When a tragedy occurs, they’re the first ones on the scene. They witness traumatic events and intense situations, sometimes on a daily basis. First responders put themselves on the line time and again, which can take a toll and eventually require access to first responder mental health resources.
Rates of substance use disorder, post-traumatic stress disorder (PTDS), depression, domestic violence, and suicidal ideation are all higher among first responders than other demographics. For example, research indicates that more than half of firefighters may be at risk for anxiety, PTSD, depression, and/or alcohol use disorder.2
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First Responder Mental Health Statistics
3 out of 10 first responders develop mental health issues like depression.1
More than 1/3 of police officers, approximately 35%, experience PTSD.1
Roughly 20% of dispatchers and 911 operators experience PTSD.1
PTSD and depression are 5 times more common among first responders.1
The rate of PTSD among first responders is 13% higher than the general population.1
85% of first responders have experienced mental health issues.1
Substance Abuse and First Responders
Approximately 1 out of every 10 firefighters abuse drugs.1
Approximately 3 out of every 10 firefighters abuse alcohol.1
Approximately 40% of EMTs engage in high-risk use of drugs or alcohol.1
First Responder Suicide Statistics
As many as 300 police officers commit suicide every year.7
More than a third of fire and EMS first responders have considered suicide, which is 10 times the rate of the national average.7
Domestic Violence Among First Responders
Among all occupations, police officers have the highest rate of domestic violence in their families.3
The rate of domestic violence for families of police officers is 4x higher than that of the general population.3
Early Signs of First Responder Mental Health Problems
To protect first responder mental health, it’s crucial to recognize early signs of problems. Following are common red flags to watch for that indicate a first responder is suffering from mental health challenges and could use first responder mental health resources.
Depression/anxiety/constant sadness: Do the bad days outweigh the good? Are you finding it hard to feel pleasure or joy? If this is the case, it’s time to reach out for mental health support.
Irritability/anger: Do little things bother you that never used to get under your skin? Are you snapping at loved ones more often than usual? This irritability is a sign of mental health problems.
Increased or new substance use: Have you started using substances you never used in the past? Are you using drugs or alcohol more often than in the past? These are signs that you are experiencing mental health challenges and are attempting to self-medicate them with substances. This pattern can lead to severe consequences and substance use disorders.
Reliving traumatic events: Are you replaying traumatic events again and again in your mind? Do you have sudden flash-backs to troubling events? These are symptoms of PTSD, which are treatable.
Burnout: Are you experiencing nightmares, fatigue, headaches, muscle tension, or digestive issues? These are symptoms of burnout, which can lead to substance abuse and other mental and physical health issues.6
Making the Workplace a Mentally Healthy Environment for First Responders
Follow the Asher model: Employers can adopt this seven-point model to develop a culture of mental health awareness in first responder settings.5
Awareness – Be open and honest and make sure everyone knows it’s ok to not be ok.
Solution-focused approach – Rather than focus on the problems, keep the focus on solutions.
Peer support – Establish a trained peer-support team that takes a proactive approach to offering support and accountability.
Resiliency – Educate and train employees on methods that build resiliency, such as deep breathing exercises and mindfulness.
Healthy habits – Offer only healthy options for lunch menus and vending machines and provide a fitness facility to encourage physical health.
Spirituality – Establish a chaplain program to offer support for first responders and provide outreach programming, such as “Pray with the Police.”
Family – Offer relationship support and involve first responders’ families throughout their career.
Establish policies that are mental-health friendly: Offer sick leave for mental health reasons. Allow employees to use leave time for therapy appointments. Provide breaks based on individual needs rather than a fixed schedule. Allow beverages and food at work in case employees need to mitigate the side effects of medications.
Offer trainings on mental health awareness: These trainings equip first responders to recognize when someone needs mental health support. Train them to respond appropriately and be proactive in getting help for others or themselves.
Establish employee assistance programs: These offer support for first responder mental health and physical health. Incorporate stress management training, yearly wellness checks, incentivized fitness programs, anti-stigma campaigns, and work environments that offer natural light to connect with the outside world.
Provide peer-support programs: These programs should include employees with a variety of backgrounds and ranks. Often, peer programs encourage first responders to seek help, because they are more comfortable speaking with someone who has been through what they are currently going through.
Schedule resiliency check-ins: These discussions allow employees to share how they’re doing with self-care and stress levels. The check-ins also provide opportunities for employees to discuss any other supports they may need.
Prioritize rest: Establish shift schedules that encourage first responders to get ample sleep. Educate employees about proper rest, and complete annual sleep-disorder screenings.
Treatment Barriers to First Responder Mental Health Resources?
Despite the clear need for first responder mental health support, many of these professionals don’t get the help they need. Fewer than 50% of first responders who need mental health care seek treatment.4
Why? It’s not because treatment isn’t available. Resources are there, but several barriers prevent first responders from tapping into these supports. Common barriers include:
Time constraints due to on-call duties and shift work make services hard to access.
The first responder culture stresses self-reliance and self-sufficiency.
First responders may not realize the mental health risks and long-term consequences involved with the stress of their careers.
First responders don’t know how or where to access services for mental health.
Professionals fear that getting treatment will have a negative impact on their career.
40% fear being fired or demoted.1
More than half of first responders fear negative repercussions for seeking help.1
Many of these barriers can be removed with proper education about first responder mental health and the resources available. If first responders and their families have a better understanding of the prevalence, cause, and treatment of mental health issues, this can help remove the stigma associated with first responder mental health treatment.
Additionally, first responder employers can offer more flexible hours and shorter shifts to allow first responders easier access to mental health services. Lastly, offering resources – like the list of resources below – can help make first responders more aware of the many supports available.
List of Substance Abuse and First Responder Mental Health Resources
There are a wealth of foundations, non-profits, and professional organizations offering support resources for the first responder community. Following are 60 of the top resources available for first responders who are at risk, including resources for loved ones looking for ways to help them.
Counseling and Therapy Programs for First Responders
Intensive outpatient programs: IOPs allow first responders to get treatment while maintaining family obligations. The programs provide aggressive intervention that addresses first responder mental health as well as issues with substance abuse and first responders.
12-step Groups/Peer Support for First Responders: These groups provide treatment that creates a sense of community and accountability. The setting gives first responders the opportunity to share their struggles with their peers, who have experienced similar challenges.
Trauma-informed therapy: Evidence-based methods include Cognitive Behavioral Therapy (CBT), narrative therapy, and eye movement desensitization and reprocessing (EMDR). These treatments can be effective in addressing symptoms of PTSD.
Alternative therapies: These therapies allow first responders to manage and heal from mental health problems by tapping into their physical or creative sides. Methods may include equine therapy, yoga, adventure therapy, tai chi, or art therapy.
First Responder Mental Health Resources
911 At Ease International: Offers free trauma-informed counseling for first responders and their families.
Bulletproof: Provides confidential resources for addiction, mental health, and treatment for law enforcement professionals and their families.
For the Frontlines: First responders can text 741741 for help with fear, stress, isolation, and other issues. Counseling is free and is available 24/7.
Livengrin Foundation: This nonprofit offers a FRAT program (First Responders Addiction Treatment), which specializes in recovery services for first responders and their families.
Firefighter Behavioral Health Alliance: Focuses on suicide prevention and behavioral health awareness. Provides workshops for EMS, dispatch, and fire departments.
Fire Hero Families: Connects firefighters and their families throughout the country to virtual support groups.
First Responder Support Network: A group of professionals who volunteer their time to provide treatment and aftercare for first responders and their families.
ResponderStrong: Offers a help line, self-help tools, articles, educational resources, and professional assistance for first responder mental health.
Reviving Responders: A nonprofit organization that is dedicated to suicide prevention and promotion of mental health among EMS workers.
Share the Load Program: Helps fire and rescue departments establish behavioral health programs and offers resources for those seeking support for mental health and addiction issues.
Survive First: Provides mental health resources for first responders and their families who are seeking support.
The Code Green Campaign: Also called Code Green, serves all types of first responders with advocacy and education on mental health.
Wings of Change: In-person and virtual peer support groups, offered for first responders and led by first responders.
Crisis Lines for First Responders
Access EAP: 800-248-1688. Free, confidential hotline available 24/7. Offers support for mental health and substance abuse problems.
Copline: 800-267-5463. Answered by retired officers trained in providing mental health support. Available 24/7.
Crisis Text Line: Counseling support for mental health crises. Available 24/7 by texting BADGE to 741741.
Frontline Helpline: 866-676-7500. First responders and family members struggling with trauma can get support from former first responders.
Hero’s Warm Line: 844-833-HERO. Provides resources and confidential peer-support services. Designed for first responders and their friends and family.
I Love a Fire Fighter – What the Family Needs to Know: Psychologist Kirschman shares strategies for firefighters and their families who are facing occupational hazards such as trauma and substance abuse issues. By Ellen Kirschman.
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I have been to several Rehab centers. This the best Rehab I have been too, the Counselors, are excellent. The Clinical Director Donna, is Great. She has a zero tolerance for Foolishness. The groups, are engaging and deal with the coor of the clients addiction.
Edward Woods
1 month ago
Attending extensive care at Avenues Metairie has been very beneficial for my recovery. I have learned so much from the groups and I feel like I’ve been challenged in positive ways that will help me stay sober and maintain a healthy lifestyle.
Jessica Sciortino
1 month ago
Counseling and group therapy are the best things about this place in my experience. The staff is friendly and supportive. If you apply yourself and are willing you will be able to learn a lot. An except first step in recovery. Nursing and mental wellness are some of the best I’ve received. Very caring and supportive. 10/10
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Amazing residential home! Or at least the one I was at in Huntington beach. Love the food, staff, nd they also helped me get a job towards the end of my treatment!!
Cassie Lee
4 months ago
Definitely recommend this treatment center !!
Brittany Jefferson
4 months ago
This residential treatment has honestly helped me so much to be a better person. Everyday is a struggle but this place really helped start me on the right path. The techs are amazing and go out their way to help me out. Admission was quick and easy and had so much patience. Thank you so much
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This is gonna be a lengthy review but hopefully it’ll be helpful to someone. I always read reviews of detox’s before I go to them (sounds horrible, I’ve only been to 3 lmao). Anyway, I’m always so anxious for the unknown and scared, so I read reviews, these one were mixed. This place is an amazing detox. I have wicked bad anxiety and I felt so comfortable here. I almost didn’t wanna leave. I only went for detox but the people I met in those 7 days are friends for life. The case workers such as Kim and Mark are amazing people. They work with you. If you act like an asshole you’ll probably have a tougher time. If you show respect you’ll be given respect. The rooms are like a 5 star hotel, showers huge, 2 tv’s for each roommate with private headphones. Like 5 tv’s in different spaces around the building if you don’t wanna isolate in your room. The food was freaking amazing, shout out to the hard working kitchen staff. If they had a restaurant I’d go lol. The detox groups are short and sweet but that’s because most people feel like shit. If it’s nice out, they take you outside to chill, walk, play basketball, cornhole, etc. oh and shoutout to Treasure who was always finding a fun activity for us. They also have an art therapy class which was super fun. As well as reiki and yoga being offered. No other detox I’ve been to has offered stuff like this. Yeah it sucks not having your phone but it’s a time to focus on you. You get to call your loved ones 3 days a week. You really can’t beat that. I’ve been to detox’s where you don’t get to make phone calls. If you isolate in your room here, yeah your gonna have a shitty experience. If you work the program, it’s a great detox. Thank you Haven for taking care of me during my stay there. Hope this review helps someone decide, seriously as someone who gets so nervous to go to new places, so glad I went here. ❤️
Kayleigh Lavin
2 months ago
Great facility clean staff is amazing and great food would strongly recommend this facility
Brad Cosgriff
2 months ago
The Haven is a great facility. They treat you with respect and kindness. I am so glad I went there. I now an alcohol free for almost 2 months because of them. Thank you, Haven.
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The clinicals were great smaller groups and the teachers have real life experience! Staff makes the place. Great food and you can vape!
Zach Rumell
1 month ago
Great program and facility. The staff goes above and beyond!
Savannah Tessmer
1 month ago
1st Time client, in which I’ll be graduating this week and I’m going to a 6 month program at avenues complete in Philly. I’ve had a tremendous experience here in Clarksville Indiana God bless everyone.
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I recently spent time at ICFR and was initially hesitant about getting sober and beginning my recovery journey. While the first day was intimidating, the staff quickly made me feel welcomed, safe, and genuinely cared for. From the techs and nurses to the therapists, group facilitators, and case managers, I never once felt judged—only supported. I want to give a special shoutout to one of the facilitators, Connor. He truly cares and was always willing to listen when I needed someone to talk to. Thank you, Connor, and thank you to the entire ICFR team for making such a difference during a difficult time.
Casey K
1 month ago
Amazing staff all around… therapists, facilitators, and client care coordinators go above and beyond expectations!
Thank you!
Mark Gonzales
Wrestling Crazy
1 month ago
This is a great place to go for recovery. The Techs and Alumni here are amazing and really care for all their clients. They will go above and beyond to make you feel at home and comfortable as possible. If your having issues and need a place for recovery please take a look here.
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the staff was very nice and helpful my case manager was awesome. I want to give a shout out to lorenzo and jess. We had good showers and comfortable beds and the food was pretty good
Janna Palomo
2 months ago
The staff are wonderful. They really get to know clients individually on first name basis. I never felt like another #. Also the food & snacks are yummy!!! I would recommend The Haven Detox to anyone who needs help.
Emily Stokes
2 months ago
Very unprofessional A joke of a place a zoo run by monkeys. Upon visiting for intake was met with a desk clerk flirting with another guy that also worked there… was told to exit the facility after being let in by said guy…. Spent 30 minutes standing outside while their phone intake person Michael confirmed i was supposed to be there at that time and confirming admission approval, but they couldn’t find me in the system… Tiffany helped me find my info, Micheal pulled up the info to show who I was and Mary started this entire process…
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I would highly recommend this for anyone that has a teen suffering with mental health issues. The tools my son learned during this program gave him his life back. He is on track to graduate in a few months, has a job and is looking forward to college!
Terri Harris
6 months ago
Sandstone Care is a fantastic resource for teens & young adults seeking support for mental health or substance use challenges. The staff truly care about making a difference, and their programs focus on genuine healing. Highly recommend!
Ray Sawvell
6 months ago
Guys If y’all read the 2.0 black book, I’m summer the sandstone legend and I’m also a baddie my insta is starzyx.ccc tell my man to add me back
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Caitlyn was awesome. I had a wonderful hete at ICFR. THANKS TO ALL
John Kendall
1 month ago
My experience at ICFR Bloomington, has far exceeded my expectations! The campus is beautiful, you can actually be outside in nature while walking to classes. The facilities are very clean and well maintained. There is snack foods available 24/7, with three hot meals daily. They have everything you need while you’re here, if you forget anything at home. Pack like you’re on vacation! This is not a typical facility, as they offer much more freedom and actual apartments to live in. The programs they offer are amazing too! I learned so much more in my time here than anywhere else I’ve been.
Thank you ICFR!!
Ashley Vincent
1 month ago
Wonderful place and the rec center is awesome!! I especially love the staff.
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Leachelle, Sharice, ALLEN, Ron best recovery workers in florida
Dave Penon
1 month ago
The whole staff was extremely helpful!! And a beautiful facility.
Nathaniel Hennig
1 month ago
The care team at The Recovery Team are very kind, caring and want what’s in the best interest for the clients they service. Shoutout to the following staff members who have gone above and beyond their call of duty and have made a difference in my life.
Leachelle-BHT Supervisor
Jared-Client Care Coordinator
Sara-Therapist
Rafael-BHT
Lynn-BHT
Edith-BHT
Walter-Lead BHT
Stephanie-Case Management
Nurse-Slay
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We had such a wonderful experience at Sandstone and felt supported every step of the way during IOP. Family nights were always a bright part of the week and Stacey and Kiah are amazing therapists.
Kathryn West
3 months ago
I spent so much time talking to an amazing employee named Jade. She seemed like a therapist because she was so good at her job. She literally explained everything patiently. She literally Helped me in so many ways personally that I didn’t expect. I’m excited and motivated about being a new patient at this facility. I was referred by a good.
DEJUANTE JACKSON
5 months ago
Great group therapy and learned a lot of good applicable strategies to improve my ways of thinking.
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RTN has been a great experience for me. The Willing House in Newton is run by two very capable and great house managers and the people who run the groups are amazing. I was hesitant to do aftercare after CSS but I’m glad I did so and came here. Pam is an amazing clinician if you end up with her as yours. Case management has been great as well. I don’t have a negative thing to say about this program. I highly recommend this place to anyone for aftercare after CSS or detox.
Sean Brooks
2 months ago
Recovery team newton has given me a life experience this team has lead me in the right direction to recovery and offers many ways and solutions of all problems with addiction and mental health the staff is amazing I couldn’t ask for a better place! I’m extremely grateful for everything thank you so much recovery team newton as of today I’m 70 days sober 🙏🐪🏁
William J Kerr
3 months ago
This place has been influncial in my recovery. The staff at the facility is top notch. The personal care and attention that each client gets is second to none. The level of understanding you get while going through the program will stick with you throughout the rest of your life. I would highly recommend going to Recovery Team Newton when you are looking for a place to continue exceptional treatment.
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As a professional who regularly refers clients to Sandstone in Virginia, I can confidently say their communication is top-notch and the quality of care they provide is exceptional. Truly a trusted partner in client care.
Jakob Stone
3 months ago
Getting help for your substance use is very personal and personalized. Everybody is gonna have different experiences. While asking for help and following through is not easy or necessarily fun, the team you work with is going to help you a lot. Sandstone helped me with the building blocks I needed to be alive today. Find the therapist and ppl who genuinely care and are serious. Addiction is not your fault but indeed your responsibility.
ana r-c
5 months ago
Thoughtful and accessible care, really helped me learn and grow.
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My friend recently completed the PHP/IOP program in Seymour, TN, and I can’t say enough good things about the experience. The serene setting provided the perfect backdrop for healing, and the staff was compassionate, knowledgeable, and truly dedicated to my friend’s well-being. The program offered personalized care and practical tools that made a real difference in their mental health journey. I’m incredibly grateful for the positive impact this program had on my friend’s life and would highly recommend it to anyone seeking support.
roger leroy
4 months ago
I am incredibly grateful for the amazing staff at the PHP/IOP program in Seymour, TN. My friend received not only professional support but also genuine care and empathy throughout their journey. The team went above and beyond to ensure they felt heard, understood, and equipped to handle their mental health challenges. Thanks to the dedicated staff, my friend has made incredible strides toward healing. I truly can’t thank them enough for their unwavering support and for changing my friend’s life.
Tony Vavakas
4 months ago
Sanctuary has been a life saver. It helped me so much! The whole staff really cares about people. Sarah and her clinical team have been simply amazing. You can tell she cares, is knowledgeable about mental health issues and has compassion for everyone. I am grateful to have met her and gone through the program! Definitely recommend the Sanctuary team! ”
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I’m not sure if the provider for young adult IOP Bridgette is still there, but about two years ago at the lowest point in my life her and sandstone taught me so so much and I appreciate them every day honestly
Alex Glass
3 months ago
I had a good experience overall. The people there were very welcoming. I could relate to other people who have experienced similar things to me. And I felt like people there took me seriously and heard what I have to say.
Mitchell Poppek
4 months ago
I was really satisfied for the services y’all gave me,
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Staff has a TON of knowledge an truly cares an wants you to be the best version of you. I truly appreciate the Love I felt!!!!
Henry Plonski
1 month ago
This place truly saved my life I never thought of it helping me but the facilitators really care about the people holly really goes to the ends of the earth much love
Kamron Wright
1 month ago
I came to avenues a broken soul. I didn’t love myself or anybody else. I did not want to live anymore. I have been to 5 star rehabs with private chefs and rooms that look like the four seasons and those places have nothing on avenues Cambridge. This place is truly amazing and that’s coming from a dope fien. I’m no longer a slave to my addiction and I will forever love avenues, holly is the alumni cordinatoor and she is amazing I definitely recommend coming here if your struggling
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As a Licensed Clinical Psychologist from Harvard Medical School, I find Reign to provide a peaceful therapeutic setting that one needs in order to find inner peace and healing. Very dedicated staff and a small, intimate and safe environment. I highly recommend this hidden jewel.
DR BLAIR BARONE
9 months ago
Hello my name is Adam. I came to Reign about a month ago. I came from NJ and enrolled to the treatment center because I was struggling with some mental health symptoms that were unmanageable with life and needed assistance with getting myself back on track. The admissions team was so helpful and supportive, they were there when I was making my 22 hour drive. Jake, Benzi, Justin, and Morgan were so supportive on my drive. When I arrived at the facility and during the duration of my stay Corey the primary therapist was very friendly and welcoming. He wasn t like normal therapists where you would have your 30 min session and you re out but he gave me as much time as I needed and let me use my phone and make calls as much as I wanted to do. Then there was Brantley the operations manager and he Was just the absolute best. I developed a great friendship with him and every night we had a thing where we watch movies together. Gina was a great group facilitator and had very informative groups. Overall I had an amazing life changing experience,
Adam Ilbaher
10 months ago
Cory is a nice therapist and it is a nice place to stay
Wright, H. M., Fuessel-Hermann, D., Pazdera, M., Lee, S., Ridge, B., Kim, J. U., Konopacki, K., Hilton, L., Greensides, M., Langenecker, S. A., & Smith, A. J. (2022). Preventative care in first responder mental health: Focusing on access and utilization via stepped telehealth care. Frontiers in Health Services, 2, 848138. https://doi.org/10.3389/frhs.2022.848138
Wright, H. M., Fuessel-Hermann, D., Pazdera, M., Lee, S., Ridge, B., Kim, J. U., Konopacki, K., Hilton, L., Greensides, M., Langenecker, S. A., & Smith, A. J. (2022). Preventative care in first responder mental health: Focusing on access and utilization via stepped telehealth care. Frontiers in Health Services, 2, 848138. https://doi.org/10.3389/frhs.2022.848138
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