Bridging the Treatment Gap: Peer support for first responders

by Erin Craw, Ph.D. - Strategic Account Manager, Youturn Health

First responders experience a multitude of stressors throughout their careers, including operational (job-related), organizational (structure or leadership-related), and personal (managing familial commitments). They often witness suffering, tragedy, death, serious injury and are exposed to threatening situations and critical incidents.  

It’s the nature of their job. This can lead to cumulative stress, as they move from one incident to the next without effectively coping. First responders also experience post-traumatic stress, where stress responses linger after traumatic calls. When that stress intensifies and continuously interferes with their ability to function, they may develop post-traumatic stress disorder (PTSD). This is particularly common among first responders because they often do not have the necessary support or recovery time  after traumatic calls. Consequently, first responders are five times more likely than the general population  to experience depression and PTSD, which can heighten their risk of suicidal thoughts.  

Despite the elevated risk of developing mental health conditions, first responders are often unwilling to seek support due to concerns about negative consequences (such as  desk duty), stigma, appearing weak, and concerns about confidentiality.1

In a study of about 1300 first responders, researchers found that nearly 60% were reluctant to seek support due to potential repercussions. Consequently, they resort to harmful coping strategies instead of processing their experiences. First responder culture has historically fostered the use of maladaptive coping mechanisms by emphasizing the need to suppress emotions. For instance, alcohol consumption as a coping mechanism or form of "self-medicating" tends to be socially accepted. In some cases, it’s endorsed as a means of managing the emotional and psychological strains of the job.2

Given the social aspect of drinking among first responders – and the desire for camaraderie – recognizing the issues with that coping mechanism can be a challenge. While there may be a short-term sense of relief, maladaptive coping mechanisms like alcohol use can exacerbate the adverse effects of stress on responders’ well-being.

Research has shown that using alcohol to cope can also exacerbate PTSD symptoms, And more severe symptoms of PTSD can lead to increased reliance on drinking.

Potential Solutions

In addition to concerns about the confidentiality, first responders hesitate to seek support from resources that don’t cater specifically to their work-related stress. Trust and shared understanding are vital to them to seek help, and they often prefer peers with lived experiences.

First responders in recovery can act as a role models, connecting them with reliable resources. Peer-to-peer support also boosts first responders' self-efficacy in coping with stress. And it normalizes conversations about mental health. It is important to note that many first responders are unwilling to seek aid from colleagues within their department due to the fears mentioned above. While agencies are making efforts to provide mental health resources, utilization remains low. And the negative effects of stress and trauma continue to impact their health.

Thus, it is essential to offer opportunities for first responders to connect with peers from outside their department, ensuring they feel comfortable and confident in seeking support.

Youturn Health: Bridging the Gap

Youturn Health addresses these challenges by offering substance use and behavioral health support for first responders. Our program uses peer coaches with lived experience as first responders, who are in long-term recovery from substance use disorders and/or mental illness. These peer coaches apply their lived experiences to help other first responders in making meaningful progress. This can include developing new behaviors, accessing community resources and increasing family support.

Participants also gain access to over 400 educational videos, which are available online or through the Youturn Health app. These videos provide first responders and their family members with foundational knowledge on topics like stress management, substance use, anxiety, depression, grief and suicidal thoughts. 

The Youturn Health app is available through the FirstNet App Catalog and provides access to the video library and peer coaching support. For more on Youturn Health, please visit

Erin Craw, Ph.D. earned her doctorate in communication from Chapman University in Southern California with emphases in health and interpersonal communication. Her research interests are at the intersection of health and interpersonal communication as it relates to social support, stigma, and resilience. Her dissertation explored police officers’ preferences for support and factors influencing mental health-related disclosure decisions. Craw is particularly interested in work that improves access to needed support for underserved populations and those who face extensive barriers to gaining assistance. As the daughter of a police officer (36 years) and granddaughter of a firefighter (40 years), she has a true passion for research that informs mental health-related interventions for first responders, enhances communication surrounding mental health, and improves access to support. At Youturn Health, Craw manages client success for our clients in the public sector. 

1 Jones, S., Agud, K., & McSweeney, J. (2020, January 1). Barriers and facilitators to seeking mental health care among first responders: “Removing the darkness.” Journal of the American Psychiatric Nurses Association, 26(1), 43–54.

2 Violanti, J. M., Slaven, J. E., Charles, L. E., Burchfiel, C. M., Andrew, M. E., & Homish, G. G. (2011). Police and alcohol use: A descriptive analysis and associations with stress outcomes. American Journal of Criminal Justice, 36, 344–356.