Sometimes the helpers need help themselves, a reality made clear in 2007 after the Sofa Superstore fire left nine firefighters dead, their families and colleagues devastated.
Back then, firefighter organizations and Charleston Mayor Joseph Riley Jr. worked with the Charleston Dorchester Mental Health Center to help those dealing with trauma, loss and survivors' guilt.
That effort grew to serve all kinds of first responders including police and paramedics.
Now, the center's freshly expanded Public Safety Behavioral Health Program has a new home in West Ashley. And its two counselors have begun to serve Charleston County workers in all kinds of public safety jobs, from police to parole officers to dispatchers to paramedics. Already, their caseload has reached 75.
The program is a good that came from a horrific event, one that offers help to people whose daily work brings them close to life's traumas.
"It's the phoenix out of the fire," said Deborah Blalock, executive director of the mental health center, part of the state Department of Mental Health.
The only one of its kind in the state, the program has become a model for shifting away from the macho, toughen-up culture that once defined public safety work, local leaders said.
"The message is changing," Charleston Fire Chief Karen Brack said. "It's becoming more humanized."
Yet, it still can be hard for those who go into law enforcement and fire work to admit they need help, said Capt. Jon Jacobik of the Charleston County Sheriff's Office.
"You're there to help, not to get help," Jacobik said. "But more and more, we don't see it as a weakness."
The program's counselors are trained in evidence-based therapies along with the unique cultures of different public safety agencies, Blalock said.
For instance, firefighters spend entire days together. After a traumatic call? They head back to their stations where they forge close bonds that also make loss that much harder.
"We spend more time together than we do with our own families," Brack said. "We live together."
Police, however, usually leave the scene of a murder, rape or child's death only to spend hours isolated in a squad car.
"Law enforcement goes to a major incident, and then they all go off to the next incident," Jacobik said. "They don't talk about it. But for 12 hours a day, you're in your car thinking about it."
That's why the center's counselors went on emergency calls, spent time in fire stations and squad cars, and attended various training programs.
They are available to public safety workers who seek help with on-the-job traumas and stresses but also personal ones as well. Therapy can remain confidential, and the program's offices sit off Savage Road, away from the mental health center's main site.
The City of Charleston pays for the building's lease and half the salary of an administrative worker. The mental health center pays for a psychiatrist's time, the counselors and the remainder of the administrative worker's salary.
"It's moving us in a much healthier direction," Brack said.