PRIMARY AUTHOR(S): Sasha Johnston1,2
OTHER AUTHORS: Jo Mildenhall3,4, Jaimee Wylam5,6
INSTITUTIONAL AFFILIATIONS OF ALL AUTHORS:
1 South Western Ambulance NHS Foundation Trust, UK.
2 Department of Experimental Psychology, University of Oxford, UK.
3 College of Paramedics, UK.
4 University of York Management School, University of York, UK.
5 UK Health Security Agency, UK.
6 Leeds Teaching Hospitals NHS Trust, UK
Self-identification of psychological wellbeing: a mental health continuum for EMS employees
Emergency Medical Service (EMS) employees are more likely to experience poor psychological health and suicide than the general workforce. Exposure to work-related stressors and cultural stigma related to the acknowledgment and acceptance of mental ill-health are pivotal factors. The EMS environment is unique and unpredictable, making it challenging to find time for staff wellbeing. Therefore, a visual aid that enables employees to identify, articulate and disclose their mental wellbeing status and seek support in an easy and concise manner is needed.
To develop a visual mental health continuum, tailored to the EMS sector.
A literature review of available English-language, adult population articles related to mental health continua was conducted in July 2021. Electronic databases Cochrane Register of Controlled Trials, Cochrane Database of Systematic Reviews, Embase, Epistemenikos, Medline, Prospero, PsycINFO, Scopus and Google Scholar. Existing mental health continua utilised by EMS organisations were also identified and alongside the identified database articles, an expert working group created through stakeholder mapping, examined and debated findings and developed an EMS specific continuum.
A descriptive narrative of the included studies was produced. Several factors for supporting wellbeing, such as regular eating and sleeping patterns, are not achievable for irregular EMS shift work and would likely create a barrier to participation. Factors such as concise and de-stigmatising language and taking a holistic view towards employee mental wellbeing, were also identified as important. A visual four-point continuum consisting of Thriving, surviving, struggling and ‘in crisis’, anchored by five holistic factors of emotional, psychosocial, social and physical wellbeing, and addiction was developed. Elements such sleep hygiene moderated by shift work were included. Four suggested supportive techniques are provided to align with the four continuum self-identification points.
Evidence suggests that a visual continuum can promote a shared understanding of fluctuating mental health and can help to reduce stigma. Although we recommend that this tool is disseminated and adopted by EMS organizations, given the lack of validation and evaluation for visual mental health continua identified in the literature, we suggest that evaluation of adoption, acceptability and effectiveness should be prioritised.