10/05/2026
We couldn't agree more.
What Would Make a Mental Health Clinic Actually Work for First Responders?
We often talk about getting first responders into mental health care. But simply making services available doesn't mean people will feel comfortable using them.
Researchers in Ottawa, Canada asked an important question:
What would it take to successfully design and implement a mental health clinic specifically for first responders?
The researchers conducted in-depth qualitative interviews with 14 key stakeholders representing police, fire, paramedicine, unions/associations, and the Workplace Safety and Insurance Board. The interviews explored what a first responder-specific Operational Stress Injury (OSI) clinic would need to look like to actually work.
Four major areas emerged:
• Implementation context: Is there a recognized need, and does the workplace culture support seeking care?
• Clinic design: How will services be delivered? What will confidentiality look like? What will it cost? How will first responders learn about it?
• Implementation: What barriers could prevent the clinic from succeeding, and what factors could help?
• Broader impact: How might creating a specialized service influence first responders and their organizations?
One finding stood out to me:
Confidentiality and cultural competency were considered paramount to first responder uptake. PubMed Central (PMC)
Participants also described the importance of multidisciplinary services, care for first responders and their families, low barriers to entry, minimal wait times, connections with other levels of care, virtual and in-person options, and a clinic located away from environments that first responders associate with their work.
The confidentiality piece deserves particular attention. Participants emphasized that first responders would need confidence that employers could not access their clinical information. The researchers also identified practical considerations as detailed as staggering appointments so first responders would be less likely to encounter coworkers in a waiting room.
That says a lot about what access really means.
We can build a clinic.
We can create an EAP.
We can hand someone a therapist's phone number.
But if the person doesn't trust the system, doesn't believe their information will remain confidential, or doesn't believe the clinician understands their occupation, technically having access may not translate into actually receiving care.
This study also reinforces something I continue to see across first responder research: workplace culture and service design cannot be separated. Participants described culture as capable of either supporting help-seeking or undermining even well-intentioned mental health initiatives.
For those of us working to improve first responder mental health systems, perhaps the question shouldn't only be:
"Do we have mental health resources?"
We also need to ask:
"Have we designed those resources in a way that first responders will trust and use?"
This was a small qualitative study conducted within one Canadian community and focused primarily on stakeholder perspectives about implementation, so the findings should not be treated as evidence that a specialized clinic itself improves mental health outcomes. But it provides valuable insight into what first responder communities believe should be considered when building one.
Citation:
MacLean, S. E., Edgar, N. E., Ahluwalia, C., Testa, V., & Hatcher, S. (2025). A qualitative study on the design and implementation of a first responder operational stress injury clinic. Health Services Insights, 18. PubMed Central (PMC)
DOI: 10.1177/11786329251333019
