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Special Issue "Stress, Prevention, and Resilience among First Responders"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (1 September 2021).

Special Issue Editors

Dr. Konstantinos Papazoglou
E-Mail Website1 Website2
Guest Editor
Trauma Section, Yale School of Medicine, New Haven, CT 06510, USA
Interests: police stress; trauma; moral injury; compassion fatigue; health; training; resilience
Dr. Katy Kamkar
E-Mail Website
Guest Editor
Centre for Addiction and Mental Health (CAMH) & Department of Psychiatry, University of Toronto, Toronto, ON, M5S 2G8, Canada
Interests: anxiety; depression; operational stress injury; PTSD; workplace mental health and wellbeing; resiliency; prevention; intervention; return to work
Dr. Olivia Johnson
E-Mail Website
Guest Editor
Illinois Department of Health—Suicide Prevention Alliance, Belleville, IL 62226, USA
Interests: law enforcement suicide; first responder wellness and resilience; suicide prevention; mental health
Dr. Chuck Russo
E-Mail Website
Guest Editor
Criminal Justice, American Public University System, Charles Town, WV 25414, USA
Interests: post-traumatic stress; emerging technology applications in public safety; officer stress; officer resilience; training; non-government intelligence actors

Special Issue Information

Dear Colleagues,

First responders are exposed to a plethora of critical incidents over the course of their career. Current scholarly research has shown that first responders experience different types of stress. Despite their exposure to adversities, first responders have proven to be more resilient compared to the general population. However, exposure to critical incidents may often have negative impact on first responders’ health, wellbeing, and job performance. The role of preventative interventions is imperative in helping first responders recover following exposure to adversities, hence maintaining resilient trajectories over the course of their career.

This Special Issue aims to provide the readers with valuable information with regards to the multidimensional nature of stress among first responders. In addition, some papers in this Special Issue will focus on resilience and the exploration of how resilience can be studied in first responders; in addition, the application of resilience promotion interventions will be studied and discussed in some of the manuscripts included in this Special Issue. Moreover, the current Special Issue encompasses the term “prevention” to emphasize the important role of prevention or preventative interventions in helping first responders cope with efficiency in the exposure to challenges they experience in the line of duty. All scholars whose work focuses on this present topic are more than welcome to submit their manuscripts for peer review. The Special Issue is an open access one, meaning that professionals, policy makers, leaders, and students who are interested in first responders’ work will have access to this Special Issue with no additional fees. In addition, this Special Issue will be indexed in some of the major databases; therefore, academicians, researchers, instructors, and scholars interested in the topic explored in the current Special Issue will have a unique opportunity to study the papers published in this Special Issue. 

That being said, we would like to invite you to send us your manuscript (IJERPH offers different types of manuscripts, including theoretical essays) for consideration for publication in our Special Issue. Your manuscript will initially go through the peer-reviewed process before publication is approved. You may submit anything related to the topic and the work you have been doing. Please feel free to invite other co-authors to collaborate with you on the completion of your manuscripts.

Dr. Konstantinos Papazoglou
Dr. Katy Kamkar
Dr. Olivia Johnson
Dr. Chuck Russo
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • stress
  • prevention
  • resilience
  • first responders
  • critical incidents
  • performance
  • health
  • interventions

Published Papers (12 papers)

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Research

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Article
Job Demands and Exhaustion in Firefighters: The Moderating Role of Work Meaning. A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2021, 18(18), 9819; https://doi.org/10.3390/ijerph18189819 - 17 Sep 2021
Viewed by 517
Abstract
Emotional exhaustion and other symptoms of burnout are often found among emergency services professions, such as firefighting. Given the social importance of this activity and the high responsibility it requires, prevention and alleviation of burnout symptoms become primary concerns in ensuring the well-being [...] Read more.
Emotional exhaustion and other symptoms of burnout are often found among emergency services professions, such as firefighting. Given the social importance of this activity and the high responsibility it requires, prevention and alleviation of burnout symptoms become primary concerns in ensuring the well-being of firefighters. Although work meaning is one of the factors associated with a lower risk of developing burnout, its protective role has not been studied in firefighters. Therefore, the purpose of this study was to assess the buffering role of work meaning in the health-impairment process of the Job Demands-Resources model, targeting the relationship between job demands and related emotional exhaustion. A cross-sectional survey design was used to collect data from a sample consisting of Romanian firefighters (n = 1096). Structural equation modeling indicated a positive link between job demands and exhaustion. In addition, deriving personal meaning from work was associated with lower levels of exhaustion in firefighters. A small but significant interaction effect between work meaning and job demands showed that higher levels of work meaning attenuated the positive relationship between job demands and exhaustion. In conclusion, our findings suggest that work meaning has a buffering effect on the impact of various job demands on job-related exhaustion. Nevertheless, the small effect sizes warrant further research on this topic. Full article
(This article belongs to the Special Issue Stress, Prevention, and Resilience among First Responders)
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Article
The Dark Triad Traits of Firefighters and Risk-Taking at Work. The Mediating Role of Altruism, Honesty, and Courage
Int. J. Environ. Res. Public Health 2021, 18(11), 5983; https://doi.org/10.3390/ijerph18115983 - 02 Jun 2021
Viewed by 943
Abstract
Firefighting is considered a dangerous profession that imposes unique safety hazards. In this research, we investigated the relationship between the Dark Triad traits of firefighters (N = 1434, Mage = 39.03, SD = 6.9) and their risk-taking at work, considering the mediation [...] Read more.
Firefighting is considered a dangerous profession that imposes unique safety hazards. In this research, we investigated the relationship between the Dark Triad traits of firefighters (N = 1434, Mage = 39.03, SD = 6.9) and their risk-taking at work, considering the mediation role of altruism, honesty, and courage. We showed that firefighters high on Machiavellianism and psychopathy reported high risk-taking. Altruism, honesty, and courage mediated the relationship between Machiavellianism and risk-taking in firefighters. Honesty and courage mediated the association between psychopathy and risk-taking. Theoretical and practical implications are discussed. Full article
(This article belongs to the Special Issue Stress, Prevention, and Resilience among First Responders)
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Article
First Responder Resiliency ECHO: Innovative Telementoring during the COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2021, 18(9), 4900; https://doi.org/10.3390/ijerph18094900 - 04 May 2021
Viewed by 1068
Abstract
The First Responder ECHO (Extension for Community Outcomes) program was established in 2019 to provide education for first responders on self-care techniques and resiliency while establishing a community of practice to alleviate the enormous stress due to trauma and substance misuse in the [...] Read more.
The First Responder ECHO (Extension for Community Outcomes) program was established in 2019 to provide education for first responders on self-care techniques and resiliency while establishing a community of practice to alleviate the enormous stress due to trauma and substance misuse in the community. When the SARS-CoV-2 (COVID-19) pandemic hit the United States (US) in March 2020, a tremendous strain was placed on first responders and healthcare workers, resulting in a program expansion to include stress mitigation strategies. From 31 March 2020, through 31 December 2020, 1530 unique first responders and frontline clinicians participated in the newly expanded First Responder Resiliency (FRR) ECHO. The robust curriculum included: psychological first aid, critical incident debriefing, moral distress, crisis management strategies, and self-care skills. Survey and focus group results demonstrated that, while overall stress levels did not decline, participants felt more confident using psychological first aid, managing and recognizing colleagues who needed mental health assistance, and taking time for self-care. Although first responders still face a higher level of stress as a result of their occupation, this FRR ECHO program improves stress management skills while providing weekly learning-listening sessions, social support, and a community of practice for all first responders. Full article
(This article belongs to the Special Issue Stress, Prevention, and Resilience among First Responders)
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Article
The Quality, Readability, Completeness, and Accuracy of PTSD Websites for Firefighters
Int. J. Environ. Res. Public Health 2020, 17(20), 7629; https://doi.org/10.3390/ijerph17207629 - 19 Oct 2020
Cited by 1 | Viewed by 1286
Abstract
Firefighters appear at an increased risk for post-traumatic stress disorder (PTSD). Because of PTSD-related stigma, firefighters may search for information online. The current study evaluated the quality, readability, and completeness of PTSD online resources, and to determine how the online treatment recommendations align [...] Read more.
Firefighters appear at an increased risk for post-traumatic stress disorder (PTSD). Because of PTSD-related stigma, firefighters may search for information online. The current study evaluated the quality, readability, and completeness of PTSD online resources, and to determine how the online treatment recommendations align with current evidence. Google.ca (Canada) searches were performed using four phrases: ‘firefighter PTSD’, ‘firefighter operational stress’, ‘PTSD symptoms’, and ‘PTSD treatment’. The 75 websites identified were assessed using quality criteria for consumer health information (DISCERN), readability and health literacy statistics, content analysis, and a comparison of treatments mentioned to the current best evidence. The average DISCERN score was 43.8 out of 75 (indicating ‘fair’ quality), with 9 ‘poor’ websites (16–30), 31 ‘fair’ websites (31–45), 26 “good” websites (46–60), and nine excellent websites (61–75). The average grade level required to understand the health-related content was 10.6. The most mentioned content was PTSD symptoms (48/75 websites) and PTSD treatments (60/75 websites). The most frequently mentioned treatments were medications (41/75 websites) and cognitive behavioural therapy (40/75 websites). Cognitive behavioural therapy is supported by strong evidence, but evidence for medications appears inconsistent in current systematic reviews. Online PTSD resources exist for firefighters, but the information is challenging to read and lacks evidence-based treatment recommendations. Full article
(This article belongs to the Special Issue Stress, Prevention, and Resilience among First Responders)
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Article
Organizational Solutions to the Moral Risks of Policing
Int. J. Environ. Res. Public Health 2020, 17(20), 7461; https://doi.org/10.3390/ijerph17207461 - 14 Oct 2020
Cited by 1 | Viewed by 1106
Abstract
In addition to the physical and emotional challenges faced by law enforcement professionals, the job confronts officers with numerous moral risks. The moral risks include moral distress, moral injury, ethical exhaustion, compassion fatigue, and practices that lead to lapses in ethical decision-making. The [...] Read more.
In addition to the physical and emotional challenges faced by law enforcement professionals, the job confronts officers with numerous moral risks. The moral risks include moral distress, moral injury, ethical exhaustion, compassion fatigue, and practices that lead to lapses in ethical decision-making. The paper focuses on what police agencies can do to better address the moral risks of policing. These moral risks are central to officer wellness and, thus, a crucial component of officers’ operational readiness. Strategies are presented that will improve prevention efforts, including recruiting and hiring, training, supervision, and promotional practices. Additionally, the paper offers recommendations for effective approaches to intervention with officers who have displayed the effects of these moral risks. Finally, the paper highlights the kind of law enforcement leaders who are best able to implement strategies designed to prevent negative outcomes associated with the moral risks of policing. Full article
(This article belongs to the Special Issue Stress, Prevention, and Resilience among First Responders)
Article
Factors that Influence the Decision to Seek Help in a Police Population
Int. J. Environ. Res. Public Health 2020, 17(18), 6891; https://doi.org/10.3390/ijerph17186891 - 21 Sep 2020
Cited by 4 | Viewed by 1327
Abstract
Police officers face many competing pressures and demands. Exposure to potentially traumatic incidents and significant job-related stressors can place many at higher risk of developing physical and mental health problems. The police culture exerts a pronounced influence on officers, preventing some from asking [...] Read more.
Police officers face many competing pressures and demands. Exposure to potentially traumatic incidents and significant job-related stressors can place many at higher risk of developing physical and mental health problems. The police culture exerts a pronounced influence on officers, preventing some from asking for or receiving assistance. The stigma of being perceived as weak or incompetent, concerns about being labelled unfit for duty, and worry that accessing psychological support will impact future career advancement can affect the decision to seek help. The Enhanced Critical Incident Technique was utilized to investigate the following research question: What helps or hinders the decision to access psychological services in a police population? Qualitative interviews were conducted with 20 serving Royal Canadian Mounted Police officers in the lower mainland of British Columbia, Canada. The findings encompass five main themes: the importance of systemic factors, access to information and education, quality and influence of relationships, individual characteristics, and organizational processes that will increase the likelihood of accessing mental health services. The results contribute to the empirical literature by enhancing what is known about elements that influence an officers’ decision to seek psychological services, and factors that can enable officers to overcome barriers. Full article
(This article belongs to the Special Issue Stress, Prevention, and Resilience among First Responders)
Article
Job Stress, Burnout and Coping in Police Officers: Relationships and Psychometric Properties of the Organizational Police Stress Questionnaire
Int. J. Environ. Res. Public Health 2020, 17(18), 6718; https://doi.org/10.3390/ijerph17186718 - 15 Sep 2020
Cited by 8 | Viewed by 2113
Abstract
Policing is a stressful occupation, which impairs police officers’ physical/mental health and elicits burnout, aggressive behaviors and suicide. Resilience and coping facilitate the management of job stress policing, which can be operational or organizational. All these constructs are associated, and they must be [...] Read more.
Policing is a stressful occupation, which impairs police officers’ physical/mental health and elicits burnout, aggressive behaviors and suicide. Resilience and coping facilitate the management of job stress policing, which can be operational or organizational. All these constructs are associated, and they must be assessed by instruments sensitive to policing idiosyncrasies. This study aims to identify operational and organizational stress, burnout, resilient coping and coping strategies among police officers, as well to analyze the psychometric properties of a Portuguese version of the Organizational Police Stress Questionnaire. A cross-sectional study, with online questionnaires, collected data of 1131 police officers. With principal components and confirmatory factor analysis, PSQ-org revealed adequate psychometric properties, despite the exclusion of four items, and revealed a structure with two factors (poor management and lack of resources, and responsibilities and burden). Considering cut-off points, 88.4% police officers presented high operational stress, 87.2% high organizational stress, 10.9% critical values for burnout and 53.8% low resilient coping, preferring task-orientated than emotion and avoidance coping. Some differences were found according to gender, age and job experience. Job stress and burnout correlated negatively with resilient coping, enthusiasm towards job and task-orientated coping. Results reinforce the importance to invest on police officers’ occupational health. Full article
(This article belongs to the Special Issue Stress, Prevention, and Resilience among First Responders)
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Article
Risk Factors for Duty-Related Posttraumatic Stress Disorder among Police Officers in the Mt. Ontake Eruption Disaster-Support Task Force
Int. J. Environ. Res. Public Health 2020, 17(9), 3134; https://doi.org/10.3390/ijerph17093134 - 30 Apr 2020
Cited by 5 | Viewed by 1187
Abstract
Mount Ontake in Nagano Prefecture, Japan erupted on 27 September 2014. Many police officers were called in for duty as a disaster-support task force. We investigated the association between the peritraumatic situation and posttraumatic stress disorder (PTSD) symptoms in these police officers. In [...] Read more.
Mount Ontake in Nagano Prefecture, Japan erupted on 27 September 2014. Many police officers were called in for duty as a disaster-support task force. We investigated the association between the peritraumatic situation and posttraumatic stress disorder (PTSD) symptoms in these police officers. In January 2015, a health survey (OHS) on disaster stress related to the Mt. Ontake eruption disaster support work was distributed to all of the police officers and staff involved in the disaster support. We analyzed the 213 participants who had PTSD symptoms following the eruption and no missing OHS data. Logistic regression analyses were conducted to clarify the relationship between the participants’ symptom severity and their peritraumatic situation (i.e., stressors and daily support prior to the eruption, disaster-support work duties, and postdisaster stress relief). The symptom severity was associated with ‘more than seven cumulative days at work’ (odds ratio [OR] = 2.47, 1.21–5.06), ‘selecting drinking and/or smoking as stress relief after disaster-support work’ (OR = 2.35, 1.09–5.04), and ‘female’ (OR = 3.58, 1.19–10.77). As disaster-support work, ‘supporting the victims’ families’ (OR = 1.99, 0.95–4.21) tended to be associated with symptom severity. The number of days of disaster-support work, stress-relief behavior, and gender were associated with the severity of PTSD symptoms. Full article
(This article belongs to the Special Issue Stress, Prevention, and Resilience among First Responders)
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Article
Sleep Quality and Mental Disorder Symptoms among Canadian Public Safety Personnel
Int. J. Environ. Res. Public Health 2020, 17(8), 2708; https://doi.org/10.3390/ijerph17082708 - 15 Apr 2020
Cited by 7 | Viewed by 1551
Abstract
Poor sleep quality is associated with numerous mental health concerns and poorer overall physical health. Sleep disturbances are commonly reported by public safety personnel (PSP) and may contribute to the risk of developing mental disorders or exacerbate mental disorder symptoms. The current investigation [...] Read more.
Poor sleep quality is associated with numerous mental health concerns and poorer overall physical health. Sleep disturbances are commonly reported by public safety personnel (PSP) and may contribute to the risk of developing mental disorders or exacerbate mental disorder symptoms. The current investigation was designed to provide estimates of sleep disturbances among PSP and explore the relationship between sleep quality and mental health status. PSP completed screening measures for sleep quality and diverse mental disorders through an online survey. Respondents (5813) were grouped into six categories: communications officials, correctional workers, firefighters, paramedics, police officers, and Royal Canadian Mounted Police (RCMP). Many PSP in each category reported symptoms consistent with clinical insomnia (49–60%). Rates of sleep disturbances differed among PSP categories (p < 0.001, ω = 0.08). Sleep quality was correlated with screening measures for post-traumatic stress disorder (PTSD), depression, anxiety, social anxiety disorder, panic disorder, and alcohol use disorder for all PSP categories (r = 0.18–0.70, p < 0.001). PSP who screened positive for insomnia were 3.43–6.96 times more likely to screen positive for a mental disorder. All PSP reported varying degrees of sleep quality, with the lowest disturbances found among firefighters and municipal/provincial police. Sleep appears to be a potentially important factor for PSP mental health. Full article
(This article belongs to the Special Issue Stress, Prevention, and Resilience among First Responders)
Article
Assessing the Relative Impact of Diverse Stressors among Public Safety Personnel
Int. J. Environ. Res. Public Health 2020, 17(4), 1234; https://doi.org/10.3390/ijerph17041234 - 14 Feb 2020
Cited by 35 | Viewed by 2521
Abstract
Public Safety Personnel (PSP; e.g., correctional workers and officers, firefighters, paramedics, police officers, and public safety communications officials (e.g., call center operators/dispatchers)) are regularly exposed to potentially psychologically traumatic events (PPTEs). PSP also experience other occupational stressors, including organizational (e.g., staff shortages, inconsistent [...] Read more.
Public Safety Personnel (PSP; e.g., correctional workers and officers, firefighters, paramedics, police officers, and public safety communications officials (e.g., call center operators/dispatchers)) are regularly exposed to potentially psychologically traumatic events (PPTEs). PSP also experience other occupational stressors, including organizational (e.g., staff shortages, inconsistent leadership styles) and operational elements (e.g., shift work, public scrutiny). The current research quantified occupational stressors across PSP categories and assessed for relationships with PPTEs and mental health disorders (e.g., anxiety, depression). The participants were 4820 PSP (31.7% women) responding to established self-report measures for PPTEs, occupational stressors, and mental disorder symptoms. PPTEs and occupational stressors were associated with mental health disorder symptoms (ps < 0.001). PSP reported substantial difficulties with occupational stressors associated with mental health disorder symptoms, even after accounting for diverse PPTE exposures. PPTEs may be inevitable for PSP and are related to mental health; however, leadership style, organizational engagement, stigma, sleep, and social environment are modifiable variables that appear significantly related to mental health. Full article
(This article belongs to the Special Issue Stress, Prevention, and Resilience among First Responders)

Review

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Review
Why Are Workplace Social Support Programs Not Improving the Mental Health of Canadian Correctional Officers? An Examination of the Theoretical Concepts Underpinning Support
Int. J. Environ. Res. Public Health 2021, 18(5), 2665; https://doi.org/10.3390/ijerph18052665 - 06 Mar 2021
Cited by 1 | Viewed by 998
Abstract
In Canada, public safety personnel, including correctional officers, experience high rates of mental health problems. Correctional officers’ occupational stress has been characterized as insidious and chronic due to multiple and unpredictable occupational risk factors such as violence, unsupportive colleagues and management, poor prison [...] Read more.
In Canada, public safety personnel, including correctional officers, experience high rates of mental health problems. Correctional officers’ occupational stress has been characterized as insidious and chronic due to multiple and unpredictable occupational risk factors such as violence, unsupportive colleagues and management, poor prison conditions, and shift work. Given the increased risk of adverse mental health outcomes associated with operational stressors, organizational programs have been developed to provide correctional officers with support to promote mental well-being and to provide mental health interventions that incorporate recovery and reduction in relapse risk. This paper uses two theories, the Job Demand Control Support (JDCS) Model and Social Ecological Model (SEM), to explore why workplace social support programs may not been successful in terms of uptake or effectiveness among correctional officers in Canada. We suggest that structural policy changes implemented in the past 15 years have had unintentional impacts on working conditions that increase correctional officer workload and decrease tangible resources to deal with an increasingly complex prison population. Notably, we believe interpersonal support programs may only have limited success if implemented without addressing the multilevel factors creating conditions of job strain. Full article
(This article belongs to the Special Issue Stress, Prevention, and Resilience among First Responders)
Review
New Directions in Police Academy Training: A Call to Action
Int. J. Environ. Res. Public Health 2019, 16(24), 4941; https://doi.org/10.3390/ijerph16244941 - 06 Dec 2019
Cited by 16 | Viewed by 3710
Abstract
The complexities of modern policing require law enforcement agencies to expand how officers are trained to do their jobs. It is not sufficient for training to focus solely on the law or on perishable skills; such as arrest and control; defensive tactics; driving; [...] Read more.
The complexities of modern policing require law enforcement agencies to expand how officers are trained to do their jobs. It is not sufficient for training to focus solely on the law or on perishable skills; such as arrest and control; defensive tactics; driving; and firearms. The present manuscript addresses the critical importance of infusing academy training with the psychological skills essential for officers to meet the contemporary challenges of police work. The authors suggest that the skills (i.e., cognitive; emotional; social; and moral) discussed in this paper may improve officers’ wellness as well as promote relationships between police officers and community members. Specific methods of incorporating these skills in academy training are offered. Full article
(This article belongs to the Special Issue Stress, Prevention, and Resilience among First Responders)
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