The Frontlines of Mental Health
First responders answer the call when others are in crisis. But many of those calls aren’t about gunshots or flames. They’re about emotional distress, mental illness, and trauma unfolding in real time. A recent study analyzing data from the National Emergency Medical Services Information System (NEMSIS) found that the fourth most common provider impression of EMS calls was behavioral psychiatric disorders for adults. And the second most common provider impression for the pediatric population (Panchal et al., 2022).
A Front Row Seat to Mental Health
As a paramedic, I’ve witnessed the growing mental health needs in our communities. The increase isn’t just anecdotal, it’s backed by national data and decades of evolving calls for service, from suicide attempts to anxiety, from substance use to crisis decompensation. The requests we receive often involve pain that isn’t visible on an EKG, CT scan, or X-ray.
Dispatchers may hear the panicked voices long before anyone arrives to provide aid. Law enforcement and firefighters secure the scenes. And it’s the medical first responder who provides the medical contact. Each responder holds a piece of the mental health puzzle and carries the emotional weight that comes with it.
I've been on scene with a woman experiencing intense chest pain. Her faith community called 9-1-1 and now surrounded her, hovering over her and praying in a spirit of concern. After spending a few minutes with her, she disclosed that tomorrow is her wedding anniversary. Her soon-to-be-ex-husband had filed for divorce last week. After an appropriate EMS assessment, she was offered transport to a hospital for a comprehensive physical examination, but she refused. She didn't want a trip to the emergency room; she needed a non-judgmental listening ear as she processed the collapse of her marriage. And as we left, I realized I wasn’t so different. I was silently struggling in my relationships. I needed to talk, too. But to whom?
The Emotional Cost
It takes a toll. The repeated exposure to trauma, especially without adequate time or support to process it, can lead to emotional fatigue, compassion fatigue, burnout, or worse. We talk a lot about the importance of proper training, gear, and equipment. We maintain our apparatus, ensuring operational readiness. Emotional readiness matters, too. So does the ability to decompress and access care without stigma or delay.
Strategize Your Success
At Tactical Counseling, we specialize in supporting first responders and community members through life’s most intense moments. Whether you’re processing a recent call, struggling with long-standing stress, or navigating transitions at home and work, psychotherapy helps.
Our approach and theoretical orientation are built around real-world first responder experiences. That means flexible scheduling, solution-focused strategies, and a deep understanding of how trauma, exhaustion, and repeated exposure to crisis wear down even the most resilient professionals. We help clients take small, sustainable steps toward well-being, on shift and off.
- Confidential, culturally competent care
- Support for burnout, anxiety, grief, trauma, and more
- Tools for resilience, communication, and emotional regulation
Mental health support isn’t just for those in uniform. If you’re a spouse, a survivor of trauma, or someone struggling silently, Tactical Counseling is here for you, too. We support our communities by supporting everyone within them. You don’t have to be in crisis to benefit from counseling. You just have to be human.
Resources for Further Reading
- Panchal, A. R., Rivard, M. K., Cash, R. E., Corley, J. P., Jean-Baptiste, M., Chrzan, K., & Gugiu, M. R. (2022). Methods and Implementation of the 2019 EMS Practice Analysis. Prehospital Emergency Care, 26(2), 212–222.
- 9-8-8 Lifeline
- National Alliance on Mental Illness (NAMI)