A systematic review of the usefulness of pre-employment and pre-duty screening in predicting mental health outcomes amongst emergency workers

Marshall, Ruth E.; Milligan-Saville, Josie; Mitchell, Philip B.; Bryant, Richard A.; Harvey, Samuel B

doi:10.1016/j.psychres.2017.03.047

Cited by 27 publications

(15 citation statements)

References 48 publications

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“…All other estimates remained generally constant. Contrasted to previous meta-analyses on police, current prevalence estimates also exceed twice that previously reported for PTSD (14.3% vs 4.7%), [21][22][23][24][25][26][27] and depression (14.6% vs 7.0%). 120 Overall, these findings indicate that previous studies on mixed first responders underestimate the prevalence of mental problems in the wider police population, and illuminate the critical health care needs of police worldwide.…”

Section: Sensitivity Analysis Of Risk Factorscontrasting

confidence: 92%

“…We full-text articles and reviews. [21][22][23][24][25][26][27] Finally, 16 frequently cited police health authors were contacted for additional article recommendations. The last retrieval of studies occurred on October 20,…”

Section: Search Strategy and Study Eligibilitymentioning

confidence: 99%

“…20 Instead, most cited estimates rely on indirect data derived from mixed samples of multidisciplinary disaster workers, with little relevance to police. Approximately 600 studies relevant to psychiatric problems among rescue workers have been identified in recent meta-analyses, [21][22][23][24][25][26][27] with only six independent police samples on PTSD. [28][29][30][31][32][33] Compared to other first responders, police are uniquely exposed to graver interpersonal violence (e.g.…”

Section: Introductionmentioning

confidence: 99%

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Global prevalence and risk factors for mental health problems in police personnel: a systematic review and meta-analysis

et al. 2020

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Police face an increased risk of developing mental health problems, yet reliable estimates of their psychological difficulties remain unknown. This systematic review and meta-analysis estimate the pooled prevalence and risk factors for mental health problems among police personnel worldwide. Three independent reviewers searched 16 databases and screened 11 506 articles published between January 1980 and October 2019. Eligible studies involved at least 100 active police professionals and used validated instruments to ascertain specific mental health problems. Estimates were pooled using random-effects meta-analyses. In total, 60 cross-sectional and seven longitudinal studies, involving 272 463 police personnel from 24 countries met criteria for inclusion. The overall pooled point prevalence was 14.6% for depression (95% CI 10.9% to 18.6%), 14.2% for post-traumatic stress disorder (PTSD; 95% CI 10.3% to 18.7%), 9.6% for a generalised anxiety disorder (95% CI 6.7% to 12.9%), 8.5% for suicidal ideation (95% CI 6.1% to 11.2%), 5.0% for alcohol dependence (95% CI 3.5% to 6.7%) and 25.7% for hazardous drinking (95% CI 19.6% to 32.4%). The strongest risk factor for depression and suicidal ideation was higher occupational stress, and the strongest risk factors for PTSD were higher occupational stress and avoidant coping strategies. Higher levels of peer-support were associated with significantly lower PTSD symptoms. Our findings suggest that the prevalence of mental health problems among police exceeds twice that previously reported in mixed samples of first responders, and is associated with poor social support, occupational stress and maladaptive coping strategies. Without effective intervention, psychological difficulties will remain a substantial health concern among police.

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Section: Sensitivity Analysis Of Risk Factorscontrasting

confidence: 92%

Section: Search Strategy and Study Eligibilitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Global prevalence and risk factors for mental health problems in police personnel: a systematic review and meta-analysis

et al. 2020

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“…The apparent lack of effectiveness of screening tools has encouraged researchers to expand their search for risk and resilience factors in populations working in trauma prone environments. A recent review on screening within the emergency services [15] identified multiple predictors of mental health including neuroticism, pre-existing psychopathology, trauma history, maladaptive coping styles including catastrophic thinking and rumination, and social factors, such as substance related disorders. Still, the study came to conclude that there were no reliable ways to enhance personnel selection through screening and the authors deduced that further research on this topic was needed.…”

Section: Introductionmentioning

confidence: 99%

The usefulness of pre-employment and pre-deployment psychological screening for disaster relief workers: a systematic review

et al. 2020

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Background: Individuals who conduct disaster relief work overseas are exposed to a variety of traumatic events that can cause distress and trigger psychological illnesses. Identification of which disaster relief workers may be at risk of experiencing psychological distress or mental health disorders is frequently carried out through preemployment or pre-deployment psychological screening. The primary objective of our review was to assess the evidence for pre-employment and pre-deployment psychological screening of relief workers who work in disaster situations. We aimed to identify specific pre-employment and pre-deployment characteristics that predict impaired wellbeing of an individual following engaging in disaster-related work. Methods: A combined list of search terms was composed relating to disaster-related occupations, screening methods, psychological disorders, and study design. The databases used were PsycINFO, MEDLINE, EMBASE, and GlobalHealth. We included studies that used cross-sectional or longitudinal study designs; were published in the English language in peer-reviewed academic journals; reported on the association between pre-employment and pre-deployment features and post-deployment psychological disorders or distress; considered any occupational groups responding to a specified, discrete crisis; and used at least one validated measure of distress or disorder. We extracted data on the author; year of publication; disaster description; country of study; study design; population sample; disorder(s) outcome and the measures used; and results. Results: Sixty-two, high-quality studies were included in the review. Forty-one potential predictors were identified. Of these, only volunteer status and previous history of mental illness and life stressors emerged as reliable predictors of distress or disorder. Conclusion: The results suggest that whilst it is attractive to screen for pre-employment and pre-deployment indicators of resilience, the evidence base for doing so is weak. At best, this sort of screening can only weakly suggest vulnerability and at worst may result in discrimination. Until better evidence about its usefulness becomes available, employers should exercise caution over its use.

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“…Military and police officers are relatively less likely to suffer from PTSD than civilians [35]. One reason for this phenomenon, we assumed, is that individuals who choose to take on military roles tend to have solid beliefs and spirits devoted to the nation and people, and they tend to feel great responsibility for national defence, so they present high resilience in the face of difficulties [36]. Another reason relies on the increasing awareness and implementation of programmes on stress management and resilience to military personnel due to their high risks of mental disorders.…”

Section: Discussionmentioning

confidence: 99%

Sleep quality and its impacts on quality of life among military personnel in remote frontier areas and extreme cold environments

Wang

Chen

et al. 2020

Health Qual Life Outcomes

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Background: Poor sleep quality negatively affects the readiness of military operations and is also associated with the development of mental health disorders and decreased quality of life. The purpose of this study was to investigate the sleep quality of military personnel from remote boundaries of China and its relationship with coping strategies, anxiety, and health-related quality of life (HRQoL). Methods: A cross-sectional survey was performed among military officers and soldiers from a frontier defence department and an extreme cold environment. The participants were surveyed using the Pittsburgh Sleep Quality Index (PSQI), Trait Coping Style Questionnaire (TCSQ), Self-rating Anxiety Scale (SAS), and Short Form Health Survey (SF-36). Results: A total of 489 military officers and soldiers were included. The participants had a mean age of 22.29 years. The median overall PSQI score was 7.0 (IQR, 4.0~9.0), with 40.9% (200/489) of the subjects reporting poor sleep quality. The difficulties with sleep were mainly related to daytime dysfunction due to disrupted sleep, sleep latency, and subjective sleep quality. The median score of the SF-36 physical component was 83.5 (IQR, 73.0~90.5), and the median score of the mental component was 74.1 (IQR, 60.4~85.1). Significant correlations were found between the PSQI and SF-36 (r = − 0.435, P < 0.01). Anxiety symptoms, marital status, educational background, and global PSQI score were demonstrated as predictors of a low SF-36 physical component by multiple regression analysis (F = 17.06, P < 0.001, R 2 = 0.117). Conclusions: Sleep difficulty is a prevalent and underestimated problem in the military that negatively influences HRQoL, especially in physical and social functioning. Evaluation of and education on pain were recommended because of body pain and its negative impacts on sleep quality, coping strategies, anxious emotions and HRQoL.

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A systematic review of the usefulness of pre-employment and pre-duty screening in predicting mental health outcomes amongst emergency workers

Cited by 27 publications

References 48 publications

Global prevalence and risk factors for mental health problems in police personnel: a systematic review and meta-analysis

Global prevalence and risk factors for mental health problems in police personnel: a systematic review and meta-analysis

The usefulness of pre-employment and pre-deployment psychological screening for disaster relief workers: a systematic review

Sleep quality and its impacts on quality of life among military personnel in remote frontier areas and extreme cold environments

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