Change must come "from the bottom up" if the city's emergency services want to help first responders struggling with mental illness, according to the head of an organization that provides support to public safety and military personnel.

"It all comes down to a culture change," said Vince Savoia, executive director of Tema Conter Memorial Trust (TCMT), on CBC's Metro Morning on Monday.

"People always look to the chief or the organization but ... I'm a firm believer that change has to begin at the bottom, among the rank and file."

Savoia, a former paramedic who founded the organization after his own battle with PTSD, says the stigma often attached to mental illness in the general public is especially acute among police officers and other front-line workers.

"It's something people just don't want to talk about."

First responders across Canada have already seen three suicides among their ranks this year, according to the TCMT. Last year saw 39 such cases, with another 12 suicides among military personnel.

The issue of mental illness and suicide among Toronto police officers is making headlines as the Ontario Human Rights Commission pursues a claim with the province's Human Rights Tribunal to have the names of officers who killed themselves added to a memorial wall, alongside the names of those who died in the line of duty.

Heidi Rogers, the widow of one such officer, recently recounted her husband's struggle with PTSD and alienation within the force on Metro Morning.

More sympathy and understanding from an officer's immediate superior can make a big difference, Savoia said.

"If a police officer goes to his or her staff sergeant and says 'I'm having trouble' … a lot of the perceived support will come from the way that staff sergeant deals with that individual," he said.

"The chief may want a culture change to take place but if that staff sergeant doesn't buy into the process and he or she dismisses that front-line officer, they've lost the battle."