As a paramedic and suicide survivor, Dennis Cole followed his heart and became the president of Uniformed Services Peer Council.

The council is a nonprofit organization dedicated to sourcing mental health and addiction resources for first responders and veterans.

In 2018, he started EMS Confessions, an online storytelling project for first responders and veterans who want to ease their minds and better their mental health. They do this by sharing anonymous first responder stories about work, life and painful conversations that many people brush under the rug.

Cole shares why he started the project and how sharing first responder stories helps address mental health.

Q: Why did you start EMS Confessions?

The idea for first responder stories actually came from a popular EMS Facebook group. I initially offered it to another organization, but they didn’t express any interest in the project.

So, I offered to host it. After seeing the first batch of submissions and the impact sharing them had, we decided to make it a long-term project.

Q: How do you select stories to publish?

An automated script chooses them at random, so when the script runs, we look at it and decide to publish it or pick another.

We remove any identifying or specific information to maintain anonymity.

Q: What feedback do you get from people who read the content or post first responder stories?

Outsiders generally feel shocked or saddened.

Those in EMS find it relatable and express a sense of relief to say these things — often privately through messages or email.

Q: What is it about posting an anonymous confession that helps with first responder mental health?

Fear of reprisal or being ostracized is a big barrier in these discussions, so being able to speak your peace without others knowing helps.

Not being pointed out as the elephant in the room allows more constructive conversation on controversial or taboo subjects.

It also helps that we have a screening guideline for publishing stories, so people know it’s not just random, unfiltered stories we’ve spammed out.

Cole shared how two authors from the project shared difficult topics for first responders.

*Note: We changed the interviewees names to protect the their privacy.

Tina, NREMT, on first responder mental health

Tina launched her EMS career in 2018. A few bad calls led her to EMS Confessions, where she needed to vent anonymously about how those calls started to affect her.

“The second and third one I posted was to say, ‘It’s OK to not be OK,’” she said.

Each time Tina goes out on a call, she prepares herself mentally for all the unknowns. That includes those rough patches afterwards when lying in bed trying to process all the trauma and emotions — not only her own, but those of her teammates and strangers.

“We have to do a lot of things that require quick thinking, and it may not be what we want to do,” she said. “It’s usually a hard decision, such as getting someone out of a smoking car, dealing with family after bringing someone back with CPR or if you cannot bring them back, then you have to deal with people losing a family member.”

By sharing stories on EMS Confessions, Tina said it brings her relief after working with patients or families who linger in her mind.

When people read her story and make comments, such as “I’ve been through that too,” it helps her feel more connected to her peers. Feedback like that inspires her to keep sharing stories.

“On any bad call, or any pediatric (case), it’s really hard. You know you’re not alone, but it solidifies that we’re all in this together,” she said. “With a cardiac arrest, your first one will always stick with you. You can perform CPR on a dummy all day long, but when you do it on a human being, it’s much different.”

Sarah, firefighter, EMT-B on the importance of first responder mental health

Sarah is a firefighter with PTSD. When she received her diagnosis in 2014, many people did not openly discuss the subject, she recalled.

Sarah said a lot of people considered a stigma. It’s difficult to find someone to talk to about PTSD or depression symptoms other than confiding in a therapist.

Even though PTSD gets more press coverage than in previous years — and more people openly talk about it — it’s too personal to discuss for some people. That’s why EMS Confessions can be such a valuable tool.

Sarah posts and reads EMS Confessions because it gives her relief and creates a sense of relatability among her peers.

“I submitted a story,” she said. “It was very freeing and liberating to write it.”

Seconds before hitting the send button, Sarah recalls that twinge of nervous energy. But she soon overcame her butterflies and posted it anyway.

“It was nice to get it out because it helped me realize what I went through was real and I could put words behind my feelings,” she said. “I was a little nervous, but as soon as I saw the post online and saw how people were reacting, I knew I made the right decision about being honest with my journey.”

Posting a story helped her “own it” and that allowed Sarah to turn a corner from being a survivor to a thriver, she said.

“Because I was able to verbalize what I went through, it made me feel strong, and I did not need to feel shame anymore,” Sarah said.

Want to post an EMS confession? Click here.

Learn more about first responder mental health in our course Individual ALS L-11 — Includes Psych and Behavioral Emergencies, Field Triage MCI today.