Mental health provider perspectives: preparedness and professional needs in first responder care

Purpose As part of assessing clinicians’ experiences within the [MASKED FOR BLIND REVIEW], researchers used survey methodology to assess perceptions of preparedness, occupational cultural understanding, referral processes and engagement with first responder clients. While this design does not permit causal conclusions regarding the impact of occupationally tailored training on symptom reduction, treatment retention or long-term recovery outcomes, it reflects a pragmatic and necessary step given the limited empirical base in this area. Studies have yet to systematically evaluate clinician experiences within a structured, statewide occupational competency and referral registry for first responders. The purpose of this study was to provide novel empirical insight into clinician-level factors and establish a foundation for future research examining patient outcomes and system-level effectiveness. Design/methodology/approach This study used a cross-sectional survey design to examine the experiences, perceived preparedness and professional needs of licensed mental health providers listed in [MASKED FOR BLIND REVIEW]. Eligible participants were clinicians currently listed in one or more of the directories and providing mental health treatment services to first responders. The survey was distributed electronically to all clinicians listed in the Lines directories (n = 124). A total of n = 54 clinicians completed the survey, for a response rate of 43.5%. The survey was developed by doctoral-level subject matter experts in first responder mental wellness and administered using the Qualtrics online survey platform. Findings Clinicians reported using a range of modalities, with a relatively high reliance on Eye Movement Desensitization and Reprocessing (EMDR), reflecting its perceived fit with first responders. However, EMDR is not universally indicated. Lower endorsement of suicide-specific and emotion regulation interventions suggests variability in evidence-based practice implementation and highlights the need for broader training across modalities. Experiential learning, including ride-alongs, was widely perceived as valuable, yet formalized occupational training varied. Respondents also emphasized unique treatment considerations, including confidentiality concerns, family-system stressors and the importance of structured, goal-oriented approaches. Originality/value Findings underscore the need for standardized clinician competencies, expanded suicide- and substance misuse-specific training, strengthened family-focused care and enhanced system-level infrastructure to improve access and quality of first responder behavioral health services.