Why was the study done?
It is well documented that public safety personnel (PSP) experience higher levels of mental health symptoms than the general population. However, less is known about the effects of PSP work on PSP families. PSP families may experience secondary trauma and unique stressors as a result of the work their family member does as a PSP.
The current review of the research literature explored:
- The type of mental health and well-being outcomes investigated in PSP families.
- The prevalence of negative and positive mental health and well-being outcomes in PSP families.
- PSP family experiences with their mental health and well-being.
- Risk and protective factors identified for PSP family mental health and well-being.
What was done in the study?
Studies on PSP families from 2000 onwards, including the families of police, fire, ambulance, mountain rescue, coast guard and communications officials, were reviewed. Studies included in this review were empirical studies published in peer-reviewed journals. While the researchers identified nearly 30,000 studies through database searching, once duplicates were removed and titles and abstracts reviewed, 170 articles remained; of those, 43 papers met the full inclusion criteria for the review. Most papers reviewed came from the United States; over half (24) were on police or law enforcement families. The papers were reviewed to determine common themes.
What did we find out?
Researchers identified five themes in the literature:
- spousal or partner mental health and well-being;
- couple relationships;
- child mental health and well-being;
- family support and coping strategies; and
- positive outcomes.
Spousal or partner mental health
- Many papers (9) reported that spouses felt extreme pressure due to the nature of day-to-day PSP work and its effects on the family.
- Spouses in the U.S. reported that they felt it was their responsibility to manage the household and children, often describing themselves as feeling “like a single parent.”
- Studies in the U.S. and Canada found that spouses were concerned about the danger involved in their partner’s work.
- Studies that measured mental health showed that 14% of spouses reported probable posttraumatic stress disorder (PTSD), and there was qualitative evidence of secondary trauma syndrome (STS) in spouses of police.
- The studies that looked at divorce were mixed with U.S. studies of police, showing lower divorce rates than the general population but slightly higher than firefighters.
- Several studies (13) found a relationship between the quality of communications, PSP spouse/partner relationship experience, and impacts on PSP partner well-being.
- Emotional withdrawal of either party was found to affect partner well-being and increase marital tension negatively.
- Common reasons for emotional withdrawal were:
- behaviour associated with PTSD or STS;
- partners protecting each other from difficult experiences;
- behaviours learned by PSP in work roles ( e.g. detachment); and
- the impact of work stress or shift work.
- Several studies (8) showed that PSP partners subdued their emotional needs, avoided conflict, and compensated emotionally in their relationships to balance their partner’s high stress or mental health difficulties. In some studies, this behaviour caused spouses/partners to withdraw and have adverse well-being outcomes.
- In 10 studies focused on U.S. police forces, 7.4–10% self-reported physical aggression against their spouse/partner and 8.1–8.9% reported physical aggression against their children.
Child mental health and well-being
- Children whose parent was involved in a major incident (e.g., World Trade Centre attack, Boston Marathon bombing) had higher levels of PTSD and behaviour difficulties.
- Studies of U.S. police children reported overprotective parenting, bullying from others over their parents’ occupation, and worry for their police parents. All of these factors affected the child’s well-being.
Family support and coping strategies
- Studies from Australia, the U.S., and Canada reported little or no government or organizational support for families.
- Five studies highlighted the crucial role of informal support for families.
- Several studies (9) looked at positive aspects of PSP family well-being, including:
- pride of PSP spouse/partner and children at being a responder family who impacts the community;
- protective police parents who made them feel safe, and parents who were a resource on what is right and legal;
- police families who felt financially secure and had good health benefits; and
- families who were highly resilient and had varied coping strategies.
Where do we go from here?
This review was limited by the available research, which often focused on the PSP and not directly on their families. However, the study demonstrates some evidence of PSP work’s negative impacts on families. More research is needed, especially research that directly investigates families. Such analysis could be used to develop government, organizational and personal interventions to support families. The original wording of the study was changed and condensed for the current research summary.
Sharp, M-L., Solomon, N., Harrison, V., Gribble, R., Cramm, H., Pike, G., & Fear, N.T. (2022). The mental health and well-being of spouses, partners and children of emergency responders: A systematic review. PLoS ONE , 17(6). https://doi.org/10.1371/journal.pone.0269659
Prepared by Kossick, E. Reviewed and edited by Barootes, B. & Sharp, M-L.