Research

The systematic review revealed there was a dearth of research evaluating the acceptability, utility and efficacy of wellbeing support interventions and strategies in the UK ER population; and there are many health and wellbeing areas with little or no research. Furthermore, of the 50 different types of mental health and wellbeing initiatives/strategies that were identified (see Table 2), the systematic review found only five as having peer-reviewed, published research associated with them in the UK (resilience training, MHFA, TRiM, CISD, CBT). While these interventions were generally found to be acceptable to ERs, only three studies investigated mental health outcomes in ERs, and only two of these were found to be effective interventions (TRiM and TF-CBT/TF-CBT- CFT). Thus, considerably more research is needed in this area.

RECOMMENDATION

Need to conduct research specifically focused on intervention evaluations, eHealth, and service utilisation. It may be particularly beneficial to focus on assessing interventions that fill gaps in provision.

On-going research projects

We acknowledge that the systematic review only identies UK-based reaserch that has been published in academic journals. As such, one of the aims of the landscape review was to try to identify research that is currently underway (and unpublished). Several research projects were identifed either through interviews or through internet searches, so the evidence base for wellbeing and support in the emergency services is likely to increase. However, as these are ongoing unpublished pieces of work, it is difficult to say what the outcomes are likely to be. Identifed projects investigating interventions are outlined in Table 6 below.

Identifying ongoing research proved difficult, as online searches only identified eight ongoing research projects; and interviews produced limited information. It is likely that many ongoing research projects have been missed from this report. There is a need to better facilitate the sharing of research in this area, and to build a supportive research community to encourage collaborations that can potentially address the research gaps that currently exist in the literature.

Chapter 5

What are the gaps in provision

and what is the scope for

Table 6 - Ongoing Research Projects by Service

Fire

Nottingham Trent University is assessing social transitions into retirement and post traumatic growth.

London Metropolitan University is examining nutrition and eating habits.

Bath University is monitoring the physical health and wellbeing of firefighters. While not an intervention in itself, this research may inform future strategies for supporting firefighter wellbeing.

University of Brighton is looking at the effects of exposure to heat and contaminants effects. While not an intervention study, it may help to better inform wellbeing strategies in the future. Ongoing research about Grenfell by Public Health England and Reading University. Zeal Solutions to do an 18-month cultural audit with a Fire service using focus-groups, questionnaires and validating data repeatedly exploring different elements of their culture and how it impacts on health, wellbeing and productivity.

Fire Fighters Charity do their own evaluation. They have a research group and are setting up their research strategy for the next 3 years University of Roehampton is carrying out research investigating inflammation and

contaminant levels in firefighters and the impact of the menstrual cycle and menopause on heat tolerance. While not an intervention study, it may help to better inform wellbeing strategies in the future.

King’s College London are using biobank data to investigate the mental health of emergency services personnel in comparison to the general working population. While not an intervention study, it may help to better inform wellbeing strategies in the future.

The University of Liverpool is looking at how common alcohol problems are in the UK Police Service, and the level of comorbidity with mental health problems. While not an intervention study, it may help to better inform wellbeing strategies in the future.

Table 6 - Ongoing Research Projects by Service (continued)

Ambulance

University of Lincoln, Edge Hill University and the University of East Anglia are examining sickness absence rates and undertaking analysis of the strategies and policies for every ambulance trust and service.

University of Oxford is working with South East Coast Ambulance Service students looking at their wellbeing from students to qualified paramedics; and investigating whether early intervention can prevent depression and post- traumatic stress disorder.

University of Bradford is assessing resilience training for staff.

Research commissioned by Health Education England and led by Yorkshire Ambulance is reviewing wellbeing initiatives across the UK ambulance services.

University of Sheffield and University of Surrey are independently looking at retention of ER workforce. While not an intervention study, it may help to better inform wellbeing strategies in the future.

The Yorkshire and Humber Patient Safety Translational Research Centre is looking at enhancing workforce engagement, well-being and patient safety in ambulance services: a mixed- methods exploratory and interventional study using feedback.

University of East Anglia is investigating solutions to fatigue and poor sleep quality.

University of South Wales is investigating ways of improving care for staff of health services; resilience of emergency workers; psychosocial aspects of emergencies, disasters and major incidents (including investigating the long-term impacts of the Manchester bombing in 2017). TRiM is being evaluated by one ambulance service using the Warwick-Edinburgh Mental Wellbeing scale.

MHFA is being evaluated in at least one ambulance service.

The University of Plymouth and Glasgow Caledonian are exploring the perceptions and experiences of staff mental health support, led by South Western Ambulance National Health Service (NHS) Foundation Trust.

The University of Leeds is exploring the work- related determinants (and impacts) of wellbeing amongst ambulance service staff and looking to identify opportunities for intervention.

Table 6 - Ongoing Research Projects by Service (continued)

Police

Lancaster University is investigating the utility of psychological screening.

University of Central Lancaster - Landscape review investigating wellbeing and supportive initiatives across the UK.

Police staff surveys are conducted with support from Durham University (just collected baseline of 34 forces), which are used to investigate the impact of interventions (such as hindrance stressor reporting).

Nottingham University is reviewing peer support networks in Devon and Cornwall.

Leeds University is interested in investigating suicide prevention with police.

Imperial College London is carrying out the Airwave Health Monitoring Study, investigating whether there are any long-term health impacts of Airwave use on police personnel.

Exeter University is looking at the impact of FitBits in police on physical and psychological wellbeing.

Police Care and Cambridge University are assessing PTSD in large police study.

Police Care and National Association of Retired Police Officers are looking at assessing new support for transition to retirement.

The Open University is exploring the use of charities as wellbeing support.

Essex Police are evaluating the impact of their Feel Well, Live Well program.

The College of Policing is looking at evaluating the effectiveness of peer support; and in

collaboration with the University of East Anglia are investigating the efficacy of mindfulness -based eHealth interventions.

KEY HIGHLIGHTS • Identifying on-going research projects proved difficult and was primarily reliant on word of mouth. • Several on-going projects/studies were identified assessing mental health and wellbeing in ERs, including the topics of transition, peer support and suicide prevention.

RECOMMENDATION

The sector could benefit from the creation of a ‘Research Consortium’ where researchers can utilise shared resources in aligning research measures, can make connections, and can share their research ideas. This is more likely to increase collaboration, research grant funding success, and decrease duplication of work.