Dynamic psychosocial risk and protective factors associated with mental health in Emergency Medical Service (EMS) personnel

Abstract

Background: EMS personnel have a heightened risk of developing posttraumatic stress disorder (PTSD) and major depression relative to other occupational populations necessitating a greater understanding of the risk and protective factors that operate each day in relation to this risk. This study examined dynamic psychosocial factors and their relationship with daily mental health symptoms among EMS workers. The psychosocial factors examined consisted of occupational stressors, sleep disturbance, social conflict, meaning made from the day's challenges, recovery activities, social support, and perceived prosocial impact.

Method: Seventy-nine EMS workers recruited from an emergency medical service provider in Central New York completed a daily assessment for 8 days asking questions about occupational stressors encountered, sleep efficiency, social conflicts, meaning made from the day's challenges, recovery activities engaged in, social support received, and perceived prosocial impact.

Results: Daily occupational stressors were associated with elevated daily PTSD symptom severity (b = 0.13, SE = 0.06, p = .023). Social conflicts were associated with greater depression symptom severity (b = 0.75, SE = 0.14, p < .001); the meaning made from day's stressors (b = -0.17, SE = 0.05, p = .002) and the recovery activities engaged in (b = -0.30, SE = 0.07, p < .001) were associated with lower daily depression symptom severity.

Limitations: A relatively modest sample size and small sampling window may constrain the generalizations made from this study.

Conclusions: Occupational stressors and social conflicts are key risk factors related to the daily expression of PTSD and depression symptom severity in EMS workers. The meaning made from the day's challenges and the recovery activities engaged in may protect against depression. These results reveal several dynamic psychosocial factors that aid in understanding features of the work day that contribute to the mental health burden observed among EMS personnel.

Keywords: Ambulatory assessment; Depression; Emergency medical service (EMS) personnel; Posttraumatic stress disorder (PTSD); Protection; Risk.