helps.

   Studies show that PFA and SFA help responders feel supported, stay functional, and trust their leadership. That’s how you build a resilient department.

3. Because Peer Support Is the Future.

   Gone are the days of “suck it up.” What people need is someone to notice the signs, offer real support, and guide them toward help—without judgment or delay.

4. Because This Can Save Lives.

   The sooner we intervene, the better chance we have of preventing suicide, burnout, addiction, and broken homes. That’s not theory—that’s reality.

How to Get Started with PFA in Your Agency

• Train your officers, firefighters, or EMTs in Dr. Everly’s RAPID model (you can find certified instructors or use FEMA/NCTSN resources).

• Embed PFA in peer support teams, critical incident response, and supervisor training.

• Make it part of your culture—not a one-and-done check box.

• Track outcomes and check in—PFA works best when it’s part of a bigger wellness effort.

Final Thoughts

Psychological First Aid isn’t just about feeling better. It’s about staying functional, supporting each other, and protecting the people who protect everyone else.

If your department doesn’t have a plan for what to do after the call, then you’re leaving your people vulnerable—and that’s unacceptable.

Mental readiness is operational readiness. Train it like you train anything else that saves lives. RiseUpFight.org is committed to the mental health and well-being of first responders. Please consider donating to this important mission. www.riseupfight.org/donate.

Be safe out there.

-Tom