Problem:
Introduction:
Public safety personnel experience regular exposure to chronic stressors that contribute to a higher prevalence of adverse physical and mental health outcomes than other occupations (Kaplan et al., 2017). High levels of mental distress are evidenced by the increasing numbers of suicides, depression, and burnout among the ranks of first responders (Dvoskina & Cole, 2020). In addition, a growing body of research suggests that factors such as of as childhood trauma (Behnke et al., 2020) play a role in mental health, issues that have historically not been considered in the research on this subject. Paramedics and firefighters have an elevated risk for developing psychopathology due to routine exposure to workplace violence (Setlack et al., 2021), which has been shown to contribute to the prevalence of anxiety-related chronic pain (Carleton et al., 2018).
Evolving evidence shows that physical movement plays a pivotal role in reducing stress and creating healthy workplaces (Joyce et al., 2019). Finally, research is being conducted on the efficacy of using therapy dogs for responders and 911 call-takers (Dvoskina & Cole, 2020). This review will address the current studies regarding first responder mental health and the research concerning individuals working on the front lines of public health and safety.
Discussion:
Resilience can be considered as" a dynamic process reflecting a person's ability to adapt, manage, and recover effectively from stressful experiences and adverse circumstances"(Joyce et al., 2019). The ability to "bounce back" is an essential skill for all front-line personnel. One group of public safety personnel (PSP) who require a high degree of resilience is 911 dispatch operators(Dvoskina & Cole, 2020). Call takers are at an exceptionally high risk of developing compassion fatigue and face unique challenges to stress management and trauma decontamination (Dvoskina & Cole, 2020). Unlike paramedics and firefighters who are physically active during a shift, 911 operators sit in one place for hours in high-stress environments due to the nature of their jobs. Study participants reported that downtime was spent either sleeping or sitting at a desk completing paperwork. Studies indicate that prolonged sedentary periods are linked to obesity, hypercholesterolemia, and hypertension, which increase the likelihood of psychological stress (Dvoskina & Cole, 2020).
Evidence suggests that prolonged sitting creates an additional obstacle to trauma mitigation (Dvoskina & Cole, 2020) and that 911 operators would benefit from a different approach to the delivery of therapeutic services (Dvoskina & Cole, 2020). Research supports the conclusion that "movement is a key factor in trauma resolution and that sedentary states can contribute to an increase in trauma symptoms." It is understandable then that the inability to move in response to sympathetic nervous system activation may result in fatigue and depression (Dvoskina & Cole, 2020). In addressing trauma as a functional whole with both linguistic and nonverbal integration, one may be better able to adapt to the chaotic feelings triggered by the traumatic experience itself (Dvoskina & Cole, 2020). In other words, physical activity is necessary for the body to process stress hormones produced during "flight or fight" and signal to the brain that the immediate threat has been mitigated. Research has shown that canine therapy is especially effective in re-setting the sympathetic nervous system (Dvoskina & Cole, 2020).
A retrospective study of emergency medical personnel published in 2019 investigated whether PSP with childhood maltreatment were at increased risk of mental and physical stress symptoms after exposure to occupational trauma (Behnke et al., 2020). Data from 130 German EMS personnel was collected as part of a cross-section survey distributed to the regional Red Cross (Behnke et al., 2020). Participants self-reported to an anonymous questionnaire that asked about childhood abuse/mistreatment, exposure to occupational trauma, as well as post-traumatic and depressive feelings that included somatic symptoms (Behnke et al., 2020). The study results provided initial evidence that childhood trauma could increase vulnerability to high-stress levels while on duty (Behnke et al., 2020).
A recent study at the University of Manitoba showed that in 2019, over 80% of paramedics and firefighters experienced violence directed at them by the public. However, its impact on mental health is poorly understood(Setlack et al., 2021). Recent events in the media demonstrate that workplace violence is increasing. However, there continues to be a severe lack of comprehensive research into how these events affect first responders over time (Setlack et al., 2021). A systematic review found that psychological injuries such as anxiety and mental exhaustion were linked to on-scene violence; however, the literature has not outlined the extent of the association between them.(Setlack et al., 2021)Social support can be a critical factor in developing resilience, but outside of studies focused on police, information on how to provide that support to EMS personnel is nonexistent. This may be due to an unspoken allegiance to an ethos of "silent trauma".
What is missing from the knowledge base:
At this point, it appears that most of the research being done around PSP mental health and wellness is being done in Canada, Germany, and Australia. There is very little information available that includes statistics of the mental health of PSPs in the United States, despite the US having the highest number in terms of cost incurred by decreased staffing numbers, on the job injuries, burn out and disability claims due to anxiety and chronic pain (Carleton et al., 2018). Also missing is data about race and gender identity and how (or if) they impact the factors involved in PSP mental health. The world is not getting less violent, and the need for quality, prehospital care is not lessening. The system must make wellness training readily accessible to those we trust to provide that care. It will require qualitative as well as quantitative research to accomplish this goal. I hope to utilize my lived experience to take the study in this area to the next level in my role as a social worker. break down by citation. Need Assignment Help?