Clint Bowers

Background: Emergency medical services (EMS) personnel experience high rates of psychological distress yet demonstrate low utilization of mental health services. Factors associated with actual service use—rather than intentions or attitudes—are not well understood. Methods: Using secondary data from 36,697 licensed Florida EMTs and paramedics collected during the 2022 licensure renewal process, logistic regression models evaluated the relative contributions of workplace factors, attitudinal variables, trauma exposure, and mental health symptoms in their association with service utilization. Results: Psychological symptoms, particularly anxiety and depression, were the strongest factors associated with help-seeking. Peer support emerged as one of the few system-level factors associated with increased service use, even after accounting for symptom presence. Stigma-related variables showed weaker and, in some cases, counterintuitive associations. Suicidality and substance use were modestly associated with help-seeking beyond core symptom variables. Findings were consistent among trauma-exposed personnel. Discussion: Results are consistent with the potential value of early identification, routine symptom screening, and integrated, system-level supports such as peer support and access to confidential, occupationally competent care.

First responders face adverse health effects because they regularly encounter stressful situations and potentially traumatic events. Peer support programs have emerged as a method to reduce these adverse outcomes. A growing interest in peer programs exists despite a restricted body of research in this field. Additionally, the current research on this topic faces significant conceptual and methodological shortcomings. This paper conducts an extensive analysis of present peer support research gaps before proposing future study directions to improve our understanding of this intervention.

Background: Suicide risk is elevated among first responders. The three-step theory of suicide (3ST), not yet tested in first responders, proposes that the combination of pain and hopelessness leads to suicidal desire, but most relevant studies examine psychological pain and a few studies exist regarding the impact of physical pain. Aims: This study aimed to replicate and expand the understanding of the 3ST by examining physical and psychological pain in Step 1 within first responders. Method: First responders ( n = 204) completed an anonymous online survey assessing physical pain, psychological pain, hopelessness, and suicidal desire. Moderation analyses were used to test whether psychological pain and physical pain, respectively, potentiate the relationship between hopelessness and suicidal desire. Results: Physical pain moderated the relationship between hopelessness and suicidal desire, such that high levels of physical pain potentiated the relationship and low levels diminished the relationship, while psychological pain did not. Findings support the 3ST and provide evidence for the important role of physical pain in examining suicidal desire among first responders. Limitations and Conclusion: Although data were cross-sectional, results may inform development of measures tailored to first responders, which could ultimately lead to improved methods for assessing critical components of first responder and suicide risk.

This study evaluates the effectiveness of a brief psychoeducation training program in reducing mental health stigma, both toward others and oneself, among public safety personnel, while also comparing the relative effectiveness of in-person and online training modalities. In total, 1686 public safety personnel in Florida received psychoeducation on the mental health impacts of public safety work. Participants completed pre- and post-training questionnaires assessing demographics, mental health knowledge, and mental health stigma toward others and themselves. Among the participants, 871 completed the training online, and 44 completed the training in-person. A paired samples t-test assessed changes in knowledge from pre- to post-test, and 2 × 2 repeated measures ANOVAs analyzed stigma-related data. Mental health knowledge increased and mental health stigma toward others decreased post-training, with no differences between training modalities. No changes in mental health self-stigma were found. Police officers reported significantly greater self-stigma than firefighters. Firefighters and dispatchers reported significantly less stigma toward others than police officers. This study found that both in-person and online psychoeducation can similarly improve mental health knowledge and reduce stigma toward others, which may help reduce barriers to seeking care.

Workplace coaching has experienced a dramatic rise in popularity over the past decade and is one of the fastest growing performance-enhancing interventions used by modern organizations. Yet, despite its popularity, workplace coaching has not been the subject of much empirical research and a true science of coaching has yet to be developed. The purpose of this research was to update prior meta-analyzes that investigated the impact of coaching on organizational outcomes and to provide recommendations for how the field needs to evolve. Results indicated that, consistent with prior meta-analyzes, workplace coaching is effective in achieving positive organizational outcomes. The effects of several moderators were also investigated. Finally, we discuss the results in terms of recommendations for future directions that we believe will establish and advance the science of coaching.

Stigma about mental illness is often identified as one of the most prominent obstacles to seeking mental health services. This seems to be particularly true among first responders. Unfortunately, the research regarding stigma in first responders is lacking. This may be due, in part, to the absence of appropriate measurement tools to allow such research. Police Officer Stigma Scale (POSS) has recently been developed to address this issue, but its psychometric properties have gone largely untested. Therefore, this study sought to identify the underlying factor structure and internal consistency of the POSS. This paper used a sample of 135 first responders. Using factor analysis with an orthogonal rotation on Stuart's 11-item POSS, the participant's results revealed two main components, accounting for a total of 72.79% of the overall variance. Factor one is “maltreatment of colleagues with a mental disorder,” and is associated with six of the 11 items on the scale, such as “Most police officers believe that a colleague who has had a mental illness is not trustworthy.” Factor two is “fear of disclosing a mental disorder.” It includes items such as “Most police officers would not disclose to a supervisor/manager if they were experiencing a mental illness.” Findings from this research are similar to the results of previous studies with components such as unwillingness to disclose a mental health condition, fear of how the public will treat an individual with a mental disorder, and anger toward those who decide to seek treatment or get diagnosed with a mental illness. These findings imply that Stuart's POSS is reliable but needs to include two components rather than one. With the two main components, further research can now be conducted to understand why and ultimately mitigate maltreatment or stigma against first responders with a mental health condition.

This chapter focuses on the broader topic of team resiliency within the healthcare profession. Specifically, the authors discuss the current body of literature relating to healthcare teams, the concept of team resilience, and its potential application within the field of healthcare. Moreover, the authors propose different means of developing team resilience within healthcare teams including the theoretical application of an existing team resilience model to the healthcare profession. Lastly, suggestions are provided for future research that could help to develop the body of knowledge related to the topic. Request access from your librarian to read this chapter's full text.

Workplace interventions that leverage social tactics to improve health and well-being are becoming more common. As an example, peer mental health support interventions aim to reduce stigma and promote treatment seeking in first responder populations. Given the social nature of these interventions, it is important to consider how the preexisting social context influences intervention outcomes. A peer mental health support intervention was delivered among first responders, and self-efficacy and intention to have supportive peer conversations were measured pre-and post-intervention. Trust in peers was measured prior to the intervention. Results suggest a floor effect may exist for self-efficacy, in which a foundational level of trust and pre-intervention self-efficacy may be needed to maximize intervention effectiveness. As the future of work brings complex safety and health challenges, collaborative solutions that engage multiple stakeholders (employees, their peers, and their organization) will be needed. This study suggests that more frequent attention to pre-existing intervention context, particularly social context in peer-focused intervention, will enhance intervention outcomes.