Burnout Among Frontline Workers in Ohio: Secondary Trauma, Fatigue, and What’s Working

State data and national research point to rising demand, persistent staffing gaps, and serious health risks if support systems don’t keep pace. Ohio has begun to respond with peer-support programs, wellness training, and workforce pipeline initiatives, but lasting change requires broader reach and sustained funding.

Secondary traumatic stress (STS) refers to PTSD-like symptoms caused by exposure to others’ trauma—common among first responders, therapists, and caseworkers. According to SAMHSA, hallmark signs include intrusive thoughts, emotional numbness, and sleep disturbance. Left untreated, STS accelerates burnout and turnover. In Ohio, the Department of Mental Health & Addiction Services warns that secondary trauma increases risks of cardiovascular disease, substance use, and family strain—highlighting the urgent need for trauma-informed workplace supports.

Pressures In Emergency And Clinical Settings

EMS professionals face repeated exposure to violence, severe injury, and death—conditions strongly linked to higher PTSD rates. A National Library of Medicine study found PTSD symptoms in the mid-teens among EMS workers, underscoring the emotional toll of the job. To address this, Ohio created the Office of First Responder Wellness to centralize peer support, fitness-for-duty resources, and mental health training. Grants have funded peer-support training and staffing relief in departments from Akron to rural districts. In Allen County, leaders expanded EAP access, peer teams, and resiliency training to combat stress injuries among firefighters and medics—offering a scalable model for small agencies.

Ohio’s behavioral-health sector is overwhelmed by demand. The Ohio Council reports multi-year increases in treatment needs, while federal workforce projections warn of severe counselor, psychologist, and psychiatrist shortages. Even after 2024 Medicaid rate increases and salary adjustments, agencies struggle to retain qualified staff, especially in front-line roles with the highest STS risk. Evidence-based trauma therapies—such as TF-CBT, CPT, EMDR, and PE—can reduce compassion fatigue and moral injury for providers, according to the APA.

Strain In Child Welfare Services

Turnover in Ohio’s children-services workforce remains alarmingly high, with some counties seeing 40%+ annual churn and nearly half of caseworkers having less than two years’ experience. State programs like Coach Ohio and resilience trainings through the Child Welfare Training Program aim to boost optimism, reduce stress reactivity, and improve retention.

The Child Welfare University Partnership now reaches 90% of Ohio counties, offering internships and direct employment pipelines to stabilize staffing. These workforce investments are essential, as high turnover not only impacts worker well-being but also reduces service continuity for vulnerable children and families.

Why It Matters And What’s Working

Unchecked burnout impacts both worker and public safety. Studies from the NIH link trauma exposure to higher PTSD, depression, and anxiety rates among frontline professionals. High turnover also drives up operational costs due to recruitment, onboarding, and lost productivity—issues documented in child welfare retention research.

Some Ohio programs are showing promise. The Office of First Responder Wellness and initiatives like Akron Fire’s peer-support training create confidential, trusted spaces to process trauma and prevent long-term stress injuries. State-led trauma-informed care initiatives in schools, clinics, and justice systems are helping reduce downstream crisis loads for frontline workers. Meanwhile, scholarship programs like Great Minds for Behavioral Health are expanding entry paths and retention incentives for high-need roles.

Action Steps For Sustained Change

Experts recommend that agencies protect time, team, and sleep by implementing duty-hour limits for EMS crews and clinicians, along with structured decompression after high-stress calls. Employers should ensure fast-track access to trauma therapy via EAPs or external specialists.

Retention should be built around resilience. Scaling programs like Resilience Alliance and Coach Ohio, monitoring caseloads quarterly, and offering differential pay for high-acuity positions can strengthen the workforce. Leveraging HRSA funding streams can help sustain these efforts beyond initial grants.