Peer Support and Crisis-Focused Psychological Interventions Designed to Mitigate Post-Traumatic Stress Injuries among Public Safety and Frontline Healthcare Personnel: A Systematic Review

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). Public safety personnel (PSP) and frontline healthcare professionals (FHP) are frequently exposed to potentially psychologically traumatic events (PPTEs), and report increased rates of post-traumatic stress injuries (PTSIs). Despite widespread implementation and repeated calls for research, effectiveness evidence for organizational post-exposure PTSI mitigation services remains lacking. The current systematic review synthesized and appraised recent (2008–December 2019) empirical research from 22 electronic databases following a population–intervention–comparison–outcome framework. Eligible studies investigated the effectiveness of organizational peer support and crisis-focused psychological interventions designed to mitigate PTSIs among PSP, FHP, and other PPTE-exposed workers. The review included 14 eligible studies (n = 18,849 participants) that were synthesized with qualitative narrative analyses. The absence of pre–post-evaluations and the use of inconsistent outcome measures precluded quantitative meta-analysis. Thematic services included diverse programming for critical incident stress debriefing, critical incident stress management, peer support, psychological first aid, and trauma risk management. Designs included randomized control trials, retrospective cohort studies, and cross-sectional studies. Outcome measures included PPTE impacts, absenteeism, substance use, suicide rates, psychiatric symptoms, risk assessments, stigma, and global assessments of functioning. Quality assessment indicated limited strength of evidence and failures to control for pre-existing PTSIs, which would significantly bias program effectiveness evaluations for reducing PTSIs post-PPTE. This research was funded by WorkSafeBC, grant number RS2019-SP13 (G.S.A.). The APC was funded by the granting agency. The views, results, opinions and conclusions expressed herein do not represent the views of WorkSafeBC. Faculty yes