This study will conduct qualitative interviews with firefighters and EMTs/ paramedics across Arkansas. To address this aim, opt-in methods will be used to recruit a diverse group of firefighters and emergency medical technicians/paramedics from across Arkansas to participate in qualitative interviews, defined as focus groups and individual interviews. Through this work, this will generate the scientific foundation to develop a comprehensive, mental health service model that will motivate engagement in services by diverse first responders.

Firefighters and emergency medical technicians (EMTs)/ paramedics respond to more than 50 million emergency calls in the U.S. every year. The daily operations and experiences that are expected and accepted as part of their job expose them to various traumatic events. The nature, frequency, and intensity of duty-related traumatic exposures place these first responders (FRs) at significant risk for mental health (MH) problems, such as post-traumatic stress disorder (PTSD) and suicide. However, due to the stigma of mental illness and the culture of self-reliance and strength that surrounds FRs, few are willing to seek help. There will be a two-stage exploratory, qualitative study that will use a statewide community-engagement approach to conceptualize a MH service model that would motivate FRs to be more engaged in services. In Stage 1, qualitative interviews with firefighters and EMTs/ paramedics will be conducted across Arkansas. In Stage 2, product development process grounded in these findings to conceptualize a MH service model feasible for implementation in real world settings. (Protocol for Stage 2 will be submitted for IRB approval at a later time.) Stage 1, Specific Aim: Identify FRs' preferences and priorities regarding MH service and delivery methods, including the feasibility, acceptability, and value of each method. To address this aim, we will use opt-in methods to recruit a diverse group of firefighters and EMTs/paramedics from across Arkansas to participate in qualitative interviews, defined as focus groups and individual interviews. After all qualitative interviews have been analyzed, a series of product development activities in Stage 2. Through this work, the scientific foundation to develop a comprehensive, MH service model that will motivate engagement in services by diverse FRs. This study's findings will guide a multi-stage, research agenda that will include development and pilot testing of the MH service model, ultimately, promoting engagement in MH services may decrease suicide rates and improve the overall MH outcomes among this at-risk population.

Inclusion Criteria:

• ages 18 and over volunteer and career personnel active, inactive, and retired

Exclusion Criteria:

• Non- English speaking (due to the nature of focus group/interview discussions)

Firefighters and EMT/paramedics in Arkansas

1.5 years