Organizational and Personal Barriers

Organizational Barriers

While cost is a structural barrier, low pay and poor benefits are an organization barrier. Combined with low wages, some medical insurance does not cover mental health treatment (O’Dare et al., 2024).

PTCOs report several organizational barriers to seeking mental health. The prominent complaint is getting time off approved so they can schedule and attend therapy appointments (O’Dare et al., 2023). O'Dare et al., (2024) had two respondents who write their organization does provide access to mental health clinicians, but not enough clinicians exist to help everyone in the department, or the individual was not sure how to access clinicians.

First responders note a lack of leadership support as a hinderance to obtaining mental health treatment. O'Dare et al. (2024) note an absence of encouragement from their supervisors and guidance from their organization as a barrier to finding treatment.

Personal Barriers

Mental health clinicians are viewed as outsiders in the culture (Jahnke et al., 2014). The familial culture of first responders is insular and does not like opening up to outsiders. Firefighters talk about the clinician as someone who cannot understand their culture and therefore would not be able to help (O’Dare et al., 2024; Partnoff, 2021; Smith et al., 2021). Clinicians are also perceived as being judgmental and anti-police, providing the first responder with excuses to not get help (O'Dare et al., 2024).

Some first responders just believe getting help is a waste of time (O'Dare et al., 2024). It is unclear why they believe it is the case but one bad experience by one person can spoil an entire shift by sharing that bad experience. First responders say mental health clinicians breakdown and cry in session when the FR is recounting a scenario. Some firefighters note the clinician asked invalidating questions such as, "What's the worst thing you've every seen?" First responders, those who are willing to discuss mental health with colleagues, describe the negative experiences with mental health clinicians and bolster the idea that seeking help is a waste of time. The negative experiences confirm the bias that the first responder cannot be helped.

References

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