Purpose and Research Goals

Typical features of late modernity include reliance on abstract systems, risk, globalization, and uncertainty (Giddens 1991). The risk dimension – understanding late modern societies as risk societies (Beck, 1992) – and the uncertainty that individuals experience in their everyday life are central and particularly relevant to the present project. The individual in late modern society – the risk society – is thus under pressure to be prepared for complex crisis and as well as natural and other disasters (e.g., terrorist attacks, various crises related to the war on European soil, cyber crises, the energy crises, environmental crises, as well as health crises such as the recent pandemic). First responders are at high risk for mental disorders such as post-traumatic stress disorder (PTSD), depression or problematic substance use, as they are repeatedly exposed to stressful and traumatic events. A recent study found that law enforcement officers and firefighters are more likely to die of suicide than in the line of duty (Heyman M., Dill J., Douglas R., 2018) and emergency medical providers are 1.39 times more likely to die by suicide than the general public (Tiesman et. al, 2021). The group of first responders in various professions are among the most vulnerable, as they have to deal with the crisis situation immediately (time restraints in assessment and adaptation possibilities in the new situation). On top of that, their response has an impact on society and the quality and adequacy of a broader crisis response.

Analyzing the socioecological context of all the factors influencing their mental well-being and overall resilience (related to mental health) is fundamental not only for their own health, but also for the society and the country, since the minimization of human and material consequences of crisis and overall success of the crisis response depend greatly on the response of first responders. Therefore, the response of first responders affects the overall response of the society and country.

In this proposed project the observed first responders will be professionals from three occupations; namely health care workers, the military and the police. The focus is on socioecological context of the first responder’s mental health (i.e., stress, burnout, anxiety, depression, PTSD) during complex crisis.

In our study we will focus on two main objectives:

1) We will assess the mental health of first responders in times of complex crises (i.e., recent pandemic). In addition, using the socioecological model, we will simultaneously identify the risk and protective factors for first responders’ mental health in times of complex crises, stemming from different levels.

2) We will consider the importance of the structurally based gender inequalities that still exist today in society and in observed gendered organizations (military, police, and health care) and how they relate to first responders’ mental health in times of complex crisis. We will use gender as an analytic category in combination with other factors within the socioecological model (see below).

The main focus of this project will be to study the socioecological context of the first responders’ mental health during and after the complex crisis by considering factors at the individual, micro (family and work place), meso (organizational), and macro (societal) level simultaneously, in critical professions (i.e., health care, military, police). We will use interdisciplinary research methods and include quantitative and qualitative analyses of data. We will focus on policies and country trends,  individual, micro, meso and macro levels (regression models and qualitative analyses) and prospective data collections (multi-level analyses) to examine socioecological models of mental health and burden within and across countries. The existing literature on the mental health of critical occupations has identified risk factors, but studies that systematically approach the complexity of risk factors are needed to gain a better understanding of the interactions among socioecological levels of risk and protection.

Figure 1: Intertwining of potential risk and protective factors for mental health in critical professions on various socioecological levels

The risk and protective factors will be developed and measured on the following levels:

1) Macro societal level.

2) Meso organizational level.

3) Micro family  and workplace levels.

4) Individual level.