Work-Related and Nonwork Stressors, PTSD, and Psychological Distress: Prevalence and Attributable Burden Among Australian Police and Emergency Services Employees

Clinical Impact Statement Stressful events while working in emergency services roles may be a stronger driver of mental health issues than events experienced away from the workplace. Targeting modifiable workplace stressors, such as conflict with management, may be necessary in offsetting the effects of trauma related stressors that are inherent to emergency services roles. Objective: Police and emergency services personnel are at an increased risk of developing mental health issues. We sought to compare patterns of exposure to work-related and nonwork stressors and associations with posttraumatic stress symptoms and psychological distress among police and emergency services employees. Method: A total of 14,868 employees from 33 ambulance, fire and rescue, police, and state emergency service agencies around Australia participated in a survey to assess the prevalence of exposure to work-related and nonwork stressors, and the prevalence of mental health conditions. Associations between work and nonwork stressors and mental health problems were estimated using logistic regression models and population attributable risk (PAR) percentages. Results: Traumatic events experienced while working in the police and emergency services sector were the most frequently reported stressor (51%). Stressful events experienced at work in the sector were associated with significantly higher levels of suspected posttraumatic stress symptoms (odds ratio = 4.5, PAR = 65%) and high psychological distress (odds ratio = 2.5, PAR = 40%) compared to stressors experienced away from the sector. Conclusions: Stressors experienced at work are a risk factor for developing posttraumatic stress symptoms and distress in the sector. Organizations should have comprehensive policies and programs to help prevent the development of mental health problems and to support personnel who develop mental health problems.