Promoting First Responders’ Resilience Resources through Safety

Climate and Safety Management Systems

Bengt B. Arnetz, MD, PhD, MScEpi, MPH

Wayne State University

Detroit, MI

Context

First responders:•Large group

•Exposed to dangerous situations

•Short decision times (High risk and High Consequences)

•Second guessed from non-First responders

•Increased media and institutional scrutiny

Statement of Problem

First responders:•Stress-related disorders (depression, anxiety, Post-traumatic stress disorder)

•Cardiovascular disorders

•Metabolic disorders

•Misuse of alcohol and pharmaceuticals

•Performance

CI1

Stressor

Determinants

Mechanisms

Downstream Outcomes

Chronic work stressors; Organizational and Safety climateNew critical incident1 exposure

Risk Reactions

Stress – Safety Climate – Health and Safety Model

Psycho-Biological and Environmental Resilience Resources

High Risk – Decisions & Consequences

Source: Japantimes.co.jb

Source: mintpressnews.com

“Affective realism: feelings influence what you see – not what you think you see, but the actual content of your perceptual experience.”Lisa Feldman Barrett, Jolie WormwoodsNYT, Sunday Review April 17, 2015

Statement of Need

Optimal decisions and behavior in high stress situations requires:•Established decision support system•Safety Climate

• Individual and group values• Perception• Competencies• Behavior

•Safety Management Systems

National Study of First responders

Stress, Risk & Resilience Factors, Health & Professional Performance

•Organization and Safety Climate

•3,656 First Responders in Sweden (60% response rate)

Measure:

•Professional Stress (Work, Threats, Organizational challenges)

•Organizational Climate (Support, Safety culture, Work strategy)

First Responders’ Job Perception

• Unsafe at work (11.8%)

• Differences across First Responder Groups:• Defense (12.8%)

• Customs (12.4)

• Law Enforcement (12.3)

• Coast Guard (10.3)

• Fire (5.8)

P<.001

Adverse stress effects on job performance

P<.001

• Adverse stress effects on performance (43.3%)

• Differences across First Responder Groups:• Fire (31.1%)

• Coast Guard (37)

• Defense (37.8)

• Customs (48.1)

• Law Enforcement (56.2)

Organizational support

P<.001

• Clear workplace strategy to deal with professionally—induced stress (31.6%)

• Differences across First Responder Groups:• Fire (55.3%)

• Coast Guard (32.2)

• Law Enforcement (29.8

• Defense (29.2)

• Customs (27.3)

Work has become more dangerous

P<.001

• Work among the public more dangerous (45.8%)

• Differences across First Responder Groups:• Customs (71.1)

• Law Enforcement (67.4)

• Fire (52.4%%)

• Coast Guard (45.8)

• Defense (18.1)

Alcohol to cope with work stress

P<.001

• I do not use alcohol to cope with work stress (87.5%)

• Differences across First Responder Groups:• Fire (95.5%%)

• Coast Guard (91.6)

• Customs (88.3)

• Law Enforcement (86.7)

• Defense (85.2)

Self-esteem at work

P<.001Adjusted for general self-esteem

Work Stress – Coping – Mental Health

Organizational climate scale across FR1

Organizational Climate Scale

Aggregated questions related to organizational support, culture of safety, and strategy at work to manage stressors.

Organizational Climate Scale: 56.5 out of 100.

•Highest ratings: Military

•Lowest ratings: Coast Guard and Firefighters

Organizational Climate Scale explained 9% of the variance in work stress (p<.001)

1First Responder

P<.001

Law enforcement stress in real lifeThe video demonstrates how a law enforcement officer within a brief period of time has to make critical strategic and tactical decisions when he faces a man, armed with a large knife that already had cut the throat of three other people.

The video also demonstrates the responses of other law enforcement officers and shines light on the importance of established safety climate and safety management systems.

High Risk & High Consequence

P<.001

ConclusionStress among First Responders1

• Numerous stressors from within and outside the profession

• A major challenge to health and professional performance

• Implications for the safety of both the public and the safe practice of the profession

Need for:

Safety climate and Safety management systems that are:

• Adapted to FR1 special situations

• Proactive

• Integral part of the organizational culture and behavior

• Inclusive and supportive – also when things go wrong

• Transparent

P<.001

Acknowledgement

Bengt Arnetz and work reported here was partially supported by:

NIMH/NIH R34MH086943

NIEHS/NIH P30ES020957 CURES – Center for Urban Responses to Environmental Stressors

Kungafonden (Royal Foundation of Sweden)

P<.001