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What EMS Taught Me About Mental Health (and What It Didn’t)

During EMS Week, Matt reflects on the strengths and opportunities for growth of emergency medical training. In this post, he shares how years in the field shaped his crisis response, why EMS programs must do more to prepare providers for mental health care, and what he's learned from stepping out of EMS and into the world of counseling.   

After decades in emergency medical services, I thought I understood crisis. But what I didn’t understand, at least not fully, was what it meant to support someone through a mental health crisis with the same care and clarity we bring to physical trauma.

Honoring EMS Week

This EMS Week, we celebrate the skill, strength, and heart of our medical first responders. But it’s also a time to look honestly at where we can grow. One area where our field still falls short is mental health, not just in how we care for patients, but in how we care for ourselves and each other.

The Crisis Mindset

In EMS, we’re trained to act fast, stabilize, and move on to the next call. We follow protocols like a cookbook, what some may call "cookbook paramedicine," especially early in our careers. And while experience builds clinical intuition and "street smarts," realizing when to apply various protocols, the comfort remains in the structure of the algorithm.
But mental health isn't linear. Mental health doesn’t resolve in a 15-minute ride to a hospital or with a 10-step protocol. I learned quickly that the same urgency that helps in a cardiac arrest can feel dismissive and harmful when someone is navigating emotional pain.

What EMS Didn’t Teach Me

Academic paramedic programs taught me how to manage an airway, perform CPR, and assess trauma. But they didn’t teach me how to talk to a suicidal patient. I wasn’t trained to sit with someone’s sadness. I wasn’t taught how to validate a person whose pain didn’t stem from a visible injury. They didn’t show me how to recognize the signs of burnout in a partner or in myself. In fact, I saw fellow first responders treat people in mental health crises with confusion, discomfort, and even disdain. That broke my heart and pushed me to change.
Pre-pandemic, I started a project focused on identifying human trafficking victims in EMS settings. That experience opened my eyes to how far we still have to go and how much good medical first responders can do. It led me down a path I didn’t expect: pursuing a career in mental health counseling.

From Paramedic to Counselor

Now in counseling, I carry the lessons of EMS with me: staying calm in crisis, acting without judgment, and focusing on what someone needs right now. But I’ve also learned that the best support isn’t always about action. It’s about presence.Their emergency isn’t mine. That’s a phrase I remind myself of often. It helps me stay grounded, so I can be the steady voice in someone else’s chaos. In EMS, that steadiness was about vital signs and trauma. In therapy, it’s about emotion, identity, and sometimes simply bearing witness to someone’s pain.

Strategize Your Success

At Tactical Counseling, we understand both sides of the crisis coin, physical and emotional pain. Whether you’re a first responder who’s seen too much or someone navigating your own emergency crisis, we try to meet you where you are.
We don’t just treat symptoms. We help you build the tools, insight, and resilience to move forward on your own terms.

Resources for Further Reading


Post by Matt Short. Content was written and verified by Matt Short. ChatGPT-websitegenerator.b12.io and Grammarly (v1.118.2.0) were used to assist with HTML formatting and proofreading.

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