Resilient responders: How psychosocial factors shield first responders from mental harm

Photo: Mark Poprocki/Adobe Stock

Just before the pandemic in 2020, we completed research to understand better what behaviours can predict first responders’ risk of occupational stress injuries (OSI). This term is a concept, not a medical diagnosis. However, OSI can result in mental harm and mental illness (e.g., depression, addictive behaviours, PTSD). Not all traumatic events drive just PTSD. Other mental illnesses can be linked to traumatic events.

My hypothesis is resiliency (e.g., daily health habits and behaviours), employees’ work experiences, and employers’ supports in protecting first responders from mental harm. Our research results  published by the Conference Board of Canada for PSHSA resulted in the development of Assessing the Risk: The Occupational Stress Injury Resiliency Tool and insights. The data inferred that first responders with higher levels of resiliency could be at less risk of mental harm when exposed to traumatic events than those with lower resiliency.

I am encouraged by Mark Verhagen’s work, which challenges social scientists to use the term prediction more often to link how their research findings are relevant in the real world. A prediction made in social science may not imply cause and effect. However, it can imply causality. There is a need for more work with first responders to understand better what factors beyond exposure to traumatic events predict the risk of mental harm.

Based on evidence-based research, these insights could help employers make more informed decisions about what policies and programs can better prepare and protect their workforces from mental harm. There appears to be a gap in the literature across first responders’ sectors on what prevention programs can mitigate mental harm, injury, and illness.

This article presents five psychosocial categories for those tasked with facilitating psychological safety and inclusion programs to consider when designing action plans to evaluate psychosocial factors that drain or charge first responders. The categories can be used when conducting risk assessments and designing prevention programs and supports to protect first responders from mental harm and promote mental health.

These recommendations come from applied clinical observations treating first responders in a counselling setting, psychological health and safety consulting, and personal experiences as a first responder.

Five categories to consider when evaluating psychosocial factors

The five psychosocial factors categories outlined below can profoundly impact first responders’ daily experiences. From our social science research that includes firefighters, police, paramedics, 911 operators, healthcare workers, and corporate employees who have completed the Mental Fitness Index (renamed to Workplace Psychological Safety Assessment), we believe the degree to which employees are flourishing is a predictor of personal psychological protection (PPP). We have found in tens of thousands of data sets that flourishing employees are at lower risk of mental harm than languishing employees and are less likely to be off work due to illness or disability.

Based on our research, first responders who have a personalized action plan to care for their physical and mental health and have more positive than negative interactions in their work culture are at lower risk of mental harm and disability.

We are committed to piloting with first responders what prevention matters and what role daily mental fitness practices and psychologically safe workplaces play in preventing mental injuries.

Those tasked with creating first responders’ workplace mental health action plans or PTSD prevention plans should collect employee experience data in each of the following categories to gain insights into what factors drain or charge their workforces’ batteries:

• Core work — Core work puts first responders at risk of exposure to traumatic events. It is prudent to understand the frequency, duration and intensity of traumatic events, fatigue levels, and perception of access to meaningful and trusted resources for mental health support when necessary. That includes peer support, critical incident stress debriefing, and access to skilled mental health professionals for first responders and their families.
• Bureaucracy — The red tape and rules necessary for their assigned functions is a potential negative drain on first responders. Employers must be aware of and understand the red tape and rules perceived as unhelpful, barriers, distractions, energy drains, and stress creators. These can be referred to as the administrative part of first responders’ careers.
• Community interactions — First responders work in the community and deal with citizens firsthand. How the community responds to them when doing their jobs can be a drain or charge. There can be risks of exposure to moral injuries related to locations to which first responders are called. They may be high-risk areas that can expose them to poverty and social conditions that create additional drains and burdens.
• Work culture — Leadership, peers, and team interactions can influence first responders’ perceptions of psychological safety and inclusion. Traditionally, psychosocial factors assessment tools measure the employee experience of how work is organized, interpersonal interactions, working conditions, and having the equipment to do their jobs safely. The environment they operate in can positively or negatively impact first responders’ mental health. It is prudent to measure OHS risks of bullying and physical and sexual harassment as these can contribute to mental injuries.
• Individual resiliency — First responders’ resiliency levels, ability to manage adversity, and access to support systems in and out of the workplace can drain or charge their mental batteries, as can coping skills and ability to cope with traumatic exposure. Education, experiences, and the environment typically influence resiliency levels. Developing resiliency, mental fitness, and coping skills is a protective factor for PPP.

When collecting data, employers are encouraged to use a blended approach that includes collecting HRIS and disability data and qualitative (focus groups and interviews) and workplace assessments on workplace psychosocial factors, programs’ perceived value, and hazards like fatigue, isolation, leadership, teams, and resiliency. It is also prudent to screen for occupational health risks using subclinical scales to help first responders understand their adversity loads and risk of mental harm. All sectors are cautioned before collecting data to be confident that employers are motivated to act on the data, know what to do with it, and have the support of senior leadership to reduce mental harm and promote mental health.

Dr. Bill Howatt is the Ottawa-based president of Howatt HR Consulting.