Making best practice better for emergency service personnel

Ella Rhodes reports.

People working in the emergency services encounter traumatic events, directly and indirectly, on a daily basis. Despite this there was an apparent gap in the NICE review of managing post-traumatic stress disorder (PTSD), updated last year, when it came to guidelines for emergency service personnel. Recently several psychologists from Public Health England and elsewhere have carried out a scoping review, funded by the College of Policing, into early interventions for trauma in emergency services staff.

The authors wrote that NICE guidance on PTSD in primary and secondary care was having a detrimental impact on research into early interventions following trauma. They gave the example of the recommendation against using psychological debriefing as an intervention. ‘This assertion is based on two studies subsequently found to be methodologically flawed, and without recognition of the increasing demonstration of the effectiveness of early interventions.’

Dr Richard Amlôt (Public Health England Behavioural Science Team) led the scoping review along with four colleagues from his department, psychologist and past Chair of the British Psychological Society’s Crisis, Disaster and Trauma Section, Dr Noreen Tehrani, and College of Policing Wellbeing Lead Dr Ian Hesketh. They examined 50 studies which explored early interventions, prevention, and trauma therapy in emergency services personnel, military responders during peace-keeping missions and humanitarian aid workers, using meta-ethnography to examine intervention outcomes. They also carried out 10 consultations with stakeholders and practitioners to learn more about best practice.

Overall the authors found that where early interventions are delivered in a way that make use of existing peer support in teams, respect an organisation’s culture and are supported by organisations and senior management, they can help emergency service personnel manage post-incident trauma. The authors wrote that the review may be useful in supporting the use of early interventions in other organisations and may inform future NICE guidance.

The review will be published in the Journal of Occupational Medicine’s special issue on mental health issues in the uniformed services later this year and can also be read here: tinyurl.com/yxqyrqre 

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