As unprecedented flooding inundates towns and leaves residents stranded in parts of New South Wales, local first responders have rescued hundreds of people from floodwaters and rooftops.

Volunteering Australia estimates more than 400,000 people volunteer as first responders around the nation. Around half of those volunteer in fire services and around 25,000 in state and territory emergency services. Thousands of additional "invisible" first responders help informally and spontaneously to support their communities before and after a disaster.

In a situation such as the current flooding in NSW, local first responders, many of whom are volunteers, face a difficult dilemma. How do they prioritise their commitment to their communities and the safety of the public while also protecting their own families and homes?

It's a dilemma one of us (Cameron) knows too well. Cameron is a registered paramedic and volunteer firefighter, and responded to the Black Saturday bushfires in Victoria in 2009. He's well aware of the challenge first responders have to juggle - helping others while also ensuring their loved ones are safe.

During a disaster, first responders and their families may be at risk due to extreme weather and rising floodwaters, damaged infrastructure, and other dangers. First responders may need to evacuate homes, coordinate emergency services, and navigate dangerous conditions while trying to ensure their own family's safety.

In rapidly evolving emergencies, they may also be faced with the choice to abandon their emergency work to prioritise their family's safety, potentially placing their first responder colleagues at risk.

Even now, 16 years after the Black Saturday bushfires devastated parts of Victoria, Jessica Ciccosillo, a first responder with St John Ambulance Australia, still feels like she abandoned her community when it needed her the most. She told us:

I had a baby at home, and my husband was also volunteering during the disaster. We couldn't both respond at the same time, so I stayed home with the baby. I also wanted to protect our animals and property. But the desire to help was so strong, and it was so hard to make the decision to stay at home and prioritise our own family.

Finding the balance between helping others while their own families are at risk can create a moral dilemma for first responders, forcing them to make difficult decisions about where to focus their efforts.

These moral dilemmas can arise from conflicting values (such as having to follow organisational policies or directives that conflict with our personal beliefs), the need to make difficult decisions under pressure, or witnessing events that challenge their sense of what is right and wrong.

Moral dilemmas about who to priortise during an emergency situation can lead to a sense of moral injury, when people can feel guilty, ashamed and distressed about the choices they have made.

First responder work can significantly impact family members. Long and unpredictable hours can interfere with family activities and undermine their sense of support. Added to this is the constant fear for their loved one's safety. When emergencies occur, these fears can be heightened.

Families may even experience vicarious trauma, where they absorb the stress and trauma of their loved one's work, leading to their own mental health challenges.

When we asked local first responders what would be most helpful for supporting their wellbeing, the message was clear: they want to talk about what they have experienced with someone who "gets it".

Sharing their experience with supportive colleagues and peers offers a different kind of support for many responders who may not have benefited from, or want to use, more traditional counselling programs.

Emergency services organisations can also promote wellbeing by creating supportive cultures and strong leadership that focus on building mental-health literacy. Programs that address the needs of the whole family, rather than just the individual responder, can foster resilience.

For local first responders currently helping flood-affected communities in NSW, focusing on making small, short-term decisions can help them feel less overwhelmed and allow them to better manage their mental health.

If you are a first responder and need support now, resources include:

The National Emergency Worker Support Service, which offers free, confidential, and evidence-based mental health support, including 12 free sessions with trauma-informed clinicians

Fortem Australia provides mental health support, including clinical support and wellbeing activities, for first responders and their families

Beyond Blue offers the Police and Emergency Services Program to promote mental health and reduce suicide risk among police and emergency service personnel, including their families

Phoenix Australia offers information, support and treatment options related to trauma for first responders, including the Responder Assist program

The Code 9 Foundation provides support for first responders living with post-traumatic stress disorder, depression, anxiety and other mental health conditions resulting from their service to the community.

For families of first responders:

If this article has raised issues for you, or if you're concerned about someone you know, call Lifeline on 13 11 14.