A few years before I had the idea for Responder Support Services (RSS), I first developed a model for embedded behavioral healthcare for civilian emergency services. The unique aspect of this program was: it’s the first one in the nation based from an outpatient group private practice. The original idea was a collaboration with the then Sheriff of Buncombe County, Van Duncan, and grew out of a much smaller version of the program already in place at the Sheriff’s Office. I built the program from the outpatient group practice I co-owned at that time, the Cognitive Behavioral Therapy Center of WNC. The program was developed exclusively for Buncombe County Sheriff’s Office and Buncombe County EMS. I think the idea developed after few deputies experienced counseling with me (at that first practice) and had good outcomes. Unbeknownst to me then, first responders are a perfect fit for my personality and counseling style. The embedded program at Buncombe County was very successful. Since that initial program at Buncombe County, we’ve grown to have embedded programs at 22 different agencies and two (2) outpatient clinics serving exclusively first responders supported by over 30 different agencies. We’re close to opening another first responder-only outpatient clinic in Boone, NC.

In 2017, the practice I co-owned was purchased by a large, national behavioral health provider and I sold them everything except the first responder “part” of the business. The proceeds from the sale allowed me to follow-through on my idea of a group practice that focused on providing clinical and educational services exclusively to first responders and first responder spouses. In February of 2018, I launched Responder Support Services (RSS). That launch included opening the very first outpatient behavioral health clinic exclusively serving first responders and offering embedded clinical programs to other agencies.

I don’t think there’s only one single reason why I’m so passionate about helping first responders. There are several reasons this population is so important to me. Among the many reasons are, the realization that I finally found a treatment population ideally suited to my personality, communication style and demeanor. As a counselor, I haven’t always been a good match for civilians. It feels like a perfect fit with responders.

Another reason this population is so important to me is because all of them are willing to risk their necks for the communities in which they work, even when they don’t know the majority of the community members. In doing so, again for people they don’t know, first responders are repeatedly exposed to traumatic stressors that eventually have profound negative impacts on them.

Another dynamic that compels me to help only first responders is the gratitude they show when they receive help. No other treatment population I’ve worked with has been so open about expressing their gratitude. Hearing responders describe how their lives improved after working with us is continuously energizing to me and reminds me 1) Why I do this work and 2) I’m doing exactly what I’m supposed to be doing.

These factors combine with many others not mentioned, to drive part of the RSS mission: to provide clinical services to first responders that are the highest quality services they can find in their communities. First responders deserve the best care possible.

Some agencies, especially those in large metro areas (ex. Los Angeles PD) offer embedded services to their personnel. These clinicians are employees of the agency in which they’re embedded. RSS clinicians are employed by RSS, an independent/outside entity, and we embed inside agencies, after a training period. Many times, first responders are suspicious of anything that originates from within their own agency or municipality and decline to participate, no matter how helpful it may be (another example of how first responders look at their world).

The RSS approach is vastly different. My experience is, though responders may be immediately suspicious of RSS, they quickly ‘warm up’ to the program and staff. Being independent from the agency gives RSS a credibility-advantage in that way. That uniqueness is partly how RSS has grown so much in just a few short years. We don’t have a sales person our there prospecting for new business.

Since RSS’ inception, we’ve experienced tremendous growth. Each year, we’ve grown by 50%, except 2022. Our growth has been without any direct sales efforts.

Change and innovation is something we plan for RSS. I don’t think staying the same is healthy for a business. Each year, I look at how/what we can change to enhance the care we deliver to first responders. For example, last year, I partnered with a mobile app developer to develop a phone app for first responders. In 2023, we’re planning to offer some very specialized treatment & support groups for first responders. To my knowledge some of these groups don’t exist anywhere else in the country.

The perception of the cost of our services is a challenge we continuously have to overcome in order to help responders. Often City/County officials look too generally at the cost of implementing our program and say, “It’s not in the budget.” One year of our services is often less than the cost of hiring/employing a rookie for the first year. If our services prevent just one responder from leaving an agency, that saves the agency & municipality money. My challenge is to get those that control the money to look closely at the dollars and look from an investment perspective. More often than not, agencies expand our program after the first year because the payback is obvious.

Another challenge we encounter somewhat regularly is some of the ‘old school’ responders that feel first responders shouldn’t ever need behavioral health services, especially embedded inside their own agency. But in time, these ‘old schoolers’ eventually see the benefit and even take advantage of the services.