Trauma management with first responders and healthcare workers: developing an evidence based and co-created digital intervention

Objectives: First responders (FRs) and healthcare workers 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 and healthcare workers in dealing with occupational trauma(s) and how best to meet their mental health needs using a digital intervention.

Design: An exploratory, mixed methods research design based on semi‐structured, in‐depth interviews (n = 50) with FRs and an online cross-sectional survey (n = 1800). Interviews were audio-recorded, transcribed and analysed using an inductive thematic approach Survey data was analysed using descriptive and inferential statistics.

Results: The themes developed from the qualitative interviews were: (1) difficulties accessing timely support and engaging with mental health services, (2) adverse impact of trauma on self and others, (3) stigma, shame and self-blame as barriers to help-seeking and (4) importance of credible, specific and accessible interventions. The quantitative survey data indicated a high prevalence of exposure to occupational trauma (94%) and perceived acceptability (67%) of a digital intervention to meet their needs.

Conclusions: The implications of these findings are discussed at the service provider and organisational level, emphasising the importance of implementing a strengths-based, non-pathologising and de-shaming approach to trauma in the workplace as experienced by FRs and healthcare workers. Emphasis is placed on the importance of overcoming barriers to accessing mental health support through adopting a whole systems approach to FR and medical training and mental health support. The acceptability of digital based interventions as a means of providing flexible, accessible and credible help is emphasised. Findings will inform the development of a digital application (Sentinel) which seeks to meet FRs’ mental health needs.