They are a reassuring presence in times of crisis, rising to the occasion when Australians are most in need. Whether it’s bushfires, floods or a road accident, emergency workers play a front-line role in ensuring our safety.

In Australia, there are more than 370,000 full-time and volunteer emergency workers, including police, fire and rescue, and ambulance personnel, as well as volunteers from organisations such as the State Emergency Services (SES), Coast Guard, Marine Rescue, Rural Fire Service, and lifesavers.

It is no surprise these capable and calm people, who respond to unimaginably traumatic events, are viewed as one of the most valued and trusted occupational groups.

There is an enormous psychological toll when, as former volunteer firefighter Elisabeth Goh says in our report today, “Everybody’s worst day is your every day.”

Firefighters battling the Black Summer bushfires in 2019.Credit: Nick Moir

That toll can be seen in the disproportionately high rates of post-traumatic stress disorder (PTSD) experienced by emergency workers compared to other professions. The current estimate is it will affect one in 10 personnel.

The Black Dog Institute and the University of NSW have launched updated guidelines for the treatment of PTSD in emergency workers in recognition of the large numbers reporting ongoing psychological consequences of exposure to trauma.

The term “post-traumatic stress disorder” came into use in the 1970s in relation to Vietnam War veterans, but the condition has long been recognised where people exposed to death, assault or injury experience psychological consequences.

It can result from a single significant event or, as in the case of emergency workers, from sustained and repeated exposure to the type of trauma that is part of their normal work.

They may witness scenes where people have been badly hurt or lost their lives, be directly threatened or required to make life-or-death decisions in volatile conditions to maintain community safety.