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Supporting the Mental Health and Well-Being of First Responders from Career to Retirement: A Scoping Review

Published online by Cambridge University Press:  30 April 2021

Erin Smith Open the ORCID record for Erin Smith [Opens in a new window] ,
Greg Dean  and
Lisa Holmes
Erin Smith*
Affiliation:
Edith Cowan University, School of Medical and Health Sciences, JoondalupWestern Australia, Australia The Code 9 Foundation, Melbourne, Victoria, Australia
Greg Dean
Affiliation:
The Code 9 Foundation, Melbourne, Victoria, Australia
Lisa Holmes
Affiliation:
Edith Cowan University, School of Medical and Health Sciences, JoondalupWestern Australia, Australia
*
Correspondence: Erin Smith, PhD, MPH, MClinEpi, Edith Cowan University, School of Medical and Health Sciences, 270 Joondalup Drive, Joondalup, Western Australia6027Australia, E-mail: [email protected]
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Abstract

Introduction:

First responders are at greater risk of mental ill health and compromised well-being compared to the general population. It is important to identify strategies that will be effective in supporting mental health, both during and after the first responder’s career.

Methods:

A scoping review was conducted using the PubMed database (1966 to October 1, 2020) and the Google Scholar database (October 1, 2020) using relevant search terms, truncation symbols, and Boolean combination functions. The reference lists of all relevant publications were also reviewed to identify further publications.

Results:

A total of 172 publications were retrieved by the combined search strategies. Of these, 56 met the inclusion criteria and informed the results of this overview paper. These publications identified that strategies supporting first responder mental health and well-being need to break down stigma and build resilience. Normalizing conversations around mental health is integral for increasing help-seeking behaviors, both during a first responder’s career and in retirement. Organizations should consider the implementation of both pre-retirement and post-retirement support strategies to improve mental health and well-being.

Conclusion:

Strategies for supporting mental health and well-being need to be implemented early in the first responder career and reinforced throughout and into retirement. They should utilize holistic approaches which encourage “reaching in” rather than placing an onus on first responders to “reach out” when they are in crisis.

Keywords

emergency servicesfirst respondermental healthwell-being
Type
Special Report
Information
Prehospital and Disaster Medicine , Volume 36 , Issue 4 , August 2021 , pp. 475 - 480
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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References

Mitchell, JT. Collateral damage in disaster workers. Int Emerg Ment Health. 2011;13(2):121–125.Google ScholarPubMed
Berger, W, Coutinho, ESF, Figueira, I, et al. Rescuers at risk: a systematic review and meta-regression analysis of the worldwide current prevalence and correlates of PTSD in rescue workers. Soc Psychiatry Psychiatr Epidemiol. 2012;47(6):1001–1011.CrossRefGoogle ScholarPubMed
Kleim, B, Westphal, M. Mental health in first responders: a review and recommendation for prevention and intervention strategies. Traumatology. 2011;17(4):17–24.CrossRefGoogle Scholar
Stanley, IH, Hom, MA, Joiner, TE. A systematic review of suicidal thoughts and behaviors among police officers, firefighters, EMTs, and paramedics. Clin Psychol Rev. 2016;44:25–44.CrossRefGoogle ScholarPubMed
McCreary, DR. Veteran and First Responder Mental Ill Health and Suicide Prevention: A Scoping Review of Prevention and Early Intervention Programs Used in Canada, Australia, New Zealand, Ireland, and the United Kingdom. British Columbia, Canada: Donald McCreary Scientific Consulting; 2019.Google Scholar
Answering the call national survey, National Mental Health and Wellbeing Study of Police and Emergency Services – Final Report. Beyond Blue Web site. https://resources.beyondblue.org.au/prism/file?token=BL/1898. Accessed October 2020.Google Scholar
Mellow, R. Ground breaking data collected on mental health of first responders. JEMS. 2017;42(11).Google Scholar
Bentley, MA, Crawford, JM, Wilkins, JR, Fernandez, AR, Studnek, JR. An assessment of depression, anxiety, and stress among nationally certified EMS professionals. Prehosp Emerg Care. 2013;17(3):330–338.CrossRefGoogle ScholarPubMed
Marmar, CR, McCaslin, SE, Metzler, TJ, et al. Predictors of posttraumatic stress in police and other first responders. Ann N Y Acad Sci. 2006;1071:1–18.CrossRefGoogle ScholarPubMed
Benedek, DM, Fullerton, C, Ursano, RJ. First responders: mental health consequences of natural and human-made disasters for public health and public safety workers. Annu Rev Public Health. 2007;28:55–68.CrossRefGoogle ScholarPubMed
Asmundson, GJ, Stapleton, JA. Associations between dimensions of anxiety sensitivity and PTSD symptom clusters in active-duty police officers. Cogn Behav Ther. 2008;37(2):66–75.CrossRefGoogle ScholarPubMed
Patterson, PD, Weaver, MD, Frank, RC, et al. Association between poor sleep, fatigue, and safety outcomes in emergency medical services providers. Prehosp Emerg Care. 2012;16(1):86–97.CrossRefGoogle ScholarPubMed
Abbot, C, Barber, E, Burke, B, et al. What’s killing our medics? Ambulance Service Manager Program. Conifer, Colorado USA: Reviving Responders. http://www.revivingresponders.com/originalpaper. Accessed October 2020.Google Scholar
Botha, E, Gwin, T, Purpora, C. The effectiveness of mindfulness-based programs in reducing stress experienced by nurses in adult hospital settings: a systematic review of quantitative evidence protocol. JBI Database System Rev Implement Rep. 2015;13(10):21–29.CrossRefGoogle ScholarPubMed
A study of police suicide 2008-2016. Badge of Life Website. http://www.policesuicidestudy.com. Accessed October 2020.Google Scholar
Quevillon, RP, Gray, BL, Erickson, SE, Gonzalez, ED, Jacobs, GA. Helping the helpers: assisting staff and volunteer workers before, during, and after disaster relief operations. J Clin Psychol. 2016;72(12):1348–1363.CrossRefGoogle ScholarPubMed
Substance Abuse and Mental Health Services Administration. First responders: behavioral health concerns, emergency response, and trauma. Disaster Technical Assistance Center Supplemental Research Bulletin. https://www.samhsa.gov/sites/default/files/dtac/supplementalresearchbulletin-firstresponders-may2018.pdf. Accessed October 2020.Google Scholar
Tricco, AC, Lillie, E, Zarin, W, et al. Preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) checklist. Ann Intern Med. 2018;169(7):467–473.CrossRefGoogle ScholarPubMed
Danish Ministry of Health. Model for Development of National Clinical Guidelines. Copenhagen, Denmark; 2014.Google Scholar
Joanna Briggs Institute. Joanna Briggs Institute Reviewers’ Manual: 2014. South Australia: University of Adelaide; 2014.Google Scholar
Stanley, IH, Boffa, JW, Hom, MA, Kimbrel, NA, Joiner, TE. Differences in psychiatric symptoms and barriers to mental health care between volunteer and career firefighters. Psychiatry Research. 2017;247:236–242.CrossRefGoogle ScholarPubMed
Haddock, CK, Poston, WSC, Jahnke, SA, Jitnarin, N. Alcohol use and problem drinking among women firefighters. Women’s Health Issues. 2017;27(6):632–638.CrossRefGoogle ScholarPubMed
Bowler, RM, Kornblith, ES, Li, J, et al. Police officers who responded to 9/11: comorbidity of PTSD, depression, and anxiety 10-11 years later. Am J Ind Med. 2016;59(6):425–436.CrossRefGoogle ScholarPubMed
van Dam, D, Ehring, T, Vedel, E, Emmelkamp, PM. Validation of the primary care posttraumatic stress disorder screening questionnaire (PC-PTSD) in civilian substance use disorder patients. J Subst Abus Treat. 2010;39(2):105–113.CrossRefGoogle Scholar
McCanlies, EC, Mnatsakanova, A, Andrew, ME, Burchfiel, CM, Violanti, JM. Positive psychological factors are associated with lower PTSD symptoms among police officers: Post Hurricane Katrina. Stress Health. 2014;30(5):405–415.CrossRefGoogle ScholarPubMed
Cone, JE, Li, J, Kornblith, E, et al. Chronic probable PTSD in police responders in the World Trade Center health registry ten to eleven years after 9/11. Am J Ind Med. 2015;58(5):483–493.CrossRefGoogle Scholar
Henderson, SN, van Hasselt, VB, LeDuc, TJ, Couwels, J. Firefighter suicide: understanding cultural challenges for mental health professionals. Prof Psychol Res Pract. 2016;47:224–230.CrossRefGoogle Scholar
Heyman, M, Dill, J, Douglas, R. The Ruderman White Paper on mental health and suicide of first responders. Ruderman Foundation. https://rudermanfoundation.org/white_papers/police-officers-and-firefighters-are-more-likely-to-die-by-suicide-than-in-line-of-duty/. Accessed October 2020.Google Scholar
Blue, Help. 2019. https://bluehelp.org/. Accessed September 2020.Google Scholar
Stanley, IH, Hom, MA, Hagan, CR, Joiner, TE. Career prevalence and correlates of suicidal thoughts and behaviors among firefighters. J Affect Disord. 2015;187:163–171.CrossRefGoogle ScholarPubMed
Boffa, JW, Stanley, IH, Hom, MA, Norr, AM, Joiner, TE, Schmidt, NB. PTSD symptoms and suicidal thoughts and behaviors among firefighters. J Psych Res. 2017;84:277–283.CrossRefGoogle ScholarPubMed
Bishopp, SA, Boots, DP. General strain theory, exposure to violence, and suicide ideation among police officers: a gendered approach. J Crim Justic. 2014;42(6):538–548.CrossRefGoogle Scholar
Arnetz, BB, Arble, E, Backman, L, Lynch, A, Lublin, A. Assessment of a prevention program for work-related stress among urban police officers. Int Arch Environ Occup Health. 2013;86(1):79–88.CrossRefGoogle ScholarPubMed
Skeffington, PM, Rees, CS, Mazzucchelli, TG, Kane, RT. The primary prevention of PTSD in firefighters: preliminary results of an RCT with 12-month follow-up. PLoS ONE. 2016;11(7):e0155873.10.1371/journal.pone.0155873CrossRefGoogle ScholarPubMed
Fraternal Order of Police. Report on FOP/NBC survey of police officer mental and behavioral health. https://fop.net/CmsDocument/Doc/OfficerWellnessSurvey.pdf. Accessed October 2020.Google Scholar
Australian Federal Police. Annual report 2018-2019. https://www.afp.gov.au/annual-report-2018-19. Accessed September 2020.Google Scholar
Peach, AS. The perspectives and experiences of paramedics using employer funded counselling. Master’s Thesis. 2019. New Zealand: Auckland University of Technology.Google Scholar
Stuart, H. Mental illness stigma expressed by police to police. Isr J Psychiatry Relat Sci. 2017;54(1):18–23.Google Scholar
Spence, D. Improving law enforcement resilience: lessons and recommendations. Officer Safety and Wellness Group Meeting Summary. Washington, DC USA: Office of Community Oriented Policing Services. 2017.Google Scholar
Hesketh, I. Co-producing an emergency services well-being strategy in the UK. CSWB. 2018;3:88–90.Google Scholar
Hesketh, I. Leading the asset: resilience training efficacy in UK policing. https://eprints.lancs.ac.uk/id/eprint/123782/1/Resilience_Training_The_Police_Journal_Theory_Practice_and_Principles.pdf. Accessed September 2020.Google Scholar
McCraty, R, Atkinson, M. Resilience training program reduces physiological and psychological stress in police officers. Glob Adv Health Med. 2012;1(5):44–66.CrossRefGoogle ScholarPubMed
Mental Health Commission of Canada. The road to mental readiness (R2MR): Reduce stigma and increase resiliency in police employees. 2014. https://www.mentalhealthcommission.ca/sites/default/files/1%252520PG%252520R2MR%252520Police%252520Backgrounder%252520ENG_0_0.PDF. Accessed October 2020.Google Scholar
Weltman, G, Lamon, J, Freedy, E, Chartrand, D. Police department personnel stress resilience training: an institutional case study. Glob Adv Health Med. 2014;3(2):72–79.CrossRefGoogle Scholar
Ramey, SL, Perkhounkova, Y, Hein, M, Bohr, NL, Anderson, AA. Testing a resilience training program in police recruits: a pilot study. Biol Res Nurs. 2017;19(4):440–449.CrossRefGoogle ScholarPubMed
Joyce, S, Shand, F, Lal, TJ, Mott, B, Bryant, RA, Harvey, SB. Resilience@Work mindfulness program: results from a cluster randomized controlled trial with first responders. J Med Internet Res. 2019;21(2):e12894.CrossRefGoogle ScholarPubMed
Thompson, J, Drew, JM. Warr;or21: a 21-day program to enhance first responder resilience and mental health. Front Psychol. 2020;11:2078.CrossRefGoogle ScholarPubMed
Sansbury, BS, Graves, K, Scott, W. Managing traumatic stress responses among clinicians: individual and organizational tools for self-care. Trauma. 2015;17(2):114–122.CrossRefGoogle Scholar
Prati, G, Pietrantoni, L. The relation of perceived and received social support to mental health among first responders: a meta-analytic review. J Community Psychol. 2010;38(3):403–417.CrossRefGoogle Scholar
Knight, C. Indirect trauma: implications for self-care, supervision, the organization, and the academic institution. Clin Superv. 2013;32(2):224–243.CrossRefGoogle Scholar
Kvitne, O. Now this. Yoga for First Responders. http://yogaforfirstresponders.org/. Accessed October 2020.Google Scholar
Kragt, D, Jorritsma, K, Dunlop, P, Parker, S. Firefighters’ transition into retirement: issues, challenges, and support program design. Western Australia: Centre for Transformative Work Design; University of Western Australia; 2017.Google Scholar
Ruiz, J, Morrow, E. Retiring the old centurion: life after a career in policing—an exploratory study. Int J Public Admin. 2005;28(13-14):1151–1186.CrossRefGoogle Scholar
Bracken-Scally, M, McGilloway, S, Mitchell, JT. Retirement policies and support for emergency service personnel: the transition to retirement. Can J Aging. 2016;35(2):161–174.CrossRefGoogle Scholar
Pew Research Center. The Difficult Transition from Military to Civilian Life. https://www.pewsocialtrends.org/2011/12/08/the-difficult-transition-from-military-to-civilian-life/#:˜:text=While%20more%20than%20seven%2Din,11%2C%202001%2C%20terrorist%20attacks. Accessed October 2020.Google Scholar
Heglund, J. Helping First Responders Withstand Traumatic Experiences. FBI Law Enforcement Bulletin. 2009;78:9.Google Scholar
Dean, G. A holistic early intervention for emergency service workers at risk of developing a mental illness. https://esf.com.au/wpcontent/uploads/2020/04/2019_Greg_Dean_VicPol.pdf. Accessed October 2020.Google Scholar
The West Coast Post Trauma Retreat. https://www.frsn.org/west-coast-post-trauma-retreat.html. Accessed October 2020.Google Scholar
Badge of Life Canada. PTSD retreat for first responders. Shift Cognitive Therapy and Assessment.https://shiftct.com/badge-of-life-canada-ptsd-retreat-for-first-responders/. Accessed October 2020.Google Scholar