Ty Wooten didn’t realize the weight of answering his first 911 call — until more than a decade later.

A woman had dialed 911 to report that her husband had shot himself in front of her and their 7-year-old son, on the family’s living room couch. It was Wooten’s first call as a dispatcher.

“I wasn’t prepared for that, and I didn’t quite realize how difficult that call was for me for several years,” said Wooten, who has worked in the 911 industry for more than 30 years, both taking calls and managing dispatch centers.

He is now director of government affairs for the International Academies of Emergency Dispatch, an industry group that helps set standards for emergency dispatch centers.

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Wooten pushed the experience aside. It wasn’t until about 15 years later, while swapping stories with colleagues, that the details came rushing back — triggering a spiral of anxiety, panic attacks and depression that would take time to fully confront.

“I had taken that experience and kind of put it in the corner of my mind, and built a wall around it so I wouldn’t think about it again,” Wooten said.

Wooten’s experience reflects a broader reality for first responders, who are routinely exposed to traumatic events but often lack the space — or support — to process them.

Across the country, state and local officials are increasingly looking for ways to change that, expanding mental health resources and testing new approaches aimed at reducing stigma and improving access to care for 911 dispatchers, police officers, firefighters, paramedics and emergency medical technicians.

Research suggests that first responders face higher rates of trauma-related mental health challenges than the general public, with repeated exposure increasing the risk of post-traumatic stress, depression and anxiety. That strain has also been linked to burnout, and to higher rates of substance use and suicidal ideation.

Some policing experts say untreated trauma and stigma around mental health don’t just harm police officers — they can also ripple outward, influencing split-second decisions on the street and the quality of encounters with the public.

“It’s not just a personal and individual tragedy. It’s also potentially going to have a direct consequence for how officers treat those they encounter on duty,” said Heidi Bonner, a criminal justice and criminology professor at East Carolina University.

At the same time, rising health care costs and concerns about affordability have made access to mental health services more difficult for many nationwide. Some communities are already experimenting with new approaches for first responders.

In Brevard County, Florida, some first responders now have access to therapy dogs, peer-to-peer counseling and confidential hotlines. Florida state officials last year also announced they were developing a more coordinated, statewide mental health program for first responders.

In Virginia, Henrico County firefighters gained access to a new app that allows them to seek mental health support anonymously. They are one of the first departments in the country to use the platform. Some experts say anonymity can help reduce barriers tied to stigma and fear of professional consequences.

Expanding options

Even as awareness grows, many first responders still don’t seek help — a gap that policymakers and local agencies are increasingly trying to address.

“You’re going to see something horrible, and the expectation is, ‘Yeah, that’s what we do — you just got to deal with it,’” said Alanna Badgley, a paramedic in New York. Badgley also is the EMS external affairs coordinator for the International Association of EMTs and Paramedics.

“Bringing up if you were feeling some kind of way might have been seen as a sign of weakness, or that you weren’t cut out for the job, so a lot of people would kind of hide it,” she said, describing what the culture was like when she started in emergency medicine in 2010.

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She added that there’s now a growing recognition that first responders need to be honest about their mental health and seek support early and often.

Many agencies or departments offer employee assistance programs, or EAPs, which provide confidential counseling and support services for employees dealing with personal or work-related stress, but some first responders may hesitate to use them.

“A lot of first responders worry about the potential for their employer to know what’s going on if they go through their EAP,” Badgley said.

A 2025 survey by the National Emergency Number Association found that nearly 70% of telecommunicators reported feeling stress before every shift, with fatigue and anxiety among the most common symptoms.

In recent years, states and municipalities say they’re focusing on reducing barriers to care, including affordability.

“We will pay whatever it takes for someone to get help,” said Tom Synan, the police chief of the Newtown Police Department in Ohio. Synan also is a speaker with the nonprofit Law Enforcement Action Partnership.

“I think that’s what’s going to help first responders have long careers, better home life and better service to the community,” he added.

State efforts

In New York, state officials launched an online training program in March to help mental health professionals better understand and support first responders, with a focus on responder culture and barriers to care.

New Jersey Democratic Governor Phil Murphy in January signed into law a measure that provides employment protections for first responders diagnosed with post-traumatic stress disorder, barring retaliation and guaranteeing they can return to their jobs once cleared. The law is already in effect.

In Nebraska, Republican Governor Jim Pillen in April signed into law a bill that shields peer support conversations from being used in court or disciplinary proceedings.

Minnesota legislators are considering a proposal to allow first responders to access donated mental health services, including counseling and peer support, without violating state gift laws.

And in Missouri, lawmakers have advanced legislation to study alternative therapies, including the psychoactive compounds psilocybin and ibogaine, for treating conditions such as depression, substance use and post-traumatic stress, with first responders and military veterans eligible to participate in supervised studies.

Other states have taken similar steps in recent years. Last year, Ohio lawmakers approved $40 million for a PTSD treatment fund, while Texas is developing a statewide peer support network for firefighters and EMS personnel.

Massachusetts, New York, Ohio, Utah and Washington have enacted laws to protect the confidentiality of peer support counseling. Lawmakers in Vermont are considering similar legislation this year that would ensure conversations in peer support groups remain confidential for first responders.

Still, advocates say access alone does not guarantee use — particularly when providers may not fully understand the realities of the job.

“The trauma is so unique,” Badgley said. “It’s hard to feel comfortable confiding in somebody who just really isn’t trauma informed, or doesn’t understand the first responder mentality.”

Some first responders say the mental health strain of the job goes beyond exposure to traumatic calls. It’s often shaped just as much by internal and external pressures, including workplace dynamics, public expectations, staffing shortages and required overtime, and stressors from life outside the job.

The combination can leave first responders struggling to process their stress.

“When you feel helpless — and you’re the person who helps — who do you go to?” said Synan, the Newtown police chief.

Synan said his department has worked to create space for those conversations, holding debriefs after difficult calls and encouraging officers to talk through what they experienced without pressure or judgment.

A culture slow to change

When now-retired firefighter Frank Leto joined the New York City Fire Department in 1983, mental health support barely existed.

“The mental health support at that point was probably drinks after work,” he said.

The expectation was to absorb whatever you saw and move on — until, as Leto put it, “You just stuffed it down until it started taking things from you: your family, your relationships, your health, eventually your job.”

That code of silence began to break after the September 11 attacks in 2001.

“There was really no option for the fire department to not address the mental health needs of our firefighters and their families,” Leto said.

He moved off the line to help expand the department’s counseling unit and its early peer support efforts, but their first major idea — embedding clinicians in the hardest-hit firehouses — “was an utter failure.” Firefighters rarely spoke to those experts, and the clinicians were overwhelmed by the scale and immediacy of the trauma.

The breakthrough came when the department stopped trying to import help from the outside and instead formalized what had long existed informally. Training firefighters to support one another created a trusted buffer between the rank-and-file and clinical care, and over time that model “became part of the fabric of the department,” he said.

The International Association of Fire Fighters, a labor union, recognized how powerful that shift was and helped fund the work in New York City.

Today, Leto, who is a member of the IAFF Disaster Response To-Go Team, estimated that roughly 15,000 IAFF members have been trained in peer support — a sign that, in a culture slow to change, attitudes around mental health are beginning to shift.

But that progress has been uneven, and many departments — across fire, law enforcement, emergency medical services and 911 dispatch — are still working to build systems in which seeking support is normalized and accessible.

“Looking at mental and physical and overall well-being is not one answer with one solution,” said Wooten, the former 911 dispatcher. “These are all things that have to be worked at collectively and multifaceted to make sure that we can hopefully create an opportunity to fix some of these larger systemic problems.”