U.S. Metropolitan Municipalities EMS Medical Directors Consortium ( The “Eagles” Coalition)
INTERNATIONAL RESEARCH PERSPEC TIVES
Groundbreaking data collected on mental health of first responders
By Randy Mellow, A-EMCA, CMM III
Carleton RN, Afifi TO, Turner S, et al. Men-
tal disorder symptoms among public
safety personnel in Canada. Can J Psychia-
try. Jan. 1, 2017. [Epub ahead of print, visit
Post-traumatic stress disorder (PTSD) and
other operational stress injuries (OSI) are
both ubiquitous and harmful within the public
safety community. Although recent focus has
given rise to increased awareness to mental
health issues, barriers to the development of
evidence-informed prevention and treatment
regimens continue to exist.
Undesirable stigma associated with mental health issues has been a very difficult hurdle for the public safety community. Much
progress has been made toward reduction of
stigma; however, efforts need to continue in
order for mental health to be truly improved
for public safety personnel.
Another fundamental barrier to providing meaningful response to the mental
health needs of public safety personnel is a
true understanding of the detailed nature and
scope of the problem. Numbers matter! Until
recently, there existed a paucity of reliable data
on OSI symptom prevalence and, potentially
of equal importance, what differences or sim-ilarities exist within the specific public safety
communities (e.g., police, EMS, fire, etc.).
Realizing the critical importance of this
data, the Canadian Institute for Public Safety
and Treatment (CIPSRT) developed a study
designed to provide estimates of the prevalence of several mental disorder symptoms
and provide explicit comparisons across
diverse public safety categories. The results
are intended to support a recommended
National Action Plan that includes ongoing
increasingly robust research.
Background: Partnering with first
responder and public safety leadership and
associations, CIPSRT is a coast-to-coast
multi-university team of top Canadian
researchers working with key stakeholders on
long-term initiatives to identify the resources
required to support the recognition, preven-
tion, intervention and treatment of mental
health concerns facing Canadian first respond-
ers and public safety personnel.
Method: In this national study, CIPSRT
engaged nearly 6,000 participants in an anonymous survey designed to provide critically
needed information about OSI symptom prevalence (e.g., symptoms of PTSD, depression,
panic) for Canadian public safety personnel.
The survey was made available from September 2016 to January 2017, after which estimates of symptom prevalence were derived
using well-validated screening measures.
Data were collected using a web-based
self-report survey that included measures for
screening mental disorder symptom levels that
may warrant further clinical attention.
In order to establish a representative sample,
participants were grouped into demographic
categories (e.g., public safety category, sex, age,
marital status, provincial region, ethnicity, education, years of service and urban/rural work
location) for comparison, and subsequently
compared to the general population using
information provided by Statistics Canada.
Results: Substantial portions of the survey
participants self-reported symptoms consistent
with one or more mental disorders.
In fact, results indicate that 44.5% screened
positive for clinically significant symptom clus-
ters consistent with one or more mental dis-
orders. This proportion appears significantly
higher than previous research and comparison
to diagnostic rates for the general population,
The study also revealed some significant
differences between public safety categories
in frequencies of positive screens that war-
rant further investigation. For example, when
comparing the data between paramedics and
firefighters, the study found higher rates of
P TSD ( 24.5%), depression ( 29.6%) and panic
disorder ( 10.3%) among paramedics.
The results also indicated that rates for these
same mental health measures were lower for
paramedics when compared to corrections officers where P TSD ( 29.1%), depression ( 31.1%)
and panic disorder ( 12.2%) were all higher.
Discussion: The study results are an invaluable asset to public safety leadership. The
volume of willing participants responding to
the survey indicates success in reducing the
stigma associated with OSIs—a significant
barrier to engaging strategies and allocating
resources to support mental health for all
public safety personnel.
The study results provide a more comprehensive understanding than previously available of how common symptoms are within the
broader public safety realm. Further, identifiable differences and trends among each of the
public safety categories have been identified.
This is critically important and novel
information for researchers. It will help them
develop coordinated plans to improve methods of prevention and treatment of OSIs. JEMS
Randy Mellow, A-EMCA, CMM III, is the chief
of Peterborough County/City Paramedics in
Ontario, Canada. He’s also the president of the
Paramedic Chiefs of Canada and a member of
the CISPRT Public Safety Steering Committee.