First responders
Medication management for first responders, in private.
Police officers, firefighters, paramedics and EMTs, dispatchers, and corrections officers carry a particular load: repeated exposure to the worst days of other people's lives, on rotating shifts, inside a culture that rewards holding it together. The conditions that follow are medical, and they respond to treatment: post-traumatic stress, broken sleep, anxiety that will not stand down, depression, and drinking that started as a way to come down after shift. This page is medication management for those conditions, delivered by secure telehealth, arranged by you alone. It is not arranged by your employer, it is not an employee assistance program, and nothing about it is reported back to your department.
PsychMed Care is the medication management practice of Solutions Psychiatry. If you are looking for therapy, or therapy and medication together, the full practice is at psych.us.
Private by design
Your treatment is not your employer's business
The commonest reason responders give for not getting care is fear of where the information goes. So the boundaries belong up front, in plain language.
Not through your employer
Your department is not contacted, does not schedule anything, and is not told you are a patient. You book as any patient books, you pay or use your own insurance as any patient does, and your care stays inside your medical record.
Not the EAP
An employee assistance program is a short course of support arranged and paid for by your employer. This is not that. This is your own ongoing treatment with your own prescriber, for as long as the treatment is useful, with nobody's human resources office in the arrangement.
No fitness-for-duty work
Stated plainly: this practice does not perform fitness-for-duty evaluations, and it never performs them for its own patients. If your department orders an evaluation, it has to come from a clinician who is not your prescriber. Keeping those roles separate is what keeps your treatment yours.
What privacy means here
Your record is a medical record, protected the way every patient's record is protected. The limits are the standard ones that apply to all care: an immediate danger to you or to someone else, or a court order. Outside those limits, what you say in your appointments stays in your appointments.
If things reach the point of thoughts of harming yourself, help is available now and none of it runs through your department: call or text 988, text HOME to 741741 for Crisis Text Line, or call the NAMI Helpline at 1-800-950-6264. If someone is in immediate danger, call 911. This practice is not an emergency service. The crisis page lists more options.
The barriers are real
Care that understands responder work
Three things keep responders out of treatment, and each one has an answer here. The first is stigma: in a culture built on being the person others call, booking a psychiatry appointment can feel like filing a weakness report on yourself. It is a medical appointment, of the same kind as the orthopedist for the knee the job wore out. The second is confidentiality, answered in the section above: outside the employer, outside the EAP, off the department's radar entirely. The third is simpler and just as common: most providers have never thought about what the work does to a person. Cumulative exposure is different from a single bad event. Hypervigilance is trained into you because it keeps you alive on shift, and then it will not switch off in your own kitchen. Sleep runs against a rotation, not a clock. Treatment here is built on that reality: trauma and PTSD medication management is established work in this practice, visits are by telehealth from wherever you are, and scheduling bends around rotating shifts and night work instead of asking your life to bend around an office.
What gets treated
The conditions the job produces, and the ones it worsens
The medication work starts where the symptoms are loudest, and it is measured: symptom scores and sleep are tracked at the Comprehensive Initial Appointment and at every Follow-up Appointment, so changes are visible rather than argued from memory. When labs are part of a decision, they are drawn at any lab near you; nothing requires a trip to a particular facility. If you arrive already taking medication that dulls your alertness, that is treated as a clinical problem in its own right, because alertness on shift is a safety issue, and the deprescribing page describes how a careful reduction is run.
Trauma and PTSD
The alarm system first: sleep, nightmares, startle, irritability, the short fuse at home. Medication is paced to your nervous system and built on stability, with progress counted at every visit.
Sleep, against the rotation
Rotating shifts break sleep in a specific way, and exhaustion makes every other symptom worse. Insomnia is treated directly, not waved at, and not with a default to habit-forming sedatives.
Anxiety and depression
The vigilance that will not stand down after shift, and the flatness that settles in after years of exposure. Both are treated as conditions, with medication chosen and adjusted on measured response.
Alcohol, the off-shift sedative
Drinking to come down and drinking to sleep are the commonest self-prescriptions in responder culture. There are medicines that lower craving, and a plan that treats the drinking and its reasons together.
Cost and coverage
What it costs, and what your plan covers
The first appointment is a 60-minute Comprehensive Initial Appointment at $350. Follow-up Appointments run 30 minutes at $250 each. Most patients here use insurance: copays are typically $0 to $40, and your coverage and your exact cost are verified before your first visit, so the number is known before you commit to anything. In network: Aetna, Cigna and Evernorth, UnitedHealthcare and Optum, the Blue Cross Blue Shield family, Oscar, Oxford, Carelon, and Providence, plus Medicare in Arizona, California, Colorado, Texas, and Utah, and Medicaid in Oregon and Wyoming. Care is by secure telehealth in 34 states plus DC, for ages 17 and up. You can book here, or call (800) 303-3221.
“Holding it together on shift is not the same as being well.”
Start with a 60-minute evaluation that stays private from your employer from the first click