@article {bnh-7880, title = {Mental health and wellbeing of Australian police and emergency services employees}, journal = {Archives of Environmental \& Occupational Health}, year = {2021}, month = {03/2021}, abstract = {

Answering the Call, the Australian National Police and Emergency Services Mental Health and Wellbeing Study, surveyed 14,868 Australian ambulance, fire and rescue, police, and state emergency service employees. Emergency services personnel had lower rates of mental wellbeing and higher rates of psychological distress and probable PTSD than the general adult population. Overall 30\% had low wellbeing, 21\% had high and 9\% had very high psychological distress, and 10\% had probable PTSD. An estimated 5\% had suicidal ideation and 2\% had a suicide plan in the past 12 months, while 16\% binge drink at least weekly. Only one in five of those with very high psychological distress or probable PTSD felt they received adequate support for their condition. These findings highlight the risk of mental health conditions associated with work in the emergency services sector.

}, keywords = {Ambulance, common mental disorders, firefighters, mental health, post-traumatic stress disorder, psychological distress, service users, stigma and discrimination}, doi = {https://doi.org/10.1080/19338244.2021.1893631}, url = {https://www.tandfonline.com/doi/abs/10.1080/19338244.2021.1893631?journalCode=vaeh20}, author = {Michael Kyron and Wavne Rikkers and Jennifer Bartlett and Emma Renehan and Katherine Hafekost and Michael Baigent and Rebecca Cunneen and David Lawrence} } @article {bnh-8079, title = {Positive mental health in young adult emergency service personnel}, number = {675}, year = {2021}, month = {06/2021}, pages = {107}, institution = {Bushfire and Natural Hazards CRC}, address = {Melbourne}, abstract = {

Overview

Fire and emergency service personnel, particularly those who volunteer, contribute in innumerable ways to their communities and to Australian society more broadly. Engaging in such a role brings the benefits of connecting with like-minded others and a valued sense of contributing to the community, benefiting mental health and wellbeing (Son \& Wilson, 2012). Concurrently, however, fire and emergency service personnel are more likely than the general population to be exposed to potentially traumatic events (PTE), are at higher risk for developing mental health conditions, and are at two-fold increased risk of suicidal ideation (Beyond Blue Ltd., 2018). Therefore, maintaining good mental health for personnel is increasingly recognised as an integral part of the sustainability of the fire and emergency services. Maximising the productivity and retention of younger early-career volunteers is particularly important, given that over half of the current volunteer force across many emergency services (ambulance, fire and rescue, state emergency service) exceeds 55 years of age (Beyond Blue Ltd., 2018). To ensure the sustainability of the fire and emergency services broadly and the volunteer force more specifically, recruitment and retention of younger volunteers is imperative.

While numerous individual, social and organisational factors have been identified as contributing to mental health and, thus, the sustainability of volunteering, mental health support frameworks, along with research and resources for the mental health of fire and emergency service personnel have focused on outcomes across the age range and length of service (Varker et al., 2018), with limited consideration given to developmental factors that may impact initial uptake and engagement. In particular, emerging adulthood (the period between ages 16{\textendash}25 years) is recognised as a specific phase of development that has its own particular constellation of psychosocial and demographic correlates (e.g., identity exploration and openness to possibility; Arnett, 2000). Australian young people tend to access support for mental health difficulties through different means than traditional face-to-face mental health services or programs, including from peers, parents and sourcing information regarding mental health online (Mission Australia \& Black Dog Institute, 2017). Uptake of formal mental health programs (e.g., school counselling) can also be limited (Rickwood et al., 2007). Thus, a {\textquoteleft}one size fits all{\textquoteright} approach to mental health across emergency service personnel may not be acceptable to the younger adult cohort. Of concern, younger volunteers were reported in the AtC study into the mental health of fire and emergency responders in Australia to have higher levels of self-reported psychological distress and lower levels of resilience than older volunteers (Beyond Blue Ltd., 2018). Early intervention is recognised as an essential approach for preventing and minimising mental health conditions (McGorry \& Mei, 2018).

The present research project was developed in response to a call to action from agencies that the Australasian Fire and Emergency Service Authority Council develop data-driven approaches for supporting mental health, aligned with best practice guidelines and targeted specifically at young fire and emergency service volunteers, supported by practical guidance to agencies for implementing these approaches.

Project Aims and Objectives

The overall aim of the project was to understand what can be done at an individual, local and organisation-wide level to minimise the short- and long-term impacts of potentially traumatising events and to support and promote good mental health and wellbeing for young adult (16{\textendash}25-year-old) volunteers in emergency service organisations.

Specific objectives for the project were as follows:

  1. To summarise the international and national evidence concerning the prevalence of mental health symptoms and/or psychological distress in young fire and emergency service volunteers and individual, social and organisational risk and protective factors for mental health.
  2. To create a summary of self-reported mental health and wellbeing in the context of risk and protective factors among young Australian emergency service personnel using data from the Answering the Call: National Health and Wellbeing Study of Police and Emergency Services and the Metropolitan Fire Service Health and Wellbeing Study.
  3. To develop an understanding of the existing programs and services utilised by young emergency services volunteers to support their mental health and wellbeing following a significant Australian disaster (the 2019{\textendash}2020 bushfires) and during a worldwide pandemic, as well as their perceived usefulness.
  4. To develop an understanding of the current psychosocial safety climate within the Australian emergency service sector as it relates to young fire and emergency service personnel, as well as the mental health programs and supports available to and utilised by these young adults.
  5. To develop an understanding of the young emergency services volunteers{\textquoteright} perspective of perceived facilitators and barriers to accessing relevant mental health services both within and outside the organisation and appropriate sources and type of information that are most likely to be accessed by those volunteers.
  6. To develop a Wellbeing Framework for fire and emergency service organisations to support young adult volunteers{\textquoteright} mental health and wellbeing.
  7. To develop a plain language information guide for supporting mental health and wellbeing targeted at the young adult volunteer cohort.

This report presents information and outcomes for these objectives and provides recommendations for agency-based implementation of the proposed Wellbeing Framework for Young Fire and Emergency Service Volunteers. The outputs of this project are informed by data from this cohort and are aligned with the available evidence for best practice in relevant contexts. It is hoped that the framework and its associated implementation guide will assist agencies in providing informed psychosocial support for the mental health of their young volunteers, thereby contributing to the sustainability of the volunteer service among fire and emergency service agencies. Please note that key terms used throughout the report are defined in the Glossary (Chapter 12).\ 

}, keywords = {emergency service, mental health, personnel, volunteers, young adult}, isbn = {978-0-6452058-0-0}, issn = {675}, author = {Amanda Taylor and Jane Cocks and Sharon Lawn and David Lawrence and Wavne Rikkers and Louise Roberts and Maureen Ashe and Alexander McFarlane and Rachel Roberts and Paul Delfabbro and Holly Caruso and Miranda Van Hooff} } @article {bnh-7869, title = {Sexual Orientation and Prevalence of Mental Health Difficulties among Emergency Services Employees}, journal = {Journal of Affective Disorders}, year = {2021}, month = {02/2021}, abstract = {

Background

LGBQ+ people (Lesbian, Gay, Bisexual, Queer) are at-risk of discrimination and developing mental health issues within general populations. Limited research has assessed their mental health in emergency services occupations, a population which are known to experience poorer mental health. The current study explores the extent to which sexual orientation is associated with higher rates of mental health issues among emergency personnel.

Methods

A stratified random sample of employees from twenty-nine police (N = 8,088), ambulance (N = 3,473), and fire and rescue (N = 2,975) agencies from around Australia participated in a cross-sectional mental health survey (N = 14,536, male = 64.2\%, 42.7\% over 45 years of age, heterosexual = 92.7\%).

Results

Employees with a bisexual/pansexual orientation or those who were not sure about their sexual orientation were significantly more likely to report suicidal thoughts, suicide plans, psychological distress, and illicit drug use when compared with heterosexual employees. LGBQ+ employees reported significantly higher rates of lifetime suicide plans and attempts. Specifically, LGBQ+ fire and rescue personnel were roughly six times more likely to report lifetime suicide attempts, and approximately five times more likely to use illicit drugs weekly than their heterosexual colleagues in the fire and rescue sector. Female LGBQ+ personnel were significantly less likely to consume illicit drugs weekly and monthly than male LGBQ+ personnel.

Conclusions

Emergency services personnel are already at-risk of developing pervasive mental health difficulties. It is important that organisations foster positive working environments, particularly for LGBQ+ people who may be more marginalized within organisations.

}, keywords = {Bisexual, emergency services, Gay, Lesbian, mental health, Queer}, doi = {https://doi.org/10.1016/j.jad.2021.02.032}, url = {https://www.sciencedirect.com/science/article/abs/pii/S0165032721001506}, author = {Michael Kryon and Peter McEnvoy and Dylan Gilbey and Ashleigh Lin and Catherine Mazza and Wavne Rikkers and Jennifer Bartlett and David Lawrence} } @article {bnh-7040, title = {Experiences of Police and Emergency Services Employees with Workers{\textquoteright} Compensation Claims for Mental Health Issues}, journal = {Journal of Occupational Rehabilitation}, year = {2020}, month = {07/2020}, pages = {1-10}, abstract = {

Purpose\ To assess employees{\textquoteright} experiences of the workers{\textquoteright} compensation claim process for psychological trauma, stress or a mental health condition sustained during the course of work in the police and emergency services sector.\ Methods\ 14,868 employees (69.4\% male, response rate = 22\%) from around Australia participated in\ Answering the Call: the Beyond Blue National Mental Health and Wellbeing Study of Police and Emergency Services, and were asked questions regarding their workers{\textquoteright} compensation experiences for mental health reasons.\ Results\ 14\% of all employees in police and emergency services organisations had made a workers{\textquoteright} compensation claim for mental health reasons. Only 8.2\% of employees making a claim had a positive experience (95\% CI 6.6{\textendash}9.8) while 70.3\% had a poor experience (95\% CI 67.6{\textendash}73.0). Two-thirds of employees who had made a claim reported that the process was unsupportive and stressful, and over half reported that it had an overall negative impact on their recovery. Employees with poor overall support from their managers and those who perceived negative stigma about mental health in their workplace were more likely to report poor experiences.\ Conclusions\ The workers{\textquoteright} compensation process is perceived negatively by most police and emergency services employees who have experience with it, and a majority found that it negatively impacted on their recovery. Ways to reform the system to better support employees experiencing significant functional impairments related to mental health issues should be urgently considered.

}, keywords = {emergency responders, mental health, police, worker{\textquoteright}s compensation}, doi = {https://doi.org/10.1007/s10926-020-09909-8}, url = {https://link.springer.com/article/10.1007/s10926-020-09909-8}, author = {Michael Kyron and Wavne Rikkers and Patrice O{\textquoteright}Brien and Jennifer Bartlett and David Lawrence} } @conference {bnh-6401, title = {Fit for Duty pilot: ensuring the safety of CFA members and increasing access to health services}, booktitle = {Bushfire and Natural Hazards CRC Research Day AFAC19}, year = {2019}, month = {12/2019}, address = {Melbourne}, abstract = {

The physically and psychologically demanding nature of the tasks performed by operational firefighters in fire and rescue agencies across Australia place greater risks to health of personnel than in usual circumstances. Evidence demonstrates that individuals with underlying health issues are at greater risk of experiencing a cardiovascular event (heart attack, cardiac arrest, stroke etc.) or physical injury when performing activities of moderate to vigorous intensity. A recent Beyond Blue and Bushfire and Natural Hazards CRC survey of emergency services members highlighted a greater number of mental health issues than the average for other areas of employment. Therefore, ensuring that all employees and volunteers are physically and psychologically capable of performing their roles in a safe manner is imperative.

Guaranteeing that individuals have support and access to services that could act to identify early signs and symptoms is critical to this process. The Fit for Duty Program acknowledges that it is not known whether CFA volunteer firefighters are safe to carry out their operational roles from a holistic health perspective and as a result, intervention is required. In the pilot phase of the Fit for Duty program, several approaches were trialled for medical assessments. CFA have partnered with Deakin University to develop task-based physical assessment activities that represent the wider range of tasks required for wildfire firefighting. These activities were reviewed by volunteer members who set the benchmarks for the assessment. It is envisaged that the physical assessment component will be broadened to include other higher risk areas of structural firefighting and technical response. An awareness, education and support approach was adopted for the psychological component which incorporates new and existing CFA Wellbeing education and support programs.

}, keywords = {firefighters, Health, mental health, personnel, volunteers}, url = {https://knowledge.aidr.org.au/resources/australian-journal-of-emergency-management-monograph-series/}, author = {Georgia Thacker and Rohan Luke and Emma Court} } @mastersthesis {bnh-6162, title = {Wellbeing of firefighters: the impact of individual factors, potentially traumatic event exposure, and operational and organisational factors on mental health outcomes}, volume = {Doctor of Psychiatry}, year = {2019}, month = {10/2019}, school = {University of Melbourne}, type = {Doctorate}, address = {Melbourne}, abstract = {

Aims:
This study aimed to investigate the prevalence of the common mental health disorders associated with increased exposure to potentially traumatic events in career and volunteer firefighters, and to identify which individual, acute stressor, operational and organisational factors predict mental health outcomes.

Method: Four Australian services participated in a prospective study, with 335 firefighters completing an online survey twice (12-months apart). The survey comprised demographic and fire service information, self-report measures for PTSD, depression, anxiety, alcohol use, exposure to personal trauma and life stressors, number and types of firefighter-related potentially traumatic events experienced in the previous 12-months, job satisfaction related to operational and organisational characteristics of their role, and a measure of the priority their fire service placed on their psychological wellbeing. Structured clinical interviews were conducted with a sample of survey respondents to assess for PTSD, depression, generalised anxiety disorder and alcohol use disorder.

Results: From 297 clinical interviews (91 career firefighters and 206 volunteer firefighters), 24\% (n = 22) of the career firefighters met diagnosis for any psychiatric disorder. Of these, 3\% met criteria for PTSD, 5\% for depression, 4\% for generalised anxiety disorder, and almost 12\% for alcohol use disorder. The primary regression analyses indicated the following findings for the career firefighters. The main variable associated with each of the four disorders was the respective level of symptoms at baseline. In addition, exposure to more potentially traumatic events in the previous 12 months contributed to, and high job satisfaction associated with the operational aspects of their role protected them against the development of PTSD and depression. Finally, the findings indicated that experiencing more recent life events in the previous 12 months and rank (being a firefighter) contributed to more symptoms of Alcohol Use Disorder. From the interviews 17\% (n = 35) of the volunteer firefighters met diagnosis for any psychiatric disorder. Of these, 2\% met criteria for PTSD, 4\% for depression, 5\% for generalised anxiety disorder, and 6\% for alcohol use disorder. The primary regression analyses indicated that the only predictor of PTSD, generalised anxiety disorder and alcohol use disorder was the respective baseline level for each disorder. The main predictors of depression were baseline level of symptoms of depression and experiencing more recent life events in the previous 12 months.

Conclusions: The relatively low prevalence rates for the career and volunteer firefighters in this study indicate their reasonably good mental health across the four disorders. The rates compare favourably with other firefighter studies and are comparable with the rates in the general population for most disorders. An exception to this was volunteer firefighters{\textquoteright} high rate of alcohol dependence and low rate of PTSD. The findings indicate the importance of fire services developing cultures that support and encourage the early identification and management of symptoms and have systems in place to monitor the types of and frequency of firefighters{\textquoteright} exposure to potentially traumatic events. Finally, particularly for the career firefighters, the findings highlight the protective nature of high job satisfaction associated with operational characteristics of their role and reduced mental health symptoms, and the importance for firefighters and managers to recognise and address reductions in job satisfaction.

}, keywords = {career, firefighter, mental health, volunteer}, doi = {http://hdl.handle.net/11343/230671}, url = {https://minerva-access.unimelb.edu.au/handle/11343/230671}, author = {Heather Bancroft} } @article {bnh-6413, title = {Answering the call national survey, National Mental Health and Wellbeing Study of Police and Emergency Services {\textendash} Final report}, year = {2018}, month = {11/2018}, institution = {Beyond Blue}, address = {Melbourne}, abstract = {

Final report for Beyond Blue{\textquoteright}s national survey\ Answering the call, conducted as part of the National Mental Health and Wellbeing Study of Police and Emergency Services.

}, keywords = {emergency services, mental health, police, wellbeing}, url = {https://www.beyondblue.org.au/about-us/about-our-work/workplace-mental-health/pes-program} }