Real EMS

Why EMS Providers Are Struggling – My Take

I recently read an article in JEMS titled “Why Are EMS Providers Struggling?” A lot of what was said hit close to home, but there were a few things I felt needed to be said from the perspective of someone who’s lived this job for a long time.

First off, I had a good childhood. A solid one. I wasn’t abused, neglected, or raised in chaos. I don’t carry some hidden childhood trauma that EMS somehow unlocked later in life. That matters, because a lot of discussions about mental health in this field tend to drift toward “earlier wounds” and “unresolved past experiences.” That may apply to some people, but it does not apply to me.

What I’m dealing with didn’t come from my childhood.
It came from the job.

Over time. Call after call. Deaths. Critically injured and critically sick kids and adults. Destruction. Scenes that don’t leave you once you clear them.

That stuff adds up.

One thing the JEMS article discusses is how EMS providers hurt one another, often unintentionally. I don’t disagree with that, but in my experience, the bigger issue hasn’t been coworkers tearing each other down. It’s been the lack of real, professional mental health support when it actually matters.

After the C-130 crash — a call I was first on scene for — I did what we’re told to do. I reached out. I went through my insurance looking for help. What I found was, honestly, a joke. Automated questions, no real person to talk to, and systems that felt more like box-checking than actual care.

So what do people do when the help isn’t there?

They shut down. They get short-tempered. They withdraw. They keep working. They push things down and drive on. They walk away and find another career. 

Not because they don’t care. Because they don’t have another option.

We like to say, “Reach out if you need help,” but that only works if there’s real help on the other end. Telling someone to ask for help and then handing them a dead phone line doesn’t make you supportive — it makes you disconnected from reality.

I don’t think EMS providers are struggling because we’re weak. I think we’re struggling because we are exposed to things most people will never see, and we’re expected to process it with systems that are nowhere near adequate. Toughness gets rewarded. Vulnerability gets tolerated — sometimes — but rarely supported well.

EMS became more than a job for me. It became identity, structure, and purpose. When you pour that much of yourself into something, betrayal doesn’t always look like a person turning on you. Sometimes it looks like a system that tells you it cares but isn’t built to actually take care of you.

I’m not angry about this. I’m just honest about it now. I also want others to know that they are not alone. 

If we want EMS providers to stop struggling, we have to stop pretending resilience alone is enough. Awareness matters, but access matters more. Professional help needs to be timely, competent, and specific to what this job actually does to people.

Otherwise, we’ll keep telling providers to “reach out,” and they’ll keep finding nothing there. And they’ll keep hurting — quietly.

You can only “drive on” for so long before something inside you finally says enough