A Systematic Review of Interventions to Support Health, Wellbeing, and Job Satisfaction for Emergency Call Handlers in the Ambulance, Police, and Fire Services.

Abstract

Emergency call handlers (ECH) in ambulance, police, and fire services experience high levels of occupational stress which can have adverse health consequences. To systematically review interventions to support the health, wellbeing and employment of ECH working in the emergency services. Following PRISMA 2020 guidelines, academic databases and grey literature were searched [Last search: 06/02/25]. Studies of any design assessing physical or mental health or employment outcomes were eligible. Screening and quality appraisal were conducted independently, with data extraction completed and cross checked by two reviewers. The JBI family of tools was used to assess quality and risk of bias. Twelve studies met the inclusion criteria and were narratively synthesised into four categories: psychoeducation and resilience training, residential recovery programme, organisational wellbeing initiatives, and multicomponent interventions. Sample sizes ranged from n = 9 to n = 4020. The majority of interventions identified aimed to improve mental health, while physical health and employment outcomes were less frequently assessed. There was significant heterogeneity in study design which limited comparability between the studies. Most studies included a mixed sample of ECH and first responders and the methodological quality of included studies was variable. Some studies employed rigorous designs (e.g., RCTs), whilst others relied on observational methods. The included studies also demonstrated organisational barriers to the delivery of interventions in these settings. There was limited evidence for the effectiveness of interventions for supporting health and wellbeing or reducing stress amongst ECH. There is a need for role-specific interventions for ECH. SYSTEMATIC REGISTRATION: This systematic review was registered on PROSPERO: CRD42025639271.