Prevention and treatment of mental health conditions in first responders: An umbrella review

• Published in: Clinical psychology (New York, N.Y.) N.Y.), 2024-12
• Main Authors: Arjmand, Hussain-Abdulah, O'Donnell, Meaghan Louise, Sadler, Nicole, Peck, Tim, Varker, Tracey
• Format: Article
• Language: English
• Subjects: First Responders; Human; Mental Disorders; Prevention; Preventive Mental Health Services; Test Bias; Treatment Guidelines
• ISSN: 0969-5893; 1468-2850
• DOI: 10.1037/cps0000252

Objectives: The aim of this umbrella review was to synthesize and appraise the existing evidence to examine the efficacy of psychological interventions for the prevention and treatment of mental health conditions in first responders. Method: A search of PsycINFO, EMBASE, CINAHL, PubMed, Cochrane Library, and Web of science for systematic reviews investigating the efficacy of interventions delivered in first responder populations published from inception until July 2024. Systematic reviews were included if they focused on first responder populations, included primary studies investigating psychological interventions, and reported on mental health outcomes. The risk of bias in primary studies was assessed using the Cochrane Collaboration risk of bias tool, and the quality of evidence of interventions was evaluated using the Grading of Recommendations Assessment, Development and Evaluation framework. Results: Eighteen systematic reviews were identified. From these, 41 primary studies were extracted and synthesized against the Institute of Medicine’s framework for the classification of service activities. This included a variety of universal prevention ( n = 24), selected prevention ( n = 1), indicated prevention ( n = 2), and treatment ( n = 14) studies. Discussion: The posttraumatic stress disorder treatments supported by the most evidence included trauma-focused cognitive behavior therapy and eye-movement desensitization and reprocessing consistent with established guidelines and previous literature. There was emerging evidence suggesting imagery-based trauma-prevention training, eye-movement desensitization and reprocessing, and mindfulness-based interventions may be useful as universal prevention interventions. The findings provide insights for first responder organizations, mental health services, researchers, and clinicians on which interventions may be most effective for preventing or treating mental health conditions in first responders. (PsycInfo Database Record (c) 2024 APA, all rights reserved) (Source: journal abstract)