Hundreds of train operators have found themselves in Mr. Guity’s position over the years.

And for just as long, there has been a path through the state workers’ compensation program to receiving substantive treatment to help them cope. But New York’s train operators say that their employer, the Metropolitan Transportation Authority, has done too little to make them aware of that option.

After Mr. Guity’s incident, no official told him of that type of assistance, he said. Instead, they gave him the option of going back to work right away.

But Mr. Guity was lucky. He had a friend who had been through the same experience and who coached him on getting help — first through a six-week program and then, with the assistance of a lawyer, through an experienced specialist.

The specialist prescribed a six-month exposure therapy program to gradually reintroduce Mr. Guity to the subway.

His first day back at the controls of a passenger train was on Thanksgiving. Once again, he was driving on the D line — the same route he had been traveling on the day of the fatal accident.

M.T.A. representatives insisted that New York train operators involved in strikes are made aware of all options for getting treatment, but they declined to answer specific questions about how the agency ensures that drivers get the help they need.

In an interview, the president of the M.T.A. division that runs the subway, Demetrius Crichlow, said all train operators are fully briefed on the resources available to them during their job orientation.

“I really have faith in our process,” Mr. Crichlow said.

Still, other transit systems — all of which are smaller than New York’s — appear to do a better job of ensuring that operators like Mr. Guity take advantage of the services available to them, according to records and interviews.

San Francisco’s system provides 24-hour access to licensed therapists through a third-party provider.

Los Angeles proactively reaches out to its operators on a regular basis to remind them of workers’ compensation options and other resources.

The Massachusetts Bay Transportation Authority has made it a goal to increase engagement with its employee assistance program.

The M.T.A. says it offers some version of most of these services.

But in interviews with more than two dozen subway operators who have been involved in train strikes, only one said he was aware of all those resources, and state records suggest most drivers of trains that strike people are not taking full advantage of them.

“It’s the M.T.A.’s responsibility to assist the employee both mentally and physically after these horrific events occur,” the president of the union that represents New York City transit workers, John V. Chiarello, said in a statement, “but it is a constant struggle trying to get the M.T.A. to do the right thing.”