Confronting 5 Common Reasons for Not Getting Help

Author: IAFF Staff

October 22, 2019

If you or a fire fighter you care about is on the fence about getting behavioral health treatment, you’ve probably heard or thought of many reasons why you or the person you care about can’t get help. Let’s take a closer look. 

  1. “I’m just not ready.” While it’s preferable to enter treatment feeling ready and willing to change, it is not required. It is not uncommon to resist getting help at first, only to later enter treatment due to legal, occupational, social or complicating health factors. A last-chance agreement with the fire department, a relationship ultimatum or a sobering warning from a trusted physician can be powerful motivators to seek help, even if you don’t want the help or truly feel ready. What matters most is not why you enter treatment, but the change in attitude and behavior that can occur once you get there.  
  2. “I don’t have the time.” If you are struggling with a mental health or substance use disorder, chances are you’ve already spent many days not feeling like yourself or fully participating in life. An untreated behavioral health problem will inevitably cost you time at work, important family or social obligations and the joy of those who love you. If you could function without the crippling weight of post-traumatic stress disorder (PTSD), clinical depression or needing to turn to alcohol or drugs to get through the day, imagine how much time you would have. If you are out of sick time or vacation days, check if your department or local has a leave bank that allows you to use donated sick days from other members. Also remember, your department is required to follow the Family and Medical Leave Act (FMLA), which requires employers to provide covered employees with job protection and unpaid leave for qualified medical and family reasons for up to 12 weeks. An upset looking woman sitting on the bed behind her husband who is in distress
  3. “I can’t afford treatment.” Whether it’s outpatient counseling, medication management or residential treatment, the cost of healthcare is not cheap. Without intervention, behavioral health problems can progress into serious psychiatric disorders that can have a long-term financial impact on your career, future and family. Thanks to mental health parity and presumption laws that are growing across the United States and Canada, insurers and employers are now required to pay for some behavioral health treatment, but out-of-pocket costs still vary widely. Before you assume that you cannot afford the cost of treatment, get the facts on your insurance coverage. Also, ask if the treatment provider is willing to provide a no-interest, monthly payment plan.
  4. “My family or crew needs me here.” People depend on you to be the best fire fighter, spouse, parent or friend you can be. But if you are suffering from a debilitating mental health or substance use disorder, are you able to be that person? While local outpatient treatment is the right choice for some, others will benefit from inpatient or residential treatment that requires leaving the home for periods of time. While taking time off from work and family is no doubt disruptive, it’s a small price to pay to return to those who need you with restored health, purpose and a plan for taking care of yourself. Rather than assuming your family can’t function with you temporarily gone, share your concerns with your partner. You may be surprised by the lengths your loved ones will go to give you a chance at recovery. For common questions that family members have about sending their loved one to treatment, read the IAFF Center of Excellence Spouse and Family FAQ Guide. 
  5. “I’ll be seen as weak or it will ruin my career.” While increased awareness, education and training on mental health problems have made huge strides to reduce stigma in the fire service, we still have work to do. In a 2018 survey conducted of nearly 7,000 IAFF members, 81% said they would fear being weak or unfit for duty if they sought help for mental health issues. Consider the perspective of one IAFF member in recovery, who argues that the worst stigma we must tackle is the stigma that lies within. While many would not judge another crew member for getting mental health treatment, a double standard still exists. Some may think, “It’s okay if he or she gets help, but if I ask for help, I’m weak.”

While recovery is often a lifelong process, symptom stabilization can lead to improved self-esteem, better working relationships, improved cognition and problem-solving skills. What crew wouldn’t want that? In a one-month, post-discharge survey of IAFF members who received treatment at the IAFF Center of Excellence, 61% reported their decision to seek treatment had a positive impact on how they are viewed in the department. 

The IAFF Center for Excellence is a comprehensive treatment center designed exclusively for IAFF members struggling with PTSD, addiction and other co-occurring mental health problems. The Center is in-network with many major health insurance plans. Call today to check the insurance benefits for yourself, a loved one, a crew member or your department. 

Lauren Kosc, M.A., LCPC is a behavioral health specialist, clinician and blog writer for the International Association of Fire Fighters. If you are an IAFF member in recovery and want to share your story, contact [email protected].


Ushery, David; Stulberger, Evan; Wagner, Liz; Bott, Michael; Manney, Dave. “I-Team: National Data Shows Firefighters’ Mental, Emotional Health Not Getting Enough Attention.” 4 New York, February 24, 2008. Accessed October 22, 2019. 

IAFF Center of Excellence for Behavioral Health Treatment and Recovery. “What to Expect: A Guide to the IAFF Center of Excellence for Spouses and Family.” Accessed October 22, 2019.

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