Dawson, David (2021) Experiential and Organisational Factors Predicting the Mental Health of Emergency Paramedics: Beyond the Trauma. PhD thesis, Victoria University.

Abstract

This research aimed to investigate the prevalence and distribution of mental health conditions across the paramedic workforce, to compare levels with the general population and to assess the association of stressors with scores on measures of mental health. A survey was constructed to assess general psychological health, depression, anxiety, stress, suicidality, posttraumatic stress disorder, sleep health and the frequency and severity of stressor variables. Impact scores for stressor variables were generated by multiplying frequency and severity scores. Participant and workplace sociodemographic variables were measured. The survey was distributed within Ambulance Victoria in September 2010. Only data from 879 participants that transported emergency patients was analysed. The ANOVA procedure and chi-square tests were employed to compare means and prevalences of psychological health scores within the paramedic sample according to sociodemographic variables. Independent-sample t-tests and chi-square tests for independence were used to examine means and prevalence rates by comparing this paramedic sample with general population statistics and other paramedic populations. Logistic and multiple regression analyses were conducted to investigate associations between stressor impact scores and mental health conditions. Key findings were the higher levels of suicidal thinking and planning, PTSD, substandard sleep health and poor general psychological health compared to the general population. The level of PTSD was comparable to other paramedic populations while suicidality was higher: there were mixed findings on the other measures. Regression analyses found that stressors related to the organisation, the broader work context and shift work were significantly associated with measures of mental health while, with the exception of anxiety, emergency work was not. There were no meaningful differences in levels of mental health conditions within groups across the paramedic workforce except that PTSD caseness was higher outside the major cities and, higher levels of suicidality were reported in three ambulance service regions. The higher levels of suicidality in this paramedic sample is a new finding although further research is needed to determine its nature and sources. Many stressors associated with mental health are not emergency work related but are instead associated with the organization and aspects of the broader working environment, suggesting that some stressors may be amenable to being managed. The lack of meaningful differences within this paramedic sample indicates that targeting mental health interventions is not practical, and should instead be directed across the entire workforce.

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