Jul 31, 2026 · 27 min · 8 segments
PTSD Support for First Responders - John Hanson by Public Risk Management Association (PRIMA)
John HansonGuestyou for joining us today, John.
As you know, the mental health crisis with first responders continues to worsen.
So this discussion is extremely timely as we search for solutions to what in many ways is a very monumental problem in our culture, in our communities.
As we talk about this today, this is something of an extension from my presentation at the National Conference in June.
In that discussion, we reviewed the history of PTSD legislation, specifically comp legislation, since about 2018.
And I think what that examination demonstrates, and this is the point that I made, is that can we really solve a mental health crisis through the workers' compensation system? And I think for many folks, for many legislators in many states, there's a belief that the workers' comp system is just a very easy way to apply some type of remedy to a solution which is much broader than an occupational illness like PTSD.
And I think in many ways, if you look at the trends in 2022, which I would say is probably the high watermark for this type of legislation, there were 60 bills introduced and 45 of those were tracked by NCCI as PTSD legislation.
So, you know, states continue to look at different ways to approach this, whether it's through the creation of presumption, whether it's through the mandating of therapy, which is a relatively new drafting tactic, But I think in many ways, we really need to stop treating PTSD as a system claims problem.
But really start to look at it in terms of infrastructure, right? It's a public safety question.
That requires more than just the four corners of filing a claim within the comp system, which everyone listening to this podcast knows that those denial rates are very high in a number of states and continue to remain high and continue to generate a lot of frictional costs.
So as I look at it, the real question that we look at today is how do we widen the lens beyond legislation, because it isn't really just a claims issue.
It's a support system issue, right? And, you know, I would say the primary question is how do we reach, how do we support first responders suffering from mental health conditions or issues prior to the actual full diagnosis of PTSD? So the question is, how do we reach these folks who are in the very early stages of suffering from a witnessed traumatic event? And I think this is where I think this is really where the conversation is moving toward.
If you look nationally, you'll see an increased interest in confidential peer support programs.
And oftentimes people ask if there's the ability to create a clinical element here for therapy.
on the issues that surround first responders, right? Stigma, that first responder culture, those sorts of things.
A lot of times you'll see that therapy is oftentimes short lived or at least the commitment to it.
If if a first responder is working with a clinician who really doesn't understand this day to day issue specific to things like PTSD or just witnessing trauma, So in other words, if we look at it through a slightly different lens, what we look at is understanding that the comp system is a part of this, but it's not really the solution to it.
And I think the more that we begin to understand the magnitude of the issue, the more that we can begin to, I think, more freely begin to explore solutions to the crisis that aren't necessarily just workers' comp.
you for joining us today, John.
As you know, the mental health crisis with first responders continues to worsen.
So this discussion is extremely timely as we search for solutions to what in many ways is a very monumental problem in our culture, in our communities.
As we talk about this today, this is something of an extension from my presentation at the National Conference in June.
In that discussion, we reviewed the history of PTSD legislation, specifically comp legislation, since about 2018.
And I think what that examination demonstrates, and this is the point that I made, is that can we really solve a mental health crisis through the workers' compensation system? And I think for many folks, for many legislators in many states, there's a belief that the workers' comp system is just a very easy way to apply some type of remedy to a solution which is much broader than an occupational illness like PTSD.
And I think in many ways, if you look at the trends in 2022, which I would say is probably the high watermark for this type of legislation, there were 60 bills introduced and 45 of those were tracked by NCCI as PTSD legislation.
So, you know, states continue to look at different ways to approach this, whether it's through the creation of presumption, whether it's through the mandating of therapy, which is a relatively new drafting tactic, But I think in many ways, we really need to stop treating PTSD as a system claims problem.
But really start to look at it in terms of infrastructure, right? It's a public safety question.
That requires more than just the four corners of filing a claim within the comp system, which everyone listening to this podcast knows that those denial rates are very high in a number of states and continue to remain high and continue to generate a lot of frictional costs.
So as I look at it, the real question that we look at today is how do we widen the lens beyond legislation, because it isn't really just a claims issue.
It's a support system issue, right? And, you know, I would say the primary question is how do we reach, how do we support first responders suffering from mental health conditions or issues prior to the actual full diagnosis of PTSD? So the question is, how do we reach these folks who are in the very early stages of suffering from a witnessed traumatic event? And I think this is where I think this is really where the conversation is moving toward.
If you look nationally, you'll see an increased interest in confidential peer support programs.
And oftentimes people ask if there's the ability to create a clinical element here for therapy.
on the issues that surround first responders, right? Stigma, that first responder culture, those sorts of things.
A lot of times you'll see that therapy is oftentimes short lived or at least the commitment to it.
If if a first responder is working with a clinician who really doesn't understand this day to day issue specific to things like PTSD or just witnessing trauma, So in other words, if we look at it through a slightly different lens, what we look at is understanding that the comp system is a part of this, but it's not really the solution to it.
And I think the more that we begin to understand the magnitude of the issue, the more that we can begin to, I think, more freely begin to explore solutions to the crisis that aren't necessarily just workers' comp.
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