{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T11:01:05Z","timestamp":1785322865190,"version":"3.55.0"},"reference-count":18,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int. J. Environ. Res. Public Health","IJERPH"],"abstract":"<jats:p>Background: Emergency medical services (EMS) personnel experience high rates of psychological distress yet demonstrate low utilization of mental health services. Factors associated with actual service use\u2014rather than intentions or attitudes\u2014are not well understood. Methods: Using secondary data from 36,697 licensed Florida EMTs and paramedics collected during the 2022 licensure renewal process, logistic regression models evaluated the relative contributions of workplace factors, attitudinal variables, trauma exposure, and mental health symptoms in their association with service utilization. Results: Psychological symptoms, particularly anxiety and depression, were the strongest factors associated with help-seeking. Peer support emerged as one of the few system-level factors associated with increased service use, even after accounting for symptom presence. Stigma-related variables showed weaker and, in some cases, counterintuitive associations. Suicidality and substance use were modestly associated with help-seeking beyond core symptom variables. Findings were consistent among trauma-exposed personnel. Discussion: Results are consistent with the potential value of early identification, routine symptom screening, and integrated, system-level supports such as peer support and access to confidential, occupationally competent care.<\/jats:p>","DOI":"10.3390\/ijerph23080978","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T15:57:28Z","timestamp":1785254248000},"page":"978","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Closing the Gap Between Need and Care: Predictors of Mental Health Service Use in EMS"],"prefix":"10.3390","volume":"23","author":[{"given":"Kellie","family":"O\u2019Dare","sequence":"first","affiliation":[{"name":"UCF RESTORES, University of Central Florida, 4111 Pictor Lane, Suite 203, Orlando, FL 32816, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6988-9934","authenticated-orcid":false,"given":"Clint","family":"Bowers","sequence":"additional","affiliation":[{"name":"UCF RESTORES, University of Central Florida, 4111 Pictor Lane, Suite 203, Orlando, FL 32816, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah C.","family":"Beidel","sequence":"additional","affiliation":[{"name":"UCF RESTORES, University of Central Florida, 4111 Pictor Lane, Suite 203, Orlando, FL 32816, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junwei","family":"Jiang","sequence":"additional","affiliation":[{"name":"Florida Department of Health, Bureau of Emergency Medical Oversight, 4052 Bald Cypress Way, Bin A22, Tallahassee, FL 32399, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"McCoy","sequence":"additional","affiliation":[{"name":"Florida Department of Health, Bureau of Emergency Medical Oversight, 4052 Bald Cypress Way, Bin A22, Tallahassee, FL 32399, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Kim, J.E., Dager, S.R., Jeong, H.S., Ma, J., Park, S., Kim, J., Choi, Y., Lee, S.L., Kang, I., and Ha, E. (2018). Firefighters, Posttraumatic Stress Disorder, and Barriers to Treatment: Results from a Nationwide Total Population Survey. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0190630"},{"key":"ref_2","unstructured":"Florida Department of Health (2026, March 09). Emergency Medical Services, Available online: https:\/\/www.floridahealth.gov\/licensing-regulations\/emergency-medical-services-system\/."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1097\/EC9.0000000000000145","article-title":"The effect of ambulance clinicians\u2019 well-being on occupational and patient safety in prehospital emergency medical services: A scoping review","volume":"5","author":"Tikkanen","year":"2025","journal-title":"Emerg. Crit. 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