By William Schroeder, LPC, NCC and clinically reviewed by Teri Schroeder, LCSW
Last reviewed: October 2026
What sets first responders apart isn’t that they see hard things. It’s how often they see them. Life and death, people at their very worst, and then the next call, where they have to shove it down to get through the moment.
Maybe it’s a child who died in an accident and reminded them of someone they know. A raid that went badly. A fire where they lost someone they worked with. Each of those is hard on its own. The trouble is that they build up.
Here’s what that buildup looks like, why so many first responders wait to get help, and why EMDR often clears things faster than people expect.
When Something Gets Stuck
The way it shows up varies. Ultimately, something gets stuck and starts weighing on you.
Maybe a bad call replays in your sleep and keeps you from sleeping. Maybe you’ve started to fear having a panic attack. Maybe you’re close to retiring, and the anxiety ramps up because you’re so close to the other side but still doing work that’s dangerous in some way.
Families feel it too. Spouses sometimes need support of their own, and kids can start showing struggles that are tied to the family system.
You’re not imagining the toll. A SAMHSA research bulletin estimated that about 30 percent of first responders develop behavioral health conditions such as depression and PTSD, compared with about 20 percent of the general population (SAMHSA, 2018). And a 2021 study by NIOSH researchers found that law enforcement workers who died were 54 percent more likely to have died by suicide than people in other occupations.
Why Most First Responders Wait
The biggest reason I hear is fear of it showing up on their record or leading to a fitness-for-duty exam. In this line of work, it’s rare that you talk about your feelings, and nobody wants a paper trail that could cause problems later.
Here’s something a lot of people don’t realize. If you see a therapist in private practice, you don’t have to use insurance. You can pay out of pocket, and then it doesn’t follow you anywhere. Some people choose that for exactly this reason. (Our self-pay rates are on our rates and insurance page.)
Like any therapist, we have a few legal limits on confidentiality, such as when someone is in immediate danger. We walk through those in the first session so there are no surprises.
The culture is changing, too. The Austin Police Department has been really great about supporting the mental health of its force, and I’ve been impressed with how much it’s doing to keep therapy stigma free and used. APD even trains community clinicians in EMDR so officers, dispatchers and other staff have trained therapists to go to (APD RESET Project).
Why EMDR Often Works Fast for First Responders
EMDR (Eye Movement Desensitization and Reprocessing) helps the brain process distressing memories so they lose their charge (EMDRIA). It doesn’t require you to talk through every detail of a call.
In my experience, first responders are uniquely good at clearing things very quickly with EMDR. I think it has to do with how their brains process information and trauma. A session or two can go a really long way.
The research backs EMDR up. A 2026 systematic review of PTSD treatments for first responders found EMDR and CBT had the most consistent results, though the authors noted many of the studies had limitations.
We know most first responders don’t want to stay in therapy very long, so we work to get to it quickly. We follow the standard EMDR protocol, build a treatment plan together and get into the work.
How We Help at Just Mind
We have a close relationship with Rick Levinson, LCSW, who trains EMDR clinicians in Austin, including through APD’s community EMDR training, and our EMDR therapists train with him. Teri Schroeder, LCSW, is an EMDR Consultant, which means she can supervise other therapists toward EMDR certification. For you, that means a therapist who’s well supported, with consultation on hard cases behind every session.
We have evening and weekend appointments, in person at our North Austin and South Austin offices and online anywhere in Texas. We also see spouses, couples and kids. Over the years, we’ve worked with people at every level of government. Learn more about therapy for first responders at Just Mind.
When to Reach Out
Honestly, all of it is worth addressing: the sleep, the irritability, the drinking, the call you can’t shake. You never know when dark thoughts are linked to what you’ve been carrying, and that’s not uncommon. Don’t wait until it spikes to a scary or intensely dark place.
One thing I often tell people is that their story isn’t the worst I’ve heard, and I’ve seen people get better. The fear that it’s too bad, that it can’t get better or that it will be too hard, can really hold people back.
That first step of reaching out is truly the hardest. When you’re ready, get matched with a therapist or learn more about trauma counseling at Just Mind.
FAQ
Will seeing a therapist show up on my record at work?
Not if you choose not to use insurance. If you pay out of pocket with a private therapist, there’s no insurance claim, and nothing is sent to your department.
How many EMDR sessions will I need?
It varies. For a single call that keeps replaying, first responders often see real change in a session or two. Your therapist will build the plan with you at the start.
Can my spouse or family get support too?
Yes. We see partners on their own, couples together and kids and teens.
What if I’m thinking about suicide?
Call or text 988 to reach the 988 Suicide and Crisis Lifeline any time, day or night. If you’re in immediate danger, call 911 or go to the nearest emergency room.
