A systematic review of well-being interventions and initiatives for Australian and New Zealand emergency service workers

Abstract

ABSTRACT Objective Emergency service workers (i.e., police, fire, ambulance, rescue personnel) are exposed to stressful events that can adversely impact their mental health and well-being. This systematic review investigated (1) what well-being initiatives and interventions have been implemented with Australian and New Zealand emergency service workers, (2) how they have been evaluated, and (3) whether they were effective. Methods A systematic literature search identified 19 peer-reviewed studies eligible for inclusion. Results Eleven studies examined secondary interventions, seven examined primary interventions and only one study examined a tertiary intervention. Most studies measured mental health outcomes (e.g., depression, anxiety). However, some studies used evaluation measures that were not directly related to mental health or well-being (e.g., satisfaction, changes to attitudes). Interventions including physical activity, manager mental health training, social support, psychological debriefing, mindfulness, and an ambulance chaplaincy initiative were found to lead to improvements in mental health and well-being in Australian and New Zealand emergency service workers. Only two ongoing and self-sustaining mental health initiatives were reported. Conclusions Further research is required into primary interventions and organisational-level initiatives to enable a preventative approach to mitigate daily stress and enhance the mental and physical well-being of emergency workers. Key Points What is already known about this topic: Emergency service workers have higher rates of Post-Traumatic Stress Disorder (PTSD), anxiety, and depression than the general population. Evidence based mental health and well-being support is crucial for emergency service workers to ensure they can protect their respective communities effectively. Research focused on the prevalence of mental health issues for emergency workers is well represented in the literature, however, evidence for interventions designed to improve mental health outcomes is scarce. What this topic adds: This review contributes by identifying and evaluating studies focused on mental health and well-being interventions for emergency service workers in Australia and New Zealand. This review distinguished between interventions (programs with defined start and end points) and initiatives (programs that are ongoing and self-sustaining), and only two initiatives were reported. Interventions that led to improvements in mental health and well-being were those related to mindfulness, physical activity, manager mental health training, social support, psychological debriefing, and an ambulance chaplaincy initiative.