Mental health support for emergency responders

Counsellors are aware that it is often difficult for clients to reach out for support from professionals. The reasons are many and varied and might include perceived stigma attached to seeking help, the cost involved, or perhaps being unsure of how to find a suitable therapist. For a new client unfamiliar with the plethora of treatment options, it may take many hours of reading counsellors’ profiles, several abandoned attempts to make initial contact, and uncertainty that speaking with a counsellor will make a difference anyway.  

This reluctance is wholly understandable, and none more so than when clients are operating in a profession where their experiences are outside of normal day-to-day interactions with others. These include emergency first responders (blue-light services), serving armed forces and reservist personnel, and veterans, and require specialist support. Such support will include knowledge and understanding of their work culture, the unique emotional and physical demands upon them, and the increased potential for psychological trauma and distress, burnout and compassion fatigue. 
 
While all will have access to providers of specialist psychological support within their organisations, not all will feel comfortable seeking it due to stigma, fear of demotion or removal from active duty, jeopardising their career prospects, or potential lack of understanding or confidence in them from colleagues. Feeling alone and isolated within their situation, they may continue to struggle and spiral downwards until eventually needing to be signed off work, or worse, be struggling with suicidal thoughts.  
 
In July 2025, Dorset Police Federation reported that 365 police officers in that county alone had been signed off from work during 2024-25 due to ‘stress, depression, anxiety, or post-traumatic stress disorder’. While for Dorset Police, this is less than the number who were signed off the previous year, it is a different picture across the UK as a whole, with the latest figures (2024-25) showing an increase of 22% when compared to the previous year, with over 17,700 police officers signed off for mental health reasons. 
 
Officers struggling with mental health issues can now obtain support from a recently expanded well-being crisis support service in the form of a new 24-hour Mental Health Crisis Line developed by Oscar Kilo, The National Well-being Police Service (NPWS). Initially operating as a pilot project for twelve months in the North-East, it is now available to anyone working within a police force in England and Wales. Crucially, it is confidential and totally independent, ensuring that police staff know their information will remain completely confidential and not be shared with the force, Occupational Health departments, or line management.
 
Similarly, The Ambulance Staff Charity (TASC) operates a 24-hour Ambulance Staff Crisis Phoneline for UK ambulance staff in crisis experiencing suicidal thoughts. Once again, it is completely independent and confidential. For those staff not in crisis but needing mental health support, a weekday 9-5 service is available.  
 
The Firefighters Charity Crisis Line also offers confidential and independent 24/7 support for members of its ‘fire family’ who are experiencing suicidal thoughts, in addition to its many other services available to those seeking mental health and other support.   
 
While the provision and accessibility of independent and confidential phone support is laudable, and in terms of crisis support, lifesaving, it does not provide the opportunity for face-to-face support. Instead, this is available through their organisations’ highly trained wellbeing and mental health teams, but they are not independent of the service. This potentially places barriers to seeking support for the reasons mentioned above – stigma, fear of demotion or removal from active duty, jeopardising their career prospects, and fear of lack of understanding or confidence in them from colleagues.  
 
In response to this need, the Network of Emergency Services Therapists (NEST) was launched in late 2023 to provide its member services (The National Police Wellbeing Service, The Ambulance Staff Charity, and The Firefighters Charity), in collaboration with Police Care UK and BACP, with a register of psychotherapists experienced in supporting emergency responders. Currently, the register is open only to therapists accredited with BACP or BABCP, or EMDR therapists holding, or working towards accreditation with EMDR Europe.  
 
However, in addition to the above register, it is important to note that there are highly skilled and experienced member therapists who may not be currently accredited but are experienced in providing therapeutic support to blue light workers, serving armed forces and reservist personnel, or veterans, all of which require insight and understanding of the unique circumstances and challenges these personnel face. It is hoped that the NEST register will expand its criteria to include applications from suitably experienced non-accredited therapists at a future time.  
  
It may take considerable procrastination and many faltering attempts before a client begins to seek or engage in therapy. The more options available to them, the greater the possibility of overcoming the many blocks they face in seeking support. Crucially, providing them with a wider range of options to find a suitable therapist experienced in the treatment and support of psychological trauma in their sector, or other similar sectors, may be the important first step they need to reach out. It may save their life.