Strengthening mental wellness support for first responders: A collaborative initiative
The FirstNet Health and Wellness Coalition leads efforts to enhance first responder mental wellness through comprehensive strategies and policy changes
By Chief Paco Balderrama and Dr. Anna Courie
Traumatic experiences accumulate over the life of a public safety career. But that’s what you sign up for, that’s your job.
We hear this all too often, and maybe it is true to a degree. However, it does not mean first responders are immune to trauma, which is routinely accompanied by increased stress, mental fatigue and depression. It also does not mean first responders are undeserving of mental health support.
It is estimated that more than one-third of our nation’s first responders are dealing with mental health struggles. First responders experience higher rates of anxiety, burnout, depression, post-traumatic stress and more. 
Efforts by the FirstNet Health and Wellness Coalition
While the severity of this crisis expands and unveils itself, public-private collaborations like the FirstNet Health and Wellness Coalition (FNHWC) are working to make lasting and impactful improvements in this area.
Comprised of more than two dozen national public safety organizations representing every discipline and all chain of command levels, the FNHWC recently completed an analysis of America’s public safety and public health landscape, identifying needs, obstacles and potential solutions surrounding first responder mental health.
Our multi-year effort, which is summarized in a newly authored white paper released this past September (read in full below) to coincide with Suicide Prevention Awareness Month, included data analysis; literature review; input from numerous healthcare, mental health, academic and public safety leaders; and a survey of almost 400 first responders.
What we found was a surging enthusiasm among first responders to address their mental health and wellness. One-third of survey respondents wanted their departments to amplify awareness of programs and training opportunities. 
Better stress management techniques, physical fitness opportunities, life coaching availability, resilience training and ways to deal with anxiety were all areas of need identified by first responders. The barriers they face in getting these resources – cost, lack of awareness, no time or work-life balance – are familiar to anyone, first responder or not.
The FirstNet Health and Wellness Program, and the Coalition that oversees it, are resources within FirstNet, the nationwide public safety communications network built for first responders and those who support them. It is built with AT&T, in a public-private partnership with the First Responder Network Authority (FirstNet Authority) – an independent agency within the federal government. Through their close work with first responders building out the FirstNet platform, AT&T and FirstNet Authority officials recognized the need for health and wellness services and established the program. The aforementioned white paper, its study and its results are rooted in those relationships.
Key recommendations for cultural change
The Coalition’s collective work produced five key recommendations aimed at helping departments and individual first responders alike implement healthy behaviors and cultural change:
1. Engaging public safety leadership is essential. First responders want their supervisors to demonstrate and model behaviors of mental health and wellness practices, rather than speak in hypothetical terms about them.
2. Wellness must be integrated into training throughout a public safety career, and beyond. This means starting pre-academy, continuing through in-service training and extending to retirees.
3. Broader, more equitable funding should be allocated at the local and national level. While grants are available and important, they are not always sustainable and equal across all public safety professions. And many municipalities do not prioritize or understand the value of responder wellness for the safety of their communities.
4. We need to publish standards on evidence-based health and wellness programs. Technical assistance centers should also be available as a resource for implementation. First responders are more likely to take advantage of services if they are accessible, affordable and confidential (when necessary).
5. We need to talk about it. Wellness must be part of the broader discussion nationally and locally, within police departments, firehouses, associations and their local chapters, state agencies, hospitals, 911 call centers – everywhere. Although the topic of mental wellness has increased in frequency, there needs to be ongoing, strategic communication of best practices and lessons learned. And these lessons need to trickle down to the rank and file across our nation.
An essential component for success will be consensus among stakeholders. Advocates and leaders in this space will need to collaborate with their unions, communities, governments and families to ensure activities are universally supported. This needs to be an all-hands-on-deck effort.
Policy and funding changes for sustainable support
Policy and funding changes at the local, state and federal level will be integral. We are eager to see an expansion of grants for all public safety outlets – this includes not only law enforcement, fire and EMS, but also corrections, public safety telecommunicators, emergency management, frontline healthcare workers, and those who support them – to allocate dedicated funding for health and wellness resources. Elected officials and public safety leaders should work together to establish state-level standards for first responder health and wellness programs, and mandate integration of health and wellness education throughout the career life cycle.
Suicide remains a significant risk for emergency responders, with 127 firefighters and 116 police officers dying from suicide in 2020. Unfortunately, we don’t have the full picture since there is no single organization today that systematically tracks the health risk factors facing America’s emergency response personnel.
Further examination, dialogue and innovation across all disciplines and levels of public safety will help us learn more about the complex dynamic between emergency response, chronic stress injuries, individual mental wellness, and overall community health.
Change starts with you. We urge public safety leaders to think outside the box, examine the FNHWC recommendations, pursue wellness opportunities and, most importantly, set the tone. We owe it to every public safety hero to provide services that help them grow from trauma, erase the stigmas, change the culture, and be the strongest first responders they can be.
For additional health and wellness resources click here.
1. Purvis M, Fullencamp L, Docherty M. (2020.) Animal Assisted Therapy on Law Enforcement Mental Health: A Therapy Dog Implementation Guide. Bowling Green University.
2. Courie A, Sanati M. (2021.) The FirstNet First Responder Needs Assessment: Driving Towards Targeted Interventions. International Public Safety Association Journal. 1-14.
About the authors
Paco Balderrama serves as Chief of Police for the Fresno, California Police Department and is a member of the FirstNet Health and Wellness Coalition.
Dr. Anna Courie is the Director of Responder Wellness for the FirstNet Program at AT&T.