The transition to university and resultant social support network disruption can be detrimental to the mental health of university students. As the need for mental health support is becoming increasingly prevalent in students, identification of factors associated with poorer outcomes is a priority. Changes in social functioning have a bi-directional relationship with mental health, however it is not clear how such measures may be related to effectiveness of psychological treatments.

Growth mixture models were estimated on a sample of 5221 students treated in routine mental health services to identify different trajectories of change in self-rated impairment in social leisure activities and close relationships during the course of treatment. Multinomial regression explored associations between trajectory classes and treatment outcomes.

Five trajectory classes were identified for social leisure activity impairment while three classes were identified for close relationship impairment. In both measures most students remained mildly impaired. Other trajectories included severe impairment with limited improvement, severe impairment with delayed improvement, and, in social leisure activities only, rapid improvement, and deterioration. Trajectories of improvement were associated with positive treatment outcomes while trajectories of worsening or stable severe impairment were associated with negative treatment outcomes.

Changes in social functioning impairment are associated with psychological treatment outcomes in students, suggesting that these changes may be associated with treatment effectiveness as well as recovery experiences. Future research should seek to establish whether a causal link exists to understand whether integrating social support within psychological treatment may bring additional benefit for students.

The legal environment may improve response willingness among local health department (LHD) workers. We examined whether 3 hypothetical legal protections influence LHD workers’ self-reported response willingness for 4 emergency scenarios and whether specific demographic factors are associated with LHD workers’ response willingness given these legal protections.

Our 2011–2012 survey included questions on demographics and about attitudes and beliefs regarding LHD workers’ willingness to respond to 4 emergency scenarios given specific legal protections (i.e., ensuring priority health care for workers’ families, granting workers access to mental health services, and guaranteeing access to personal protective equipment). Data were collected from 1238 LHD workers in 3 states.

Across scenarios, between 60% and 83% of LHD workers agreed that they would be more willing to respond given the presence of 1 of the 3 hypothetical legal protections. Among the 3 legal protections, a guarantee of personal protective equipment elicited the greatest agreement with improved response willingness.

Specific legal protections augment a majority of LHD workers’ response willingness. Policymakers must, however, balance improved response willingness with other considerations, such as the ethical implications of prioritizing responders over the general public. (Disaster Med Public Health Preparedness. 2015;9:98–102)

For effective responses to emergencies, individuals must have the ability to respond and also be willing to participate in the response. A growing body of research points to gaps in response willingness among several occupational cohorts with response duties, including the Emergency Medical Services (EMS) workforce. Willingness to respond is particularly important during an influenza or other pandemic, due to increased demands on EMS workers and the potential for workforces to be depleted if responders contract influenza or stay home to care for sick dependents. State emergency preparedness laws are one possible avenue to improve willingness to respond.

Presence of certain state-level emergency preparedness laws (ie, ability to declare a public health emergency; requirement to create a public health emergency plan; priority access to health resources for responders) is associated with willingness to respond among EMS workers.

Four hundred twenty-one EMS workers from the National Registry of Emergency Medical Technicians’ (NREMT's) mid-year Longitudinal EMT Attributes and Demographics Study (LEADS) were studied. The survey, which included questions about willingness to respond during an influenza pandemic, was fielded from May through June 2009. Survey data were merged with data about the presence or absence of the three emergency preparedness laws of interest in each of the 50 US states. Unadjusted logistic regression analyses were performed with the presence/absence of each law and were adjusted for respondents’ demographic/locale characteristics.

Compared to EMS workers in states that did not allow the government to declare a public health emergency, those in states that permitted such declarations were more likely to report that they were willing to respond during an influenza pandemic. In adjusted and unadjusted analyses, this difference was not statistically significant. Similar results were found for the other state-level emergency preparedness laws of interest.

While state-level emergency preparedness laws are not associated with willingness to respond, recent research suggests that inconsistencies between the perceived and objective legal environments for EMS workers could be an alternative explanation for this study's findings. Educational efforts within the EMS workforce and more prominent state-level implementation of emergency preparedness laws should be considered as a means to raise awareness of these laws. These types of actions are important steps toward determining whether state-level emergency preparedness laws have the potential to promote response willingness among EMS workers.

RutkowL, VernickJS, ThompsonCB, PirralloRG, BarnettDJ. Emergency Preparedness Law and Willingness to Respond in the EMS Workforce. Prehosp Disaster Med. 2014;29(4):1-6.