Mental Health Needs and Wants of Younger First Responders: Identifying Vulnerabilities and Opportunities for Developing a Targeted Mental Health Toolkit for Surf Lifesavers Aged 13–25

TL;DR

• 42% of young surf lifesavers (ages 13–25) surveyed met the threshold for post-traumatic stress symptoms — higher than the general youth population baseline.
• Stigma and lack of social support were the strongest predictors of PTSS severity. Mental health literacy alone was not enough.
• Younger responders (13–17) wanted prevention-focused content. Older ones (18–25) wanted tools for processing trauma they’ve already experienced.
• Most preferred format: a mobile app. But preferences varied enough that a one-size approach won’t work.
• Toolkits without stigma reduction and community-building built in are likely to underperform.

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Young first responders are often treated as an afterthought in mental health conversations — yet the mental health needs of young first responders are significant and frequently unaddressed. The assumption is that mental health risk belongs to the career professionals — the medics with twenty years of calls behind them, the firefighters who’ve worked the worst scenes. The younger volunteers? They’ll be fine.

That assumption is worth scrutinizing. And there’s now data to support that scrutiny.

A study published in the Journal of Safety Research (2025) examined the mental health landscape of surf lifesavers in Australia aged 13 to 25. These are first responders — they run water rescues, respond to drownings, and encounter suicide and self-harm along the coast. They are also, in many cases, teenagers doing it as volunteers.

The findings are worth paying attention to — not because surf lifesaving is EMS, but because the patterns are nearly identical to what shows up in fire and EMS research on younger personnel. High PTSS rates. Stigma driving people away from help. Social support acting as a buffer. And organizations without the tools to address any of it systematically.

What the Study Asked

Researchers from UNSW Sydney and Central Queensland University wanted to understand two things. First, what does the mental health picture actually look like for young Surf Life Saving Australia (SLSA) members? Second, what kind of mental health toolkit would they actually use?

They ran an anonymous online survey through the SLSA membership database from May to November 2023. The analysis focused on 82 respondents between the ages of 13 and 25 — split between adolescents (13–17) and young adults (18–25). Researchers measured PTSS levels, stigma, social support, self-efficacy, mental health literacy, and preferences for toolkit content, format, and activities.

This was exploratory work. The sample was small. But the patterns it surfaced aren’t subtle.

What They Found

42% of respondents who completed the full PTSS screening met the criteria for clinically significant post-traumatic stress symptoms. The mean PTSS score across that group was 28.5 out of 80 — and 46% of all respondents reported currently having a mental health condition. More than half said they had sought help for one at some point.

That 42% PTSS rate is notable when compared against 2023 Australian Bureau of Statistics data showing 38.8% of Australians aged 16–24 reported a mental health condition in the past year. Those are already elevated numbers for that age group nationally. Among this first responder cohort, the study found they were higher.

The strongest statistical relationships in the data came down to two variables: stigma and social support. Participants with higher stigma scores were more likely to experience severe PTSS (r = 0.68). Participants with lower social support were also more likely to experience higher PTSS (r = -0.48). These are meaningful correlations, not noise.

Here’s what didn’t correlate: mental health literacy. The study found that knowing more about mental health — understanding symptoms, understanding help-seeking — did not significantly reduce PTSS. That finding is counterintuitive to how most training programs are designed. It raises the question of how EMS organizations should approach this problem differently.

On toolkit preferences, researchers observed a clear age split. Younger members (13–17) gravitated toward general mental health content — self-care, recognizing warning signs, maintaining relationships. Older members (18–25) wanted specific trauma-focused content — coping long-term with trauma, what to do immediately after an incident. Both groups preferred apps as a delivery format, though preferences across all content and format categories were distributed enough that no single approach dominated.

Why This Matters in EMS

The surf lifesaving context is different from EMS in several ways. But the structural dynamics are nearly identical. Young personnel. Volunteer-heavy workforces. Traumatic incident exposure that starts early. Organizations that were not built with mental health infrastructure in mind.

62.5% of people with mental health conditions experience onset before age 25. That’s not a statistic about weakness — it’s a developmental window that EMS and fire agencies are routinely failing to address. Younger members are being handed gear, given training, and sent into high-stress situations with little support infrastructure designed specifically for them.

The stigma finding deserves direct attention. Providers frequently encounter the belief — sometimes spoken, usually not — that needing help is a sign of not being cut out for the job. That belief delays help-seeking, it isolates people who are struggling, and it compounds PTSS over time. The data in this study may suggest that stigma is not just a cultural annoyance to manage — it is a measurable predictor of symptom severity.

Social support is the other side of that equation. Organizations that build genuine connection between members — not just functional crews, but real community — are creating a structural buffer against PTSS. That’s not soft leadership. That’s evidence-based risk reduction.

The mental health literacy finding should challenge some assumptions in EMS education. More information is not the same as better outcomes. Providers frequently receive training that is knowledge-heavy and implementation-light. They can tell you the DSM criteria for PTSD. They don’t have a plan for when they feel it happening to them. The gap between knowing and doing is exactly where stigma lives.

What This Looks Like on a Call

Consider a common scenario: A 19-year-old EMT-Basic, less than a year on the job, runs a pediatric drowning. The patient doesn’t make it. The crew debriefs briefly at the station, then goes back in service. The new provider doesn’t say much. Nobody directly asks how they’re doing — the senior medic figures they’d speak up if something was wrong.

Three weeks later, that provider is missing shifts. Sleep is off. They’re withdrawing from the crew socially. Nobody connects the dots until a supervisor notices the pattern and asks a direct question.

In practice, these calls are common in EMS — and the delay between exposure and intervention is almost always longer than it should be. The study’s data suggests that if that provider holds stigmatizing beliefs about mental health, and if their social connection to the crew is shallow, their PTSS risk is significantly elevated. The intervention point was weeks earlier, not when a supervisor finally noticed.

What You Should Do Differently

• Stop treating mental health training as knowledge transfer alone. Knowing about PTSD is not the same as having tools to manage it. Shift toward skill-based, application-focused content — coping plans, peer check-in protocols, crisis resources that are actually accessible on shift.
• Design support systems that address stigma directly. Myth-busting content has some value, but the research suggests it works better when paired with open disclosure, community connection, and a culture that treats mental health as a continuum — not a binary of fine or broken.
• Differentiate content by experience level, not just rank. Newer and younger providers need prevention-focused content. Experienced providers need trauma processing tools. Lumping them together produces training that serves neither group well.
• Build social connection deliberately into your organizational structure. The protective effect of social support is measurable. Team cohesion is not just a morale issue — it is a mental health intervention. Leaders who invest in crew-level relationships are doing clinical prevention work whether they label it that way or not.
• Assess your toolkit format for your actual audience. If younger members in your system are going to engage with mental health resources, those resources need to be accessible digitally, easy to navigate, and not designed to feel like mandatory training. An app, short-form online content, or in-person workshop paired with follow-up resources outperforms a PDF nobody reads.
• Ask directly. Don’t wait for people to come forward. Stigma suppresses self-disclosure. Providers who are struggling are, by definition, less likely to raise their hand. Supervisors who wait to be told have a system gap. Regular, normalized check-ins — built into crew culture, not just post-incident — reduce that gap.

Limits of the Study

The sample was small — 82 respondents — and skewed female, which is not representative of most first responder populations or even the broader SLSA membership. Male members, who previous research suggests may be at higher PTSS risk, are underrepresented here. That’s a significant gap the researchers acknowledged.

Geographic representation was also uneven, with some Australian states over- and under-represented relative to SLSA membership. Survey fatigue likely contributed to lower completion rates, and the sensitive nature of the subject matter may have discouraged some participation.

The surf lifesaving context — volunteer, coastal, Australian — does not translate directly to urban EMS or structural firefighting. Specific stressors differ. However, the structural dynamics around age, stigma, social support, and organizational response are broadly applicable.

The correlations in this study identify relationships, not causation. Stigma and low social support predict higher PTSS — they do not definitively establish causation. More targeted, longitudinal research with larger samples is needed before strong causal claims can be made.

Bottom Line

Young first responders are carrying more than most organizations have accounted for. The data in this study points to a consistent pattern: stigma is associated with elevated PTSS risk, low social support is associated with elevated PTSS risk, and simply teaching people about mental health without addressing those two factors is not sufficient. For EMS and fire leaders, the practical implication is direct. Build real community into your crews. Reduce stigma through culture, not just curriculum. Design mental health resources that your youngest providers will actually use — not resources that check a training box. These are not soft priorities. They are operational ones.

Ready to Learn More?

• Taking Stress Home: Secondary Traumatic Stress in Paramedic Intimate Partners
• The Evolution of EMS: From 911 to Community-Based Care

Frequently Asked Questions

What percentage of young surf lifesavers showed clinically significant post-traumatic stress symptoms?

A 2025 study published in the Journal of Safety Research found that 42% of surf lifesavers aged 13–25 who completed the full PTSS screening met the criteria for clinically significant post-traumatic stress symptoms. Additionally, 46% of all respondents reported currently having a mental health condition. These rates were higher than the national Australian baseline for the same age group.

Why doesn’t mental health literacy reduce PTSS in young first responders?

The study found that mental health literacy — knowing about symptoms and help-seeking — did not significantly correlate with reduced PTSS severity in young surf lifesavers. The strongest predictors of PTSS severity were stigma and low social support, not knowledge level. This suggests that information-focused training alone is insufficient and must be paired with stigma reduction and community-building efforts.

What mental health toolkit formats do young first responders prefer?

The study found that both adolescents (13–17) and young adults (18–25) most commonly preferred a mobile app as their desired format for mental health resources. However, preferences across content and format categories were distributed broadly enough that no single approach dominated. This indicates that a flexible, multi-format strategy is more likely to reach the full range of younger responders than any single delivery method.

How does stigma affect mental health outcomes in young first responders?

In the study, higher stigma scores were strongly correlated with more severe post-traumatic stress symptoms, with a correlation coefficient of r = 0.68. This means stigma is not merely a cultural obstacle — it is a measurable predictor of symptom severity. Organizations that fail to directly address stigma through culture and not just curriculum leave younger members at significantly elevated risk.

References

Stewart, E., Fien, S., Peden, A. E., & Lawes, J. C. (2025). Mental health needs and wants of younger first responders: Identifying vulnerabilities and opportunities for developing a targeted mental health toolkit for surf lifesavers aged 13–25 years. Journal of Safety Research, 92, 437–447. https://www.sciencedirect.com/science/article/pii/S0022437524002172

Fien, S., Lawes, J. C., Ledger, J., Drummond, M., Simon, P., Joseph, N., et al. (2023). A preliminary study investigating the neglected domain of mental health in Australian lifesavers and lifeguards. BMC Public Health, 23(1).

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About the Author: Sean Haaverson is a paramedic, EMS educator, and PhD candidate researching emergency services systems. He serves as EMS faculty at Central New Mexico Community College and is the founder of Code 3 Academy.