Mental Health, Well-Being and Decision-Making in First Responders and Frontline Workers

Dear Colleagues,

First responders and frontline workers play a crucial role in maintaining safety, health, and social order. Police officers, firefighters, emergency medical services, dispatch and call-centre operators, military personnel, and frontline healthcare professionals are routinely exposed to critical incidents, traumatic events, and morally challenging situations. These demanding contexts place them at increased risk of a wide spectrum of mental health problems, including post-traumatic stress disorder, depression, anxiety, substance misuse, burnout, and moral injury, as well as difficulties in family and social functioning.

At the same time, many of these professionals display remarkable resilience, effective coping styles, and adaptive decision-making under pressure. Understanding why some individuals and organisations thrive while others struggle is essential to inform prevention, early detection, and evidence-based interventions. There is also a growing need to integrate cognitive and affective mechanisms of decision-making into the study of occupational trauma and well-being in these groups, including how emotions, heuristics, risk perception, and organisational culture shape moment-to-moment choices in high-stakes situations.

The aim of this Special Issue, “Mental Health, Well-Being and Decision-Making in First Responders and Frontline Workers”, is to bring together cutting-edge research and clinical insights on the psychological impact of critical incidents, and on factors that promote or hinder mental health and optimal functioning in these professions. We particularly welcome contributions that…

• Examine the prevalence, course, and predictors of mental health outcomes (e.g., PTSD, depression, moral injury, burnout, suicidality) in first responders and other frontline workers.
• Explore decision-making and risk-taking processes under stress, including cognitive, emotional, and social determinants.
• Identify individual, team, and organisational protective factors such as resilience, social support, leadership, training, and peer-support programmes.
• Evaluate prevention, early intervention, and treatment approaches tailored to these occupational groups, including digital and scalable interventions.
• Provide qualitative and mixed-methods accounts of lived experience, stigma, help-seeking, and barriers to care in diverse cultural and institutional contexts.

We encourage submissions from different disciplines (psychology, psychiatry, neuroscience, public health, occupational medicine, sociology, criminology) and from diverse regions of the world. Original research articles, systematic reviews, meta-analyses, case series, brief reports and high-quality conceptual or theoretical papers are all welcome.

We look forward to receiving your contributions and to advancing a nuanced, evidence-based understanding of mental health, well-being, and decision-making among first responders and frontline workers.

Dr. Alberto Paramio
Dr. Ricardo Tejeiro
Guest Editors

Manuscript Submission Information

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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. Psychiatry International is an international peer-reviewed open access quarterly 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 1200 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.

• first responders
• police and public safety personnel
• firefighters and emergency medical services
• frontline healthcare workers
• critical incidents and occupational trauma
• PTSD and moral injury
• burnout and occupational stress
• decision-making under stress
• resilience and coping
• organisational culture and peer support