It’s OK to Not Be OK

Editor’s Note: This is the second article in a series called “It’s OK to Not Be OK: Real Conversations About Mental Health in Public Safety.” Over the next several months, Jason Fox will dive into topics that every EMS provider, firefighter, dispatcher, student, and leader needs to consider—not just for their career, but for their lives outside the uniform too. Catch up with the series.

Now that we’ve had time to reflect on the letter I wrote to my younger self—the wide-eyed version of me stepping into a life of public safety—I want to share something a bit more personal: what this life has truly done for me—and what it has done to me.

I don’t write this as an expert. I’m not a psychologist, therapist, or counselor. I don’t have a PhD in mental health or a research publication to cite. What I do have is 34 years of service in public safety—split between the fire service, EMS, and now, as an educator andmentor. I’ve seen a lot. I’ve lived a lot. And I’ve carried more than I ever expected to when I took my first shift.

This article, and the series it belongs to, isn’t about teaching mental health from a textbook. It’s about breaking the silence and stigma around it. It’s about sharing my experiences in hopes that they’ll resonate with you, offer some encouragement, and maybe even help you or someone you know feel a little less alone. Because mental health doesn’t care about your title, your badge, or your years of experience. It touches everyone—rookie or veteran, provider or administrator.

A Life in Public Safety: Rewarding and Relentless

I’ve been fortunate to spend most of my career serving the community I call home. While that’s been an honor, it hasn’t come without its own unique challenges. When you work where you live, you inevitably respond to calls involving people you know—your neighbors, friends, mentors, and sometimes, even your family. Some of those calls leave a mark deeper than I ever imagined.

The first time I was shaken to my core was the day we lost our service director. He was the man who hired me, who believed in me, who signed my paycheck. More than that, he was our leader, our mentor, our brother. When he began experiencing chest pain, he didn’t hesitate—he called for help and asked that we meet him. He knew something was wrong.

Two ambulances responded, including mine. When I arrived, CPR was already in progress. As I stepped into the rig, I could feel the gravity of the moment. We did everything we could—every drug, every shock, every intervention we had. We continued those efforts all the way to the hospital, and even there, we gave it everything we had—but we couldn’t save him.

There’s a unique kind of grief that comes when the person you’re trying to save is the very one who once believed you could save anyone. I carried a lot that day—guilt, sorrow, frustration. It’s a darkness I wouldn’t wish on anyone.

But that wasn’t the worst.

The Call That Broke Me

My mother had lived with chronic health problems—stroke, diabetes, cardiovascular disease. Her mobility and independence were limited, and depression set in over the years. I did my best to encourage her, to get her out of the house, to lift her spirits.

Eventually, she agreed to visit a local country market in a neighboring county. While she was out enjoying a rare moment of independence, I was on shift—doing what I always did. Then came the call: “Something’s wrong with your mom.”

I urged the caller to hang up and dial 9-1-1 immediately. My partner and I jumped in the truck, hoping to intercept the responding ambulance. But as we traveled, the silence on the radio was deafening. The farther we drove without contact, the more we knew something wasn’t right. When we finally arrived, we found multiple ambulances already on scene. Inside one of them, my mom was in cardiac arrest.

The medics on scene welcomed me aboard and allowed me to help. Three experienced paramedics, myself included, gave everything we had. By the grace of God, we achieved ROSC (return of spontaneous circulation) before arriving at the hospital. For a moment, there was hope.

But it was short-lived. My mom had suffered an anoxic brain injury. After three days on life support, we made the hardest decision I’ve ever faced. I held her hand as she slipped away.

I don’t share this story for sympathy. I share it because I know I’m not alone. Some of you have faced similar heartbreaks. Some of you will. I wouldn’t wish it on anyone—but I want you to know that if it happens, you’re not broken. You’re not weak. You’re human.

That call shattered my foundation. I questioned everything—my faith, my purpose, my profession.

I wasn’t OK. And that’s the point.

It’s OK to Not Be OK

The reality is that not every call is a life-altering tragedy. Sometimes, what wears us down is the constant exposure to stress, loss, frustration, and injustice. The late nights, the no-lunch days, the missed milestones; the moral injuries we face when we’re forced to provide care without the resources we know our patients need; the burn of showing up for others when we can’t even show up for ourselves. This is what I mean when I talk about “death by paper cuts.” The little things add up. And the dangerous part is—they’re often easy to dismiss. One small cut doesn’t seem like much. But over time—when those cuts come daily—they turn into wounds. I we don’t take care of those wounds, they fester.

Self-Care Is Not Selfish

We’ve been taught that toughness is part of the job, that taking time for ourselves is weakness, and that needing help somehow means we’re not cut out for this. Let me say it clearly: That is a lie.

Self-care is not selfish. You can’t pour from an empty cup. You can’t serve others when you’re emotionally bankrupt. And you certainly can’t sustain a long and healthy career in public safety if you ignore your own well-being.

Recovery is possible. Healing is possible. But it requires honesty, courage, and commitment. It means having hard conversations with ourselves. It means reaching out when we’re hurting. It means allowing others to help us, just like we help strangers every single day.

No One Is Immune

Mental health challenges do not discriminate. They don’t care how long you’ve been in the field, what patch is on your sleeve, or how many letters are after your name. Whether you’re a new EMT student, a seasoned medic, a chief, or an educator—we’re all vulnerable.

I’ve worked with and mentored providers at every level. I’ve seen senior leaders crumble under the pressure of their positions. I’ve seen students freeze in fear at their first pediatric code. I’ve seen rock-solid medics crack after the 100th overdose death.

Nobody gets a free pass.

That’s why we must talk about it. That’s why this series exists. I want to challenge the culture that says we need to “suck it up” and keep going. I want to offer a space where honesty is welcome, where healing is possible, and where resources are shared—not whispered in back hallways.

What Comes Next

So here’s what I’m asking of you:

• Be curious.
• Ask yourself the hard questions.
• Plan to check in with your own mental health.
• Look out for your colleagues—really look.
• Most importantly, act.

We can’t change what we don’t acknowledge. And we can’t break the stigma if we stay silent.

This series will continue to explore the impact of cumulative trauma, moral injury, and the importance of peer support. I encourage you to read the next article in this series, The Silent Weight, which dives deeper into the emotional toll this job takes over time—and why reaching out matters more than we may ever realize.

Together, we can change the conversation around mental health in public safety. We can create a culture that supports the whole provider—not just the uniformed one. We can lift each other up before someone falls too far.

Because at the end of the day, your life matters just as much as the ones you’re trying to save.

And if the weight ever feels too heavy—call for help. I promise, someone will answer.