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When is the right time for therapy for first responders?

Recognizing when to seek help is crucial yet often obscured by the stigma against mental health treatment

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Deciding to look for support is a bit like heeding the warning lights on your car’s dashboard.

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In the demanding world of first responders, recognizing when to seek help is crucial yet often obscured by the stigma against mental health treatment. The stigma surrounding mental health in such a masculine, tough-it-out culture can make it difficult for those who dedicate their lives to helping others to acknowledge when they, themselves, need help.

Let’s demystify this process, outlining clear indicators for when it’s time to seek help, exploring the options available and when it’s critical to take action.

Self-check-in reflection

As a first responder, successfully navigating the rigorous background checks and thorough physical and mental assessments upon entering this field speaks volumes about your resilience and coping capabilities. After months or years on the job, though, after having been exposed to dozens or even hundreds of traumatic incidents, you may find yourself struggling in your personal and/or professional life. The pressing issue at that point is whether you’re still making the most of the mental toughness and coping skills you demonstrated when you first started your career.

Have the regular activities that once kept you grounded and balanced been sidelined, giving way to isolation or less healthy coping mechanisms? Take a moment to reflect on your hobbies, exercise routines, and the precious moments spent with loved ones that once acted as your pillars of stress relief. If these no longer provide the comfort or happiness they used to, it indicates a significant shift. Acknowledging these changes in yourself over time is a crucial step toward grasping your current emotional and mental state. It can also highlight the potential need for exploring new or additional support systems.


Mental wellness is crucial for effective public safety work. In this video, Gordon Graham, Lexipol co-founder and risk management expert, explains the four dimensions of mental wellness: mental, emotional, social and psychological. These dimensions impact how we think, manage emotions, connect with others and make decisions. Watch the video to learn how to promote mental wellness within your team and enhance overall resilience


Notice the warning signs

Deciding to look for support is a bit like heeding the warning lights on your car’s dashboard. If you’re feeling more anxious than usual, tossing and turning at night, consistently snappy, feeling like your shoulders are up to your ears in tension, or just generally overwhelmed, those are your body’s way of flashing a “check engine” light at you. It’s all about noticing the shifts in how you’re feeling or acting.

And it’s not just about you; in relationships, continuous unresolved arguments, a sudden breakdown in communication, or a feeling like you’re just not connecting anymore can also be warning signs. Keep in mind what your warning signs might be, because everyone’s baseline is different. For example, if you’ve always been a homebody, then enjoying a quiet evening most nights isn’t a red flag. But if you’ve always been known to be the life of the party and suddenly you’re ducking out of every social invite, that might be your dashboard lighting up.

When should I seek therapy?

So, when’s the right time to think about therapy for first responders? You know, there’s this idea floating around that therapy or counseling is the emergency brake you pull only when you’re skidding off the road. This is especially true in circles where showing toughness is part of the job. You might hear someone say their marriage is hitting some bumps, but quickly add, “We’re not at therapy level yet” — as if getting help is like admitting defeat. It’s as though signing up for therapy is waving a white flag. But here’s the thing: Deciding when to seek therapy isn’t a one-size-fits-all situation. From my cozy psychologist’s chair, I’ve seen all sorts of moments when people decide they need a hand.

Thinking about starting therapy sooner rather than later can be tough, thanks to the stigma you may face in first responder culture. Let’s switch gears, then, and think about something we all understand — your car.

Imagine if I handed you the keys to a shiny, new ride and said, “This is your car for life. Take good care of it, and it’ll take care of you.” You wouldn’t wait until it’s coughing smoke on the side of the road to check under the hood, right? You’d keep an eye on those little warning lights and get regular tune-ups to keep everything humming along. Catching issues early usually means they’re easier and cheaper to fix, right? This is the case whether we’re talking about cars, leaky faucets or (you guessed it) our mental health and relationships.

An extensive checklist aims to help agencies evaluate police-friendly wellness providers, programs and products

What are my options?

Support options come in all shapes and sizes, tailored to fit the unique needs of everyone seeking help. Within your own department, you might find a range of trained helpers, including peer support groups, critical incident stress debriefers and chaplains. These folks are part of your daily world; they understand the grind, and it’s less intimidating to start a conversation with someone who’s already part of your routine. Whether you’re checking in during a shift or even while you’re still on scene, they’re there to offer an immediate listening ear and support. Plus, they’ve got the training to recognize when it might be time to bring a therapist into the mix.

If one of these helpers suggests seeing a therapist, it’s worth paying attention. They’re not doubting your strength; rather, they’re pointing out that, given your situation, a therapist could be a really helpful ally. They work alongside therapists and know the value they bring to the table, so their advice is gold.

The therapy options your department has available to you might range from professionals within your insurance network, employee assistance programs (EAPs), or even therapists who are either part of an in-house team or contracted specially. The great news is, in most of these cases, your department’s got at least some part of the bill covered — if not all of it, then a generous slice of it. It’s not unusual for there to be an agreement on the number of covered sessions you’re entitled to each year, and sometimes, this perk extends to your family too.

If it’s crucial for you to have a therapist who really gets the first responder life, you might want to direct your gaze toward those contracted specialists, the in-house crew, or even private-pay options. While insurance providers and EAPs offer a wide net, they’re not always stocked with experts in first responder issues — though they might have them if you ask.

The key takeaway here is that tapping into these sessions through your department doesn’t mean your bosses will be looped into your private business. Your access to these is confidential and they keep your sessions private, even if the department is footing the bill. So, if you’re the one reaching out for help, rest assured, it stays between you and your therapist. If the department is mandating it for any reason, that’s another story and you should always ask questions to get a clear understanding regarding what, if anything, will be reported back. Therapists have to be honest about this for true informed consent.

Crisis hotlines, such as the 988 Suicide & Crisis Lifeline, offer immediate help to those in need, providing anonymous assistance and direction. Meanwhile, online resources and specialized solutions for first responders, like Lexipol’s Cordico wellness app, act as a preventive strategy for managing your mental health. These platforms equip you with valuable tools and insights, helping you to comprehend your own challenges, navigate through them, and recognize the optimal moment to seek personalized support.

The app provides handheld access to anonymous self-assessments, peer support, instructional videos and geo-mapping of vetted therapists among other resources

Which therapies are appropriate for which situations?

The right kind of support can differ greatly depending on your needs. Mental health apps excel at preventive education and can direct you to the right resources, while trained and certified peer support team members can be just what you need for tackling everyday stress. However, for deeper, more complex issues like PTSD, anxiety, depression or troubles at home — especially when they affect your work, daily life or relationships — professional help might be the best route.

The key is understanding the depth and complexity of what you’re facing; this insight will steer you toward the most effective form of assistance. Remember, it’s completely okay to reach out to any of these resources at any time. You won’t have to justify your actions or explain how bad things are. They’re there to offer guidance on what steps to take next, tailored to your unique circumstances.

When is reaching out almost mandatory?

Reaching out for help and engaging in treatment becomes crucial when an individual exhibits signs of significant mental distress: thoughts of self-harm, profound depression or substance abuse. It’s also critical when personal and professional responsibilities and relationships are severely impacted. Additionally, when coping strategies have consistently failed to provide relief, and a person’s quality of life is diminishing, it is highly recommended they seek professional intervention as quickly as possible.

Think of it like this: If you act as soon as the check engine light in your car turns on, you’re more likely to keep it running smoothly for a long time. What you don’t want to do is slap a sticker over that warning light and pretend everything’s fine, only to end up stranded, waiting for an emergency tow because you didn’t address the problem earlier. Looking at therapy or counseling as options for early intervention, rather than last-ditch efforts, can boost your resilience, enhance your quality of life and protect your career and relationships over the long haul.

By changing how they view and approach their mental health, first responders can set a powerful example. Reaching out for help is a strong, responsible choice that underscores both professional dedication and a commitment to personal wellbeing.

Remember that it’s okay not to be okay but not to stay that way

Dr. Rachelle Zemlok is a licensed clinical psychologist in California, specializing in work with first responder families. She serves as the strategic wellness director at Lexipol, supporting the content and strategy related to first responder mental health and wellness, with a special focus on supporting spouses and family members through the Cordico Wellness App. Prior to joining Lexipol, Zemlok founded First Responder Family Psychology, which provides culturally competent therapy to first responders and their family members. She is the author of “The Firefighter Family Academy: A Guide to Educate & Prepare Spouses for the Career Ahead.” For more information on Dr. Zemlok or to connect with her please visit her website.