Where do first responders turn when they need help?

“The last thing he must have heard were the bells of St. Elizabeth’s,” a neighbor told City & State, standing just down the block from the Washington Heights apartment building where New York City police officer Gregory Purvis shot himself on Aug. 20. “We heard the gun go off right after the bells,” said the neighbor, who identified themselves as “Juju.” 

Steps away from Purvis’ apartment building on Wadsworth Avenue, “St. E’s” as it is commonly known is a sanctuary for the New York City Police Department: the 155-year-old Catholic parish hosts an annual memorial service in honor of NYPD Detective Michael J. Buczek, who was killed on the job in 1988, and was the home parish of NYPD Detective Wilbert Mora, killed on the job in 2020.

Following Purvis’ death, NYPD Deputy Commissioner for Operations Kaz Daughtry wrote on X about the mental health struggles that police officers experience. “You call the police for the worst moments of your life. Our officers respond to those calls and help you in those terrible moments. But then, when that moment is over for you, our officers go to the next call for help, the next victim having the next traumatizing moment, and then the next, and the next; and then they go home and try to have a normal life, managing all the trauma they’ve been exposed to, and wake up to do it again,” Daughtry wrote. “We lost another brother to the trauma of this work…We all experience periods of darkness…Greg, watch over your brothers and sisters and give them the strength they need to ask for help.”

Anonymous mental health services

Historically, police officers have been reluctant to seek mental health treatment for fear of the effect it could have on their careers. But a group of current and retired first responders and their families on Long Island successfully rallied for the creation of anonymous mental health care. 

“Finally, we have a couple programs we can go to for therapy and it’s not reported back to (NYPD headquarters) 1PP,” a retired detective told City & State. The detective, who asked to remain anonymous, previously worked for both the NYPD and the Nassau County Major Cases Squad and now attends a monthly family group along with his son and other first responders in Suffolk County that is sponsored by the National Alliance on Mental Illness. “No one ever wanted to seek help because they would assign you to the ‘rubber gun squad’ and you’d be stuck on a desk forever,” the detective said. “What's so good about all these new programs is increasing awareness. We have finally given cops a place to get help.”

“Years ago, while working at Bellevue Hospital in the emergency room and trauma unit, the first trauma bus in the country was set up to go to disasters with the capacity to help the huge numbers of people injured by fires, shootings and more. First responders are always involved in firsts,” said Ellen Ritz, now the president of NAMI’s Central Suffolk Long Island chapter.  “At NAMI, we focus on normalizing mental health into the fabric of our lives: we had a monthly family night with karaoke and another with a cooking class, we teach crisis intervention, we do support groups and help families and others learn how to deal with mental health crises.” 

Ritz said that NAMI is focused on bringing mental health services into communities that have few. “We are starting a program called ‘Sharing Hope’ where we train community members to bring conversations around mental health awareness to underserved communities. People, the families, who are left behind need a safe place to talk and so families of first responders fit in here,” she said.

“There was a NYPD officer I knew – nobody even realized he was struggling and you would have never known.  We had just played paintball with the kids, and then a week later he went and got a hotel room and shot himself,” another former NYPD Detective told City & State. The detective spent over 32 years on the job and is now working to center mental health care as a priority for first responders in his community. 

“Even though you are a police officer, you have the same issues other people have and many that other people don’t,” he said. “It's not easy to have to take someone’s life, trust me. Even if it's justified. It stays hidden. There are a lot of people in the NYPD suffering and they need to reach out but they are afraid. They don’t want to be stigmatized.” Next month, NAMI is honoring the retired detective at a special ceremony for his efforts to increase mental health wellness in his community of peers.

“How many times you hear that people don’t want to take pills or to go to the doctor.  It's the same thing. Isn’t that a form of suicide? You have to take care of your mental health like you take care of your body,”  said Carol Ann Viccora, who has lost three family members to suicide. Viccora runs a support group for people who have been left behind by suicide, including families of first responders, out of St. Raphael Parish in East Meadow on Long Island.

Increasing access

The city has worked to increase access to mental health resources by contracting with health care institutions to set up programs specifically tailored for first responders. Northwell Health runs the Finest Care mental health and wellness program, which is exclusively for NYPD officers.

“In the past, even if officers were open to mental health care services, they could not find availability, so having a specialty program which has dedicated providers that understand the population and have a lot of experience treating and being able to give them appointments within 48 hours has been the best part – that's the feedback we have received,” said Manish Sapra, the executive director of Behavioral Health Services at Northwell Health. “Also, it's a significant concern for police to let ‘the job’  know that they are seeking mental health care, but our program is completely confidential to the point that the first five visits are not even billed to the insurance company.  So there is not even the insurance record.” 

The Finest Care program was started in 2019 in partnership with Presbyterian Hospital and then transferred to Northwell Health under Mayor Eric Adams in 2022.  Finest Care’s offerings include a 24-hour intake hotline for assessment and booking regular therapy that also doubles as a crisis prevention line. The city pays for the first five visits; after that, Finest Care bills patients’ insurance companies directly.

Records from the New York City comptroller’s office show that the Finest Care program has billed the NYPD about $1.8 million over the past two years for the anonymous mental health care it provides to NYPD employees. There have been some months when Northwell hasn’t billed anything to the NYPD for anonymous health services and other months, particularly around the December holidays, when it has invoiced double its average.

“We see a lot of PTSD and trauma, especially because of violence police officers have faced at work or been part of.  We often see depression, anxiety and a lot of marital and work-related stresses, and sometimes we have seen serious mental illness such as bipolar disorder,” Sapra said. “Only one time where the situation had gone on too long before they had called us, we had to admit them.”

Sapra said that it is important for first responders, particularly police officers, to work with mental health professionals who are familiar with the unique pressures that they face. “Police have some kinds of stressors that the general public does not, a way of life and support system that we needed to understand: the work culture, the stigma that affects their mental health and access to mental health,” he said. “You have to know what meds you can give them; they have a gun and an automobile and it's in everyone's best interest that the cops are in their best state of physical and mental health so there are special considerations in this work.”

National blueprint

New York City’s mental health services for first responders could serve as the model for a future nationwide program. Last month, U.S. Sen. Kirsten Gillibrand introduced legislation to improve mental health resources for first responders nationwide. Gillibrand’s office shared the text of the “First Responders Wellness Act,” which has not been previously made public, with City & State.

The bill calls for the Finest Care mental health hotline to be duplicated and expanded nationally. About $100 million would be allocated over four years to institutions training mental health care professionals in treating the specific needs of first responders.  The bill also enshrines police officers’ health privacy into law: “Any mental health services provider providing services to a law enforcement officer…may not share with the leadership or management of a law enforcement agency any identifiable information of a law enforcement officer.”

Just as important as creating the program is ensuring that first responders actually use it. Sapra said that too many NYPD officers are either unfamiliar with the program or unwilling to try it. “Honestly, we have not seen an overwhelming demand as good as the program is. I think there is still a lot of stigma,” Sapra said with a sigh. “When we started, we made an effort to create awareness, to go to wellness events; we recently shot a promotional video which will be included in training for new police officers. If there is one thing I would want you to quote me as saying it would be this: ‘I wish there were more calls.’”