Interventions to prevent or treat mental health effects in first responders after disasters
Citation: Winders WT, Bustamante ND, Garbern SC, et al. Establishing the effectiveness of interventions provided to first responders to prevent and/or treat mental health effects of response to a disaster: a systematic review. Disaster Medicine and Public Health Preparedness. 2021;15(1):115-126.
Language: Abstract and full text available in EN
Free to view: No
Funding sources: Nothing noted.
What is this? In this systematic review, the authors searched for peer-reviewed and grey literature about interventions to prevent or treat mental health effects in first responders to disasters. They restricted their searches to articles published before 2018 in English, French, or Spanish. They included 25 studies (22 quantitative, 3 qualitative) from Armenia (2), Australia (1), China (1), England (1), Finland (1), Iran (1), Israel (1), Japan (3), Lebanon (1), Netherlands (1), Philippines (1), Taiwan (1), and USA (10).
What works: Preventative measures were used in a minority of studies. Pre-traumatic vaccination, in which first responders were prepared beforehand about how to react and cope during traumatic events, was the most effective preventative measure. The majority of studies used psychological interventions as a treatment, most of which improved the mental health of first responders.
What doesn’t work: Debriefing sessions after a disaster often showed no effect, and in one case, worsened symptoms.
What is uncertain: Critical Incident Stress Debriefing (CISD) is a guided process used after traumatic events. When modified locally, CISD improved anxiety and depression symptoms, yet when used in standard debriefing sessions, it had no effect. More research is needed to determine its effectiveness.
Implications: The authors of the review stated that although it is difficult to generalise their findings, proactive measures should be put in place to prevent poor mental health outcomes among first responders. Reactionary treatments should be accessible, culturally appropriate, and prioritised in all countries.
Other considerations: The authors of the review discussed some of their findings in the context of place of residence and social capital.
This summary was prepared by Briann Mensour, checked by Beirut Ibrahim, and finalized by William Summerskill.
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