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Research Summaries

Review of interventions designed to lessen the impact of PTSI

Keywords: Critical Incident, Mental Health, Peer Support, Posttraumatic Stress Injury (PTSI)

Full Publication

Why was the study done?

Public safety personnel (PSP) and frontline healthcare workers (FHW), like nurses and emergency room staff, are regularly exposed to potentially psychologically traumatic events (PPTE). Many programs have been created to try and lessen the impact of posttraumatic stress injuries (PTSI). Some of these programs are designed to be proactive and some to help after a PPTE. Yet, very little research has investigated program effectiveness.

The study was designed to review the current literature for studies on the effectiveness of programs designed to lessen PTSI in PSP and FHW. The goal of this review is to help provide more information to stakeholders and policymakers looking to improve PSP and FHW mental health.

What was done in the study?

A review was conducted of all French and English studies from 2008–2019 that referenced a program to help PSP or FHW mental health following exposure to a work-related PPTE. The review started with 3277 records found through database searches. Reviewing the 3277 records identified only 14 unique studies that matched the search parameters. The 14 studies were rated for quality and strength-of-evidence using an established scale. The 14 studies used extremely varied methods.  Data and results could not be compared directly, and instead required a written synthesis.

What did we find out?

  • There were 6 studies looking at various critical incident stress programs (i.e., debriefing or management). There were 8 looking at various peer support programs.
  • The studies looking at critical incident stress programs showed no significant improvement in mental health outcomes or PTSI symptoms, but the programs were not always used as designed so conclusive statements cannot be made.
  • The peer support studies showed small, short-term improvements in absenteeism and well-being, but there were mixed results when examining improvements for mental health.
  • None of the studies reviewed were rated as high quality. All received at least one high-risk or unclear rating on the strength-of-evidence criteria.
  • Most of the studies did not take into account pre-existing PTSI or mental health disorders, which creates a high risk of bias for the program effectiveness results.

Where do we go from here?

The study results show a need for more experimental peer-reviewed studies of programs designed to lessen PTSI in PSP and FHW. The variation in study methods means future studies need to be designed with broader use in mind for existing literature and future research. The study authors recommend that future researchers use standardized outcome measures, use methods that are sensitive to change over time (e.g., multiple data collection points over time), and control for pre-existing PTSIs. As more programs are developed and tailored to the occupational demands of PSP and FHW, stakeholders and policymakers need evidence on program effectiveness so that PSP and FHW are getting the best support.

The original wording of the study was changed and condensed for the current research summary.


Original Study

Anderson, G.S., Di Nota, P.M., Groll, D., & Carleton, R.N. (2020). Peer support and crisis-focused psychological interventions designed to mitigate post-traumatic stress injuries among public safety and front line healthcare personnel: A systematic review. International Journal of Environmental Research and Public Health, 17, 7645.


Summary prepared by Kossick, E. Reviewed & edited by Barootes, B. Anderson, G. & Carleton, R.N.

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