Drownings, fatal car crashes, and suicides are tragic events most of us hope never to have to encounter.

Key points: 10 per cent of emergency service employees have probable PTSD compared to 4 per cent of the general population.

10 per cent of emergency service employees have probable PTSD compared to 4 per cent of the general population. Around one-fifth of emergency service workers have high levels of psychological stress

Around one-fifth of emergency service workers have high levels of psychological stress An inquiry finds rural and regional first responders face additional pressures, such as working alone and shift fatigue

But for our first responders, attending life and death situations is a daily reality.

Garry Meredith knows firsthand the toll saving lives can take on the mental health of emergency service workers.

"I always thought I'm one of the lucky ones because it didn't affect me … and then, in the end, it did," he said.

Mr Meredith has spent more than three decades volunteering as a lifesaver, including time as a crew member onboard a jet boat and rescue helicopter on the far north coast of New South Wales.

"My first experience was an unconscious fellow at Shelly Beach [in Ballina] floating face down in the back of the break," he said.

"In the helicopter we were going to road crashes and body recoveries … But I think what got to me the most was the suicides and shark attacks and probably resuscitation on kids.

"I didn't know much about PTSD until I was basically diagnosed with it."

High prevalence of PTSD among first responders

Mr Meredith's experience is by no means an isolated one.

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A recent parliamentary inquiry into the mental health of first responders found 10 per cent of employees have probable PTSD, compared to the general population which is estimated to be 4 per cent.

The Beyond Blue report cited in the inquiry also found more than a fifth of emergency service workers have high levels of psychological stress — almost three times the national average.

"What we do is not a normal job," firefighter Pat Jones wrote in his submission to the inquiry.

"We are there to help those Australians who are having the worst or last days of their life, and we do it because we care."

According to figures from the National Coronial Information System in 2015, one first responder takes his or her life every six weeks.

A recent parliamentary inquiry into the mental health of first responders found 10 per cent of employees have probable PTSD. ( ABC North Coast: Samantha Turnbull )

The actual number is estimated to be much higher, given that figure does not include part-time or volunteer emergency service workers, nor those who have retired or have been medically discharged.

The inquiry also found rural and regional first responders faced additional pressures not experienced by their metropolitan counterparts.

These pressures include lower staffing levels, fatigue caused by shift work, community connections to patients or victims, working alone, and having less access to mental health services.

The inquiry made 14 recommendations including extensive data collection on the number of mental health injuries and suicide of first responders, as well as a national action plan on first responder mental health.

Peer-to-peer support a regional solution

Terry Mortimer has been a first responder for more than 40 years, with experience as a pilot and crew member onboard a rescue helicopter, as well as a lifesaver and firefighter.

He said one of the hardest parts of the job was dealing with failure.

"There's a lot of success, but there's a lot of failure too," he said.

Former rescue helicopter pilot Terry Mortimer started a local catch-up for first responders in the Northern Rivers. ( Contributed )

"But it's not failure due to want, it's failure due to the extent of their injuries."

After dealing with his own struggles and witnessing those of colleagues and friends, Mr Mortimer decided to start an informal support group for first responders in the Northern Rivers.

He said the group met once or twice a month over a pub meal to catch up and check in with each other's wellbeing.

"What we're trying to do here is show people it's OK to be injured," he said.

"If they're suffering because there are different things that trigger them, even for anxiety and depression and things like that, there is a way out.

"I've found a lot of people only need somebody to say 'hey, it's OK'."

The need to raise public awareness

Today is international PTSD awareness day.

It's a cause close to the heart of paramedic and musician Brendan Smoother who knows the importance of raising public awareness around the realities and mental health aspect of emergency service.

"If the broader public is aware of it, then it brings it out in the open and people don't have to feel ashamed about it," he said.

Mr Smoother said his songs like 'Paramedic Suicide' and 'Behind the Seen' were prompted by a growing awareness of colleagues who had been lost to suicide or damaged beyond the point of being able to return to work.

"We're exposed to trauma situations and not just the physical trauma that we do see, but there's all the emotional baggage that comes with that … and it's prolonged and protracted over many, many years," he said.

"People probably don't think about it in their everyday lives until it's brought to their attention."