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Factors That Affect Emergency Responder Wellbeing: Considerations for Public Health Responders

Published online by Cambridge University Press:  05 April 2021

Tsega Gebreyesus*
Affiliation:
Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
Julia Cohen
Affiliation:
Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
Bobby Rasulnia
Affiliation:
Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
Sachiko Kuwabara
Affiliation:
Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
*
Corresponding author: Tsega Gebreyesus, Email: tgebreye@gmail.com.

Abstract

Purpose:

The purpose of this study is to identify key risk factors that could negatively affect public health emergency responders’ health and wellbeing. We seek to use this information to provide recommendations and strategies to mitigate such risks.

Design/Methodology/Approach:

A narrative review of the peer-reviewed literature on wellbeing of military personnel and other responders was conducted. Data was grouped and categorized according to overarching domains.

Findings:

Factors associated with wellbeing were categorized into 5 domains: (1) demographics; (2) mental health concerns; (3) social networks; (4) work environment; and (5) postdeployment life. The strategies identified to promote wellbeing included mental health assessments, preparedness trainings, debriefs in the field, postdeployment debriefs, resources in the field, and further postdeployment decompression strategies.

Originality/Value:

This study provides a unique understanding of the risk factors associated with poor health and wellbeing outcomes in public health emergency response work by extending the body of knowledge that focuses on other types of emergency and military response.

Type
Systematic Review
Copyright
© 2021 Society for Disaster Medicine and Public Health, Inc.

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References

Stellman, JM, Smith, RP, Katz, CL, et al. Enduring mental health morbidity and social function impairment in world trade center rescue, recovery, and cleanup workers: the psychological dimension of an environmental health disaster. Environ Health Perspect. 2008;116(9):1248.CrossRefGoogle ScholarPubMed
Hall, C. Implications of tours of duty on service personnel’s mental health. Ment Health Pract. 2016;19(9):1420.CrossRefGoogle Scholar
Proctor, SP, Heaton, KJ, Dos Santos, KD, et al. Prospective assessment of neuropsychological functioning and mood in US Army National Guard personnel deployed as peacekeepers. Scand J Work Environ Health. 2009:349360.CrossRefGoogle ScholarPubMed
Eisen, SV, Schultz, MR, Vogt, D, et al. Mental and physical health status and alcohol and drug use following return from deployment to Iraq or Afghanistan. Am J Public Health. 2012;102(S1):S66S73.CrossRefGoogle ScholarPubMed
Hermes, ED, Wells, TS, Smith, B, et al. Smokeless tobacco use related to military deployment, cigarettes and mental health symptoms in a large, prospective cohort study among US service members. Addiction. 2012;107(5):983994.CrossRefGoogle Scholar
Brief, DJ, Rubin, A, Enggasser, JL, et al. Web-based intervention for returning veterans with symptoms of posttraumatic stress disorder and risky alcohol use. J Contemp Psychother. 2011;41(4):237246.CrossRefGoogle ScholarPubMed
Feinstein, A, Owen, J, Blair, N. A hazardous profession: war, journalists, and psychopathology. Am J Psychiatry. 2002;159(9):15701575.CrossRefGoogle ScholarPubMed
Bray, RM, Pemberton, MR, Lane, ME, et al. Substance use and mental health trends among US military active duty personnel: key findings from the 2008 DoD Health Behavior Survey. Mil Med. 2010;175:390399.CrossRefGoogle Scholar
Institute of Medicine. Returning Home from Iraq and Afghanistan: Prelilminary Assessment of Readjustment Needs of Veterans, Service Members, and Their Families. Washington, DC: National Academies Press; 2013.Google Scholar
Possemato, K, McKenzie, S, McDevitt-Murphy, ME, et al. The relationship between postdeployment factors and PTSD severity in recent combat veterans. Mil Psychol. 2014;26(1):1522.CrossRefGoogle Scholar
Maguen, S, Madden, E, Neylan, TC, et al. Timing of mental health treatment and PTSD symptom improvement among Iraq and Afghanistan veterans. Psychiatr Serv. 2014;65(12):14141419.CrossRefGoogle ScholarPubMed
Sareen, J, Belik, SL, Stein, MB, et al. Correlates of perceived need for mental health care among active military personnel. Psychiatr Serv. 2010;61(1):5057.CrossRefGoogle ScholarPubMed
Adams, RS, Nikitin, RV, Wooten, NR, et al. The association of combat exposure with postdeployment behavioral health problems among U.S. army enlisted women returning from Afghanistan or Iraq. J Trauma Stress. 2016;29(4):356364.CrossRefGoogle ScholarPubMed
Booth-Kewley, S, Larson, GE, Highfill-McRoy, RM, et al. Correlates of posttraumatic stress disorder symptoms in Marines back from war. J Trauma Stress. 2010;23(1):6977.CrossRefGoogle ScholarPubMed
Groër, MW, Burns, C. Stress response in female veterans: an allostatic perspective. Rehabil Nurs. 2009;34(3):96104.CrossRefGoogle Scholar
Street, AE, Gradus, JL, Giasson, HL, et al. Gender differences among veterans deployed in support of the wars in Afghanistan and Iraq. J Gen Intern Med. 2013;28(Suppl 2):S556S562.CrossRefGoogle ScholarPubMed
Mattocks, KM, Sadler, A, Yano, EM, et al. Sexual victimization, health status, and VA healthcare utilization among lesbian and bisexual OEF/OIF veterans. J Gen Intern Med. 2013;28(Suppl 2):S604S608.CrossRefGoogle ScholarPubMed
Blount, TH, Peterson, AL, Monson, CM. A case study of cognitive-behavioral conjoint therapy for combat-related PTSD in a same-sex military couple. Cogn Behav Pract. 2017;24(3):319328.CrossRefGoogle Scholar
Averill, LA, Fleming, C, Holens, PL, et al. Research on PTSD prevalence in OEF/OIF Veterans: expanding investigation of demographic variables. Eur J Psychotraumatol. 2015;6:27322.CrossRefGoogle ScholarPubMed
Wittchen, HU, Schönfeld, S, Thurau, C, et al. Prevalence, incidence and determinants of PTSD and other mental disorders: design and methods of the PID-PTSD+ 3 study. Int J Methods Psychiatr Res. 2012;21(2):98116.CrossRefGoogle ScholarPubMed
Javidi, H, Yadollahie, M. Post-traumatic stress disorder. Int J Occup Environ Med. 2012;3(1):29.Google ScholarPubMed
Vogt, D, Smith, B, Elwy, R, et al. Predeployment, deployment, and postdeployment risk factors for posttraumatic stress symptomatology in female and male OEF/OIF veterans. J Abnorm Psychol. 2011;120(4):819831.CrossRefGoogle ScholarPubMed
Barrera, TL, Graham, DP, Dunn, NJ, et al. Influence of trauma history on panic and posttraumatic stress disorder in returning veterans. Psychol Serv. 2013;10(2):168176.CrossRefGoogle ScholarPubMed
Street, AE, Kimerling, R, Bell, ME, et al. Sexual harassment and sexual assault during military service. In: Ruzek, JI, Schnurr, PP, Vasterling, JJ, eds. Caring for Veterans with Deployment-Related Stress Disorders. Washington, DC, US: American Psychological Association; 2011:131150.CrossRefGoogle Scholar
Booth, BM, Davis, TD, Cheney, AM, et al. Physical health status of female veterans: contributions of sex partnership and in-military rape. Psychosom Med. 2012;74(9):916924.CrossRefGoogle ScholarPubMed
Balderrama-Durbin, CM. Combat disclosure in intimate relationships: a mediator between partner support and posttraumatic stress [dissertation]. College Station, TX: Texas A & M University; 2015.Google Scholar
Brooks, SK, Dunn, R, Sage, CA, et al. Risk and resilience factors affecting the psychological wellbeing of individuals deployed in humanitarian relief roles after a disaster. J Ment Health. 2015;24(6):385413.CrossRefGoogle ScholarPubMed
Smith, TC, Ryan, MA, Wingard, DL, et al. New onset and persistent symptoms of post-traumatic stress disorder self reported after deployment and combat exposures: prospective population based US military cohort study. BMJ. 2008;336(7640):366371.CrossRefGoogle ScholarPubMed
Castro, CC. Impact of combat on the mental health and well-being of soldiers and marines. Smith Coll Stud Soc Work. 2009;79(3/4):247262.CrossRefGoogle Scholar
Perrin, MA, DiGrande, L, Wheeler, K, et al. Differences in PTSD prevalence and associated risk factors among World Trade Center disaster rescue and recovery workers. Am J Psychiatry. 2007;164(9):13851394.CrossRefGoogle ScholarPubMed
Konvisser, ZD. Healing returning veterans: the role of storytelling and community. https://www.zievakonvisser.com/docs/Monograph_8_pages%206_27.pdf. Accessed February 16, 2021.Google Scholar
Rona, RJ, Hooper, R, Jones, M, et al. The contribution of prior psychological symptoms and combat exposure to post Iraq deployment mental health in the UK military. J Trauma Stress. 2009;22(1):1119.CrossRefGoogle ScholarPubMed
Stojanovic, MP, Fonda, J, Fortier, CB, et al. Influence of mild Traumatic Brain Injury (TBI) and Posttraumatic Stress Disorder (PTSD) on pain intensity levels in OEF/OIF/OND Veterans. Pain Med. 2016;17(11):20172025.CrossRefGoogle ScholarPubMed
Aoun, O, Roqueplo, C, Rapp, C. Spectrum and impact of health problems during deployment: a prospective, multicenter study of French soldiers operating in Afghanistan, Lebanon and Côte d’Ivoire. Travel Med Infect Dis. 2014;12(4):378384.CrossRefGoogle ScholarPubMed
Kimerling, R, Street, AE, Pavao, J, et al. Military-related sexual trauma among Veterans Health Administration patients returning from Afghanistan and Iraq. Am J Public Health. 2010;100(8):14091412.CrossRefGoogle ScholarPubMed
Brignone, E, Gundlapalli, AV, Blais, RK, et al. Differential risk for homelessness among US male and female Veterans with a positive screen for military sexual trauma. JAMA Psychiatry. 2016;73(6):582589.CrossRefGoogle ScholarPubMed
Barth, SK, Kimerling, RE, Pavao, J, et al. Military sexual trauma among recent veterans: correlates of sexual assault and sexual harassment. Am J Prev Med. 2016;50(1):7786.CrossRefGoogle ScholarPubMed
Adler, AB, Huffman, AH, Bliese, PD, et al. The impact of deployment length and experience on the well-being of male and female soldiers. J Occup Health Psychol. 2005;10(2):121137.CrossRefGoogle ScholarPubMed
Dunn, R, Williams, R, Kemp, V, et al. Systematic review: deployment length and the mental health of diplomats. Occup Med (Lond). 2015;65(1):3238.CrossRefGoogle ScholarPubMed
Cardozo, BL, Holtz, TH, Kaiser, R, et al. The mental health of expatriate and Kosovar Albanian humanitarian aid workers. Disasters. 2005;29(2):152170.CrossRefGoogle ScholarPubMed
Hoge, CW, Grossman, SH, Auchterlonie, JL, et al. PTSD treatment for soldiers after combat deployment: low utilization of mental health care and reasons for dropout. Psychiatr Serv. 2014;65(8):9971004.CrossRefGoogle ScholarPubMed
Gibbons, SW, Howe, ER. Family impact of military mental health stigma: a narrative ethical analysis. Annu Rev Nurs Res. 2016;34(1):3549.CrossRefGoogle ScholarPubMed
Warner, CH, Appenzeller, GN, Grieger, T, et al. Importance of anonymity to encourage honest reporting in mental health screening after combat deployment. Arch Gen Psychiatry. 2011;68(10):10651071.CrossRefGoogle ScholarPubMed
Ricchiardi, S. After the adrenaline: once the excitement of chasing the big story subsides, journalists struggle to cope with the horror of the tragic events they’ve witnessed. Am Journal Rev. 2001;23(9):3540.Google Scholar
Bagby, TJ. Gender-Specific Psychosocial Residential Rehabilitation Treatment Program (GS-PRRTP): program development proposal for dually diagnosed female veterans. Diss Abstr Int. 2006;67(4-B):2214.Google Scholar
Afari, N, Pittman, J, Floto, E, et al. Differential impact of combat on postdeployment symptoms in female and male veterans of Iraq and Afghanistan. Military Medicine. 2015;180(3):296303.CrossRefGoogle ScholarPubMed
Gonzalez, GC, Singh, R, Schell, TL, et al. An evaluation of the implementation and perceived utility of the airman resilience training program. Rand Health Q. 20144(2):12.Google Scholar
Jones, N, Burdett, H, Wessely, S, et al. The subjective utility of early psychosocial interventions following combat deployment. Occupational Medicine. 2010;61(2):102107.CrossRefGoogle ScholarPubMed
Almonte, AL. Humanitarian nursing challenges: a grounded theory study. Military Medicine. 2009;174(5):479485.CrossRefGoogle ScholarPubMed
Johnson, DC, Thom, NJ, Stanley, EA, et al. Modifying resilience mechanisms in at-risk individuals: a controlled study of mindfulness training in marines preparing for deployment. The American Journal of Psychiatry. 2014;171(8):844853.CrossRefGoogle ScholarPubMed
van der Velden, PG, van Loon, P, Benight, CC, et al. Mental health problems among search and rescue workers deployed in the Haiti earthquake 2010: a pre-post comparison. Psychiatry Research. 2012;198(1):100105.CrossRefGoogle ScholarPubMed
Adler, AB, Castro, CA, McGurk, D. Time-driven battlemind psychological debriefing: a group-level early intervention in combat. Mil Med. 2015;174(1):2128.CrossRefGoogle Scholar
Greene, T, Buckman, J, Dandeker, C, et al. How communication with families can both help and hinder service members’ mental health and occupational effectiveness on deployment. Military Medicine. 2010;175(10):745749.CrossRefGoogle ScholarPubMed
Burdett, H, Jones, N, Fear, NT, et al. Early psychosocial intervention following operational deployment: analysis of a free text questionnaire response. Military Medicine. 2011;176(6):620625.CrossRefGoogle ScholarPubMed
Baroody, AN. Spirituality and trauma during a time of war: A systemic approach to pastoral care and counseling. In: Everson, RB, Figley, CR, eds. Families Under Fire: Systemic Therapy with Military Families. New York, NY: Routledge/Taylor & Francis Group; 2011:165190.Google Scholar
Zodkoy, S. An effective nutritional program to treat burnout/resiliency/PTSD in military personnel. Nutr Perspect. 2014;37(3):2226.Google Scholar