"I've got no PPE to protect my mind": understanding the needs and experiences of first responders exposed to trauma in the workplace

Objectives: First responders (FRs) are at high risk of being exposed to traumatic events in their occupational roles. Responding to critical incidents often involves exposure to life-threatening circumstances, dealing with fatalities as well as encountering highly stressful situations that may trigger traumatic responses. These experiences can lead to poor mental health outcomes including post-traumatic stress disorder and suicidality. Little research has explored the experiences and perspectives of FRs in dealing with occupational trauma(s) and how best to meet their mental health needs.

Design: A qualitative research design using in-depth semi-structured interviews with FRs (n = 52) was adopted. Interviews were audio-recorded, transcribed and analysed using an inductive thematic approach.

Results: The themes developed were: (1) The pervasive and salient impact of occupational trauma on mental health (self and others), (2) The demands of the job exacerbating the adverse effects of trauma, (3) Insufficient support or access to psychological input following exposure to trauma (lack of psychological safety), (4) Stigma and fear of judgement as barriers to mental health help-seeking, and (5) Need for accessible, credible and timely trauma focused interventions and workplace support.

Conclusions: The implications of these findings are discussed at the individual, service provider and organisational level, emphasising the importance of implementing a strengths-based, non-pathologising and de-stigmatising approach to trauma in the workplace as experienced by FRs. Emphasis is placed on the importance of overcoming barriers to accessing mental health support and improving access to evidence based trauma-focused psychological interventions and workplace support.