A Perspective on Law Enforcement Mental Health

From Begin Counseling Owner, Karlee Davis, LICSW:

West Virginia is my home; I love it.

I was born and raised in the Eastern Panhandle, and Begin Counseling is especially grateful to be able to support first responders and their families as a professional counseling practice.

I've been in private practice since 2007. Most of my experience over the years was in helping people deal with various forms of trauma, but it was my exposure to the unique challenges facing first responders and my training in EMDR that led me to found Begin Counseling. I realized that traditional therapy practices, while well-intentioned, often missed the mark when it came to understanding the culture, the mindset, and the very real operational demands of law enforcement.

I began connecting with local department leadership, and gradually became the place for firefighters, EMS, law enforcement, and dispatchers to deal with tough calls and whatever else might be going on. I was cultivating years of trauma therapy experience into a specialized approach for the unique trauma first responders face. This quickly outgrew what I could do as one therapist. I had goals to start my own practice eventually, but the timing became clear, and the need was urgent, so in 2023 I launched BeginCounseling—to increase access to culturally competent trauma treatment for first responders and their families.

Our team of therapists focuses on the responder's wellbeing and direct impact the career has on them and those they love. Begin is diligent in tailoring our therapists' skill set to come alongside departments to support first responders and their families. We understand that effective treatment for law enforcement specifically, isn't just about clinical expertise, it's about respecting who you are, how you think, and what you need to stay operationally ready while maintaining your mental health.

I tell our therapists we have one appointment to get it right and show we are trustworthy. In all reality, it's about 10 minutes before an officer has already decided if the therapist is genuine and if they are coming back or not.

Understanding Trauma in Law Enforcement

Let's start by acknowledging something we all know but don't always talk about, this career exposes officers to trauma regularly. Law enforcement officers experience, somewhere in the range of, 90 times the amount of trauma exposure compared to the general population.

The human brain wasn't designed to compartmentalize these experiences indefinitely. Compartmenting is essential on the job, but intentionally processing and offloading is necessary. It can be subtle overtime, but what officers do day in and day out, especially the repetitive/petty stuff, accumulates and affects not just them, but their entire family system.

What We See

I'm often asked what first responders bring up most in therapy. In our practice, law enforcement officers consistently show up with one or all three of the following:

• Department stressors. Shift work, administrative burdens, feeling unsupported by leadership, issues within the department overall.
• Family concerns. The job doesn't stay at work. It can't. The hypervigilance that keeps officers alive on the road can create distance at home. The dark humor that helps one cope with humanity's worst doesn't mesh as well with the gentleness needed as a spouse or parent. Missing important moments at home creates guilt and resentment that builds over time.
• The calls and trauma exposure. The shootings, the wrecks, the child abuse cases, the suicides, the violence, all consistent reminders of what humanity is capable of doing to itself. But it's not always the obvious "big" calls that stick. Sometimes it's the routine call that hits a little different, or the one that reminds an officer too much oft heir own family. Something pierces into the personal.

The Reality of Cumulative Trauma

Here's what we want officers to understand: Sometimes it is one call that changes absolutely everything. These are the incidents that get attention, that most understand could be traumatic. But often, it's not a single devastating event. It's the hundreds of calls that chip away at emotional and physical bandwidth. It's having a shorter fuse because of years spent confronting the parts of society that most people avoid. It's the strained connections at home, feeling emotionally depleted. It's missing a child's birthday party while dealing with someone else's worst day.

It's the quiet unraveling, the subtle damage. Snapping at children for just being kids who exist and make noise. Choosing silence over connection with spouses because it feels easier than explaining what can't be unseen. Feeling numb, distant, edgy, not yourself. It's "death by a thousand shifts." This is cumulative trauma in law enforcement. Let me be clear; officers are not weak. They are not broken. But sometimes, they will be at capacity.

How We Handle Critical Incidents

When it comes to critical incidents, we take both preventative and early intervention approaches, with EMDR being one of our primary tools. That stands for Eye Movement Desensitization and Reprocessing. EMDR is one of the most effective tools for first responders: a type of trauma therapy that we use every day in our office. It addresses how memories are stored in the brain and body and helps adaptively process information to reduce reactivity when reminded of a traumatic event.

We don't wait to find out if someone is going to be okay. We've learned that incidents that "stick”, the ones officers find themselves thinking about when they're trying to fall asleep, the ones that change how they see certain situations, these need attention before they become unmanageable. Research validates, and we have experienced firsthand, that early intervention EMDR therapy can prevent the development of long-term trauma symptoms in officers and other first responders. We help process the incidents as soon as possible, so they don't accumulate and compound over time.

A Message for Spouses and Partners

Spouses, partners: even if your officer won't get help, you can. Call us. Call someone. Start with what you have control over. You weren't trained for this career, but you're living it too. You're watching someone you love carry things that would break most people, and you need support as well.

A law enforcement career can simultaneously be the most difficult and most rewarding path a family can choose. You need preparation and support just like your officer needs tactical training. You need to understand what cumulative trauma looks like, how hypervigilance affects home life, why your usually emotionally available partner might seem distant after certain calls and how to deal with that. We help spouses find routine, purpose, and thrive in their critical role.

Training for Trauma

Here's what we want officers to understand: trauma exposure in law enforcement is inevitable. The old school thought process of "suck it up, you signed up for this" has simply cost too many lives, too many marriages, and deteriorated too much quality of life.

The most effective leaders and responders we work with, the ones who have long, successful careers and resilient families, are the ones who plan for and train for trauma. They prepare for it, learn to detect it early, address it immediately, and most importantly, they learn to lead their families through it. Because spouses and families really are the officers' super power and a key factor in the most successful outcomes in this career.

One of our favorite parts of this work is witnessing the transformation when old school officers who were raised in that "tough it out" mentality get help, try therapy, expand emotional intelligence, and the genuine strength that comes in having true control over their emotions. The combination of mental toughness, grit, and emotional intellect makes for an appropriately dangerous, self-controlled, and mentally ready officer and ultimately healthier communities.

Our Relationship with Departments

While we work closely with agency leadership, we are intentionally separate. The privacy and confidentiality of our clients is paramount. We develop working relationships with leadership at the highest levels to improve how critical incidents are handled. We're working to shift the culture around mental health, to make seeking help a sign of preparedness and competency rather than perceived weakness, and to provide access to genuinely helpful treatment rather than checking a box.

Currently, our role in providing counseling for agencies is largely referral-based and word-of-mouth. Officers come to us soon after an incident, sometimes not until years later, and sometimes in crisis. But increasingly, we're seeing officers come in routinely, which shows the culture is starting to shift. Most officers entered public safety aspiring to serve their community, county, and state. If they can proactively manage the cumulative stresses of the job, they can thrive as they envisioned in this career.

We're here when officers are ready. Not to change who they are, but to help expand their capacity. Communities need officers healthy, families need them present, and officers deserve to come home: not just physically, but emotionally and mentally as well. We can work through anything together.

Begin to reset.

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