The mental health and wellbeing of spouses, partners and children of emergency responders: A systematic review

Abstract

Emergency responders (ERs), often termed First Responders, such as police, fire and paramedic roles are exposed to occupational stressors including high workload, and exposure to trauma from critical incidents, both of which can affect their mental health and wellbeing. Little is known about the impact of the ER occupation on the mental health and wellbeing of their families. The aim of the current study was to investigate what mental health and wellbeing outcomes and experiences have been researched internationally in ER families, and to examine the prevalence and associated risk and protective factors of these outcomes. We conducted a systematic review in accordance with an a priori PROSPERO approved protocol (PROSPERO 2019 CRD42019134974). Forty-three studies were identified for inclusion. The majority of studies used a quantitative, cross-sectional design and were conducted in the United States; just over half assessed police/law enforcement families. Themes of topics investigated included: 1) Spousal/partner mental health and wellbeing; 2) Couple relationships; 3) Child mental health and wellbeing; 4) Family support and coping strategies; and 5) Positive outcomes. The review identified limited evidence regarding the prevalence of mental health and wellbeing outcomes. Family experiences and risk factors described were ER work-stress spillover negatively impacting spousal/partner wellbeing, couple relationships, and domestic violence. Traumatic exposure risk factors included concerns family had for the safety of their ER partner, the negative impact of an ER partners’ mental health problem on the couples’ communication and on family mental health outcomes. Protective factors included social support; however, a lack of organisational support for families was reported in some studies. Study limitations and future research needs are discussed. Progressing this area of research is important to improve knowledge of baseline needs of ER families to be able to target interventions, improve public health, and support ER’s operational effectiveness.

Turning to ‘Trusted Others’: A Narrative Review of Providing Social Support to First Responders

“…Unlike a systematic review, we purposely did not formally rate the quality of included studies, instead choosing relevant papers guided by our research questions. We concur with Cox et al [ 25 ] and Sharp et al [ 58 ] regarding the dearth of research on public service personnel families and acknowledge that most of our included studies originated in the USA, Canada, Australia, and the UK. This highlights a lack of focus on this topic in Europe, among other international regions, which may not be representative of all trusted others’ experiences.…”

“…We found an extreme lack of attention toward trusted others, despite documentation of secondary trauma spillover [ 12 , 28 ] and an urgent need for support specifically targeted toward their community [ 21 ]. Cox et al [ 25 ] and Sharp et al [ 58 ] summarized the outcomes of trusted others’ experiences and the impact on their health and wellbeing. Our results align with Cox et al [ 25 ] and Sharp et al [ 58 ] in acknowledging the lack of support and recognition of trusted others’ experiences in their daily lives.…”

“…Cox et al [ 25 ] and Sharp et al [ 58 ] summarized the outcomes of trusted others’ experiences and the impact on their health and wellbeing. Our results align with Cox et al [ 25 ] and Sharp et al [ 58 ] in acknowledging the lack of support and recognition of trusted others’ experiences in their daily lives. Additionally, our study summarizes the type of social support provided, the process by which it occurs, and the preparedness of trusted others for this support partner role.…”

Emergency First Responders and Professional Wellbeing: A Qualitative Systematic Review

“…By the nature of their profession, EFRs are exposed to traumatic events as part of their job roles to varying degrees. However, while turnover rates are increasing [ 1 , 2 , 3 ], the data emerging from this systematic review suggests that job-specific demands are not the main cause of this trend. Conclusively, being exposed to traumatic events as a result of EFR job roles is not a main contributor to declining professional wellbeing, and subsequent turnover.…”

“…Previous studies [ 1 , 2 , 3 , 4 , 5 , 6 ] indicate that as the need for EFRs is increasing, so do turnover rates and underperformance associated with burnout. Apart from the intense working conditions, these studies also link poor organisational leadership and negative self-regulatory strategies with professional turnover in these fields.…”