Creating a Cultural Shift for First Responder Agencies

By Stephen Odom, Ph.D.,
Founder & Chief Officer, First Responder Wellness and Shift Wellness

You’ve probably seen the data on law enforcement and firefighter/EMS suicide completion: an increase of 43% and 35% from 2018 to 2019 and 2020 had the same or higher increases2,3 and, we all know those numbers are underreported by disguised suicides. This data is devastating. What are we supposed to do? 

Departments spend significant training time and resources preparing for and then responding to calls that range from the catastrophic to the mundane. The continual training is intended to reduce risk and effectively serve the public. Strategic, tactical, and physical excellence are ongoing objectives to the success of the mission. Yet, often missing from this success formula are the strategies and tactics needed to manage the cumulative effects of the relentless onslaught of exposure to traumatic and disturbing events witnessed and intervened upon daily. Additionally, the price of vigilance, sleep interruptions, exhaustion, and all that awaits the responder at home after extended periods away are rarely entered into the cost equation.

Dealing with stress and trauma is part of the job. Unfortunately, chronic exposure to highly stressful and traumatic situations is known to have a significantly negative impact on mental health and wellbeing in myriad ways, in fact, 85% of responders experience mental health signs and symptoms1  that are in many ways a normal response to the job.

Recognizing Symptoms of a Stress Disorder

While the average civilian can experience a few traumatic events in their lifetime, responders become accustomed to acute trauma, and even though “desensitized,” there are underlying physical, emotional, and “hypersensitized” brain changes that result from exposure and exhaustion of the body and mind. Most do not realize they are experiencing the gradually increasing signs and symptoms of a stress disorder, as it has only recently come into public safety awareness that the way we feel is not normal or healthy.

Continually being there for others is a point of pride for law enforcement, firefighters, and paramedics, but that pride can also be detrimental to mental health by not prioritizing one’s own emotional and mental self-care, or as the language we use evolves Brain Health. The cultural imperative that tells responders to ‘tough it out, rub some dirt on it and drink some beers’ only perpetuates the myth that an iron will and drinking to forget works.

Over the past few years, a symptom-management approach has begun to take hold, where prescriptions for testosterone and Adderall have skyrocketed for responders and are viewed by many as tactics to boost energy, strength, and focus (along with insomnia). The long-term effects of both are the opposite of the goals, along with an addiction to either or both. Something more fundamental and permanent needs to happen.

How much do we invest in a single police officer or firefighter over the course of a career?

  • How much of those resources go towards resilience, mental health, and peer support awareness and training?
  • How many employees have we had to separate from the department due to disciplinary, job performance, or legal issues, or lost to an avoidable circumstance (e.g., suicide, alcoholism, etc.)?
  • When any of those realities occur, you’ve lost your “investment” and must start over. 65% or more of those terminations/resignations are due to behavioral issues that early intervention and awareness may likely have corrected.

So what are we to do?

Obtain and have available the right resources. Whether it’s counseling and EAP services, or intensive treatment, be very wary of those who will state they care for first responders – make them prove it. Responders will generally allow for a single negative encounter, and then it’s game over – “I tried it, counseling mambo jumbo doesn’t work for me.” Working with organizations that have both expertise and cultural competency to understand and work with your departments and their families is critical. Stories abound of responders seeking counseling or treatment, only to be put off by experiences with therapists who cannot handle the load or do not understand the demands on both responders and their families.

How can we encourage our responder family to prioritize their mental health and wellness while remaining strong, selfless, and unflinching? We need to make mental health – brain health – safe, confidential and effective for our people.

Fear of Criticism and Lack of Confidentiality

Let’s eliminate damaging affirmations, such as telling another to “suck it up.” The culture tells you to be brave, be tough, but constantly suppressing emotions and stress results in bad outcomes. The fear of criticism and lack of confidentiality is amongst the top reasons why first responders often fear seeking help for their relationship, PTSD, anxiety, depression, and alcohol/substance misuse issues1.

The adoption of behavioral support programming by departments is a vital and critical component in creating a shift in brain health and wellness for departments.  It’s important to be proactive in treating mental health rather than reactive, which will propel and strengthen the cultural shift by generating a more inclusive and aware workforce. Sadly, the impetus for change in departments around the country is often a tragedy instead of risk mitigation and planning.

Another critical goal is to design and implement behavioral care systems into your departments that should include trusted peer support, effective treatment options, a behavioral care helpline, normalized health and wellness programming, culturally competent employee assistance programs, clinicians, and critical incident stress management workshops – All the elements your III-A Health Trust has created especially for you.


Dr. Stephen Odom

Dr. Stephen Odom, Ph.D. is a 30-year first responder and healthcare behavioral health expert. He is the CEO of First Responder Wellness and Shift Wellness, and Shift is the behavioral care partner of the III-A. This article is excerpted from presentations Dr. Odom gave for the Idaho Fire Chiefs Annual Conference For more information about Dr. Odom and the work he does, visit and

Citations:  1University of Phoenix, 2017; 2FBI, 2020; 3NFPA, 2019