Across the United States, millions of firefighters, police officers, paramedics, emergency medical technicians, and other frontline public safety professionals routinely place themselves in harm’s way to protect their communities. Yet behind the bravery and composure that define their work, many first responders face profound psychological burdens. Recent research underscores the magnitude of this challenge: approximately one in seven first responders experiences probable post-traumatic stress disorder (PTSD) as a result of repeated exposure to traumatic events encountered in the line of duty. That number rises significantly after responding to large-scale crises, natural disasters, mass casualty events, or prolonged emergencies such as the COVID-19 pandemic.
Recognizing this growing concern and the need for effective, evidence-based interventions to support those who serve on the frontlines, researchers from Northwell Health’s Feinstein Institutes for Medical Research, Stony Brook University, and Texas A&M University have come together for a landmark mental health initiative. The collaborative team has secured a $3.37-million grant from the National Institute of Mental Health (NIMH) to launch a comprehensive, multi-site clinical trial designed to strengthen resilience and improve mental health outcomes among first responders nationwide.
This five-year initiative, one of the most ambitious studies of its kind, will evaluate the effectiveness of a structured resilience-training intervention that could ultimately transform mental health support systems for emergency personnel across the country.
A National Research Effort to Support First Responder Mental Health
The study—formally titled “A Large-Scale Efficacy Trial of a Resilience Training Program for First Responders”—is led by an experienced team of behavioral health researchers. Principal investigator Rebecca Schwartz, PhD, serves as associate professor at the Feinstein Institutes’ Institute of Behavioral Science and is also senior director of clinical research within Northwell Health’s Department of Occupational Medicine, Epidemiology and Prevention. She is joined by co-principal investigators Adam Gonzalez, PhD, of Stony Brook University, and Anka Vujanovic, PhD, of Texas A&M University, both of whom bring years of expertise in trauma psychology, resilience training, and first responder mental health.
Together, the team will examine the impact of the Worker Resilience Training (WRT) program, a structured, interactive workshop designed to equip first responders with practical tools for managing job-related stress, improving coping behaviors, and reducing their risk of developing severe psychological conditions like PTSD and depression. Unlike traditional mental health interventions, which often focus on treatment after symptoms become debilitating, the WRT program emphasizes prevention—teaching skills that help individuals maintain emotional well-being before, during, and after exposure to traumatic circumstances.
Building on Earlier Successes
This large-scale project builds on a growing body of research supporting resilience training for frontline workers. Drs. Gonzalez and Schwartz previously conducted a randomized clinical trial evaluating the WRT program among first responders who served during Hurricane Sandy, one of the costliest natural disasters in U.S. history. Their earlier findings were promising, demonstrating that participants who completed the WRT workshop showed fewer mental health symptoms and greater adaptive coping abilities in the months following the storm.
The new study will dramatically expand the scope of this work, enrolling 800 first responders in New York and Texas. Participants will be randomly assigned either to the WRT program or to a time-matched control workshop. This rigorous study design allows researchers to directly compare the results between the two groups and determine whether the WRT program provides measurable benefits above and beyond standard training.
What the Study Will Measure
The research team aims to answer several critical questions about the relationship between resilience training and long-term mental health outcomes for first responders. Key study objectives include:
- Evaluating improvements in resilience indicators, including perceived resilience, healthy lifestyle behaviors, physical activity, and stress management capabilities.
- Measuring whether WRT reduces the development or worsening of psychological symptoms, particularly PTSD, depression, and anxiety, in the months and years following participation.
- Assessing the program’s impact on functional impairment, such as absenteeism, job performance challenges, and disruptions in daily life.
- Determining whether the benefits of the WRT program persist over time, especially after exposure to traumatic events.
- Understanding how resilience training can be scaled across diverse first responder populations, including EMS personnel, firefighters, and law enforcement officers.
A particularly important component of the study is tracking participants who face traumatic situations after attending the workshop. The research will examine whether WRT serves as a protective buffer—helping to prevent psychological decline and supporting faster recovery when traumatic stress occurs.
Addressing a Critical Need Exposed by the COVID-19 Pandemic
For many Americans, the mental health toll of the COVID-19 pandemic is now well recognized. But for first responders, the pandemic introduced unprecedented levels of sustained stress, grief, burnout, and trauma. Emergency personnel were often the first to respond to highly infectious environments, witnessing severe illness and death on a regular basis while managing fears about their own health and the well-being of their families.
Dr. Schwartz emphasizes the urgency of supporting first responders in this context. “First responders face a heightened risk for mental health conditions due to chronic exposure to trauma; COVID-19 demonstrated that firsthand. It’s our duty to support their well-being, especially their mental health,” she said. “This NIMH grant allows us to rigorously test a preventative intervention that has the potential to significantly enhance resilience and reduce the burden of PTSD and depression in this critical population.”
Northwell Health leadership echoed this sentiment. Kevin J. Tracey, MD, president and CEO of the Feinstein Institutes and Karches Family Distinguished Chair in Medical Research, noted that the pandemic magnified long-standing mental health challenges among frontline professionals. “The COVID-19 pandemic highlighted the toll of chronic stress on first responders. Dr. Schwartz’s research provides scientific insights and new strategies to enhance mental well-being and resilience for essential workers,” he said.
Implications for Public Health, Policy, and Community Well-Being
First responders are a cornerstone of public safety, and their mental health has direct implications for the communities they serve. When first responders struggle with untreated PTSD, anxiety, or depression, the effects can be far-reaching—impacting job performance, decision-making, physical health, family relationships, and long-term career sustainability.
The WRT study aims to provide evidence-based, scalable solutions that can be integrated into training protocols for police departments, fire services, EMS agencies, and emergency preparedness organizations nationwide. If proven effective, the program could help reduce personal suffering among responders while also decreasing broader economic and social costs linked to mental health crises, including turnover, disability claims, and reduced workforce retention.
Because the WRT program is designed as a workshop rather than a lengthy therapy protocol, it holds promise for widespread adoption—especially in resource-limited or rural areas where access to mental health services may be limited.
A Path Toward a Healthier, More Resilient Emergency Workforce
Through the support of the NIMH grant, this multi-institution research team is working to reshape the landscape of mental health support for first responders. Their goal is to offer practical tools grounded in scientific evidence, empowering responders to withstand the psychological demands of their profession without sacrificing their well-being.
As communities continue to rely on these essential professionals during natural disasters, public health emergencies, and everyday crises, investments like this study signal meaningful progress toward building a healthier, more resilient emergency workforce—one where first responders receive the same level of support, care, and compassion that they extend to the public every day.
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