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Establishing the Effectiveness of Interventions Provided to First Responders to Prevent and/or Treat Mental Health Effects of Response to a Disaster: A Systematic Review

  • W. Tyler Winders (a1), Nirma D. Bustamante (a2), Stephanie Chow Garbern (a3), Corey Bills (a4), Amin Coker (a5), Indi Trehan (a6) (a7), Maxwell Osei-Ampofo (a5) and Adam C. Levine (a3)...



This review systematically explores the current available evidence on the effectiveness of interventions provided to first responders to prevent and/or treat the mental health effects of responding to a disaster.


A systematic review of Medline, Scopus, PsycINFO, and gray literature was conducted. Studies describing the effectiveness of interventions provided to first responders to prevent and/or treat the mental health effects of responding to a disaster were included. Quality was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria, and the Critical Appraisal Skills Programme (CASP) checklist.


Manuscripts totaling 3869 met the initial search criteria; 25 studies met the criteria for in-depth analysis, including 22 quantitative and 3 qualitative studies; 6 were performed in low- and middle-income countries (LMICs); 18 studies evaluated a psychological intervention; of these, 13 found positive impact, 4 found no impact, and 1 demonstrated worsened symptoms after the intervention. Pre-event trainings decreased psychiatric symptoms in each of the 3 studies evaluating its effectiveness.


This review demonstrates that there are likely effective interventions to both prevent and treat psychiatric symptoms in first responders in high-, medium-, and low-income countries.


Corresponding author

Correspondence and reprint requests to W. Tyler Winders, Department of Emergency Medicine, Medical University of South Carolina, 169 Ashley Ave., MSC 300, CharlestonSC29425 (e-mail:


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Establishing the Effectiveness of Interventions Provided to First Responders to Prevent and/or Treat Mental Health Effects of Response to a Disaster: A Systematic Review

  • W. Tyler Winders (a1), Nirma D. Bustamante (a2), Stephanie Chow Garbern (a3), Corey Bills (a4), Amin Coker (a5), Indi Trehan (a6) (a7), Maxwell Osei-Ampofo (a5) and Adam C. Levine (a3)...


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