Institute of Public Health, Florida A&M University, Tallahassee, FL, USA.
Adm Policy Ment Health. 2024 Jul;51(4):579-596. doi: 10.1007/s10488-024-01352-8. Epub 2024 Feb 18.
A growing body of evidence demonstrates potential adverse mental health outcomes associated with exposure to occupational trauma among first responders. In response, policymakers nationwide are eager to work on these issues as evidenced by the number of states covering or considering laws for mental health conditions for first responders. Yet, little information exists to facilitate understanding of the impact of mental health-related policies in the United States on this important population. This study aims to identify and synthesize relevant state-level policies and related research on first responder mental health in the United States. Using a scoping review framework, authors searched the empirical and policy literature. State level policies were identified and grouped into two categories: (1) Workers' Compensation-related policies and (2) non-Workers' Compensation (WC) related policies. While benefits levels and other specifics vary greatly by state, 28 states cover certain first responder mental health claims under WC statutes. In addition, at the time of this study, 28 states have policies governing first responder mental health outside of WC. Policies include requiring mental health assessments, provisions for counseling and critical incident management, requiring education and training, providing funding to localities for program development, bolstering peer support initiatives and confidentiality measures, and establishing statewide offices of responder wellness, among others. Authors found a dearth of outcomes research on the impact of state level policies on first responder mental health. Consequently, more research is needed to learn about the direct impact of legislation and establish best practice guidelines for implementing state policy on first responder mental health. By conducting systematic evaluations, researchers can lay the foundation for an evidence-based approach to develop more integrated systems that effectively deliver and finance mental health care for first responders who experience work-related trauma. Such evaluations are crucial for building an understanding of the impact of policies and facilitating improvements in the support provided to first responders in managing mental health challenges arising from their work.
越来越多的证据表明，一线救援人员接触职业创伤可能会导致心理健康出现不良后果。有鉴于此，全美各地的政策制定者都渴望解决这些问题，这从为一线救援人员的心理健康状况提供保障或正在考虑此类立法的州的数量上可见一斑。然而，几乎没有信息可以帮助人们了解美国与心理健康相关的政策对这一重要人群的影响。本研究旨在确定并综合美国有关一线救援人员心理健康的州级政策和相关研究。研究人员使用范围综述框架搜索了实证和政策文献。确定并将州级政策分为两类：（1）与工人赔偿相关的政策和（2）非工人赔偿（WC）相关政策。尽管各州的福利水平和其他具体细节差异很大，但 28 个州根据 WC 法规涵盖某些一线救援人员的心理健康索赔。此外，在本研究进行之时，28 个州有 WC 之外的管理一线救援人员心理健康的政策。这些政策包括要求进行心理健康评估、提供咨询和危机事件管理、要求教育和培训、为地方提供方案开发资金、支持同伴支持举措和保密措施，以及设立全州范围内的救援人员健康办公室等。作者发现，关于州级政策对一线救援人员心理健康影响的结果研究很少。因此，需要开展更多研究，了解立法的直接影响，并为实施州一级的一线救援人员心理健康政策制定最佳实践指南。通过进行系统评估，研究人员可以为制定基于证据的方法奠定基础，从而建立更具综合性的系统，为经历工作相关创伤的一线救援人员提供有效的心理健康护理和资金支持。此类评估对于了解政策的影响以及促进改善为一线救援人员提供的心理健康支持至关重要。
