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The purpose of this paper is to articulate the results of a comprehensive literature review and grassroots outreach with first responder organizations to present an operationalized framework for organizations to utilize as a blueprint in developing customized behavioral health access program (BHAP) programs.

Historically, authorities having jurisdiction (AHJ)over fire service organizations have primarily offered behavioral health interventions through Employee Assistance Programs (EAPs) or commercial insurance carriers. These programs are necessary but may prove insufficient to meet the scope and needs of trauma-exposed firefighters and the firefighters' families.

A BHAP is a comprehensive and operationalized plan which clearly specifies the mental health services fire department members and families need, where those services are available within their communities and levels and standards of care that are expected in the provision of these services.

The BHAP is becoming a world standard of behavioral health care for first responders. While some fire service agencies are beginning to create BHAP guides, developing and implementing a BHAP can be time consuming and overwhelming, particularly for departments with limited internal and external resources. While the results of this review focus on BHAP within the fire service, this framework is applicable across all first responder professions.