Differences in psychiatric symptoms and barriers to mental health care between volunteer and career firefighters
Differences in psychiatric symptoms and barriers to mental health care between volunteer and career firefighters
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DOI：
10.1016/j.psychres.2016.11.037
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发表时间：
2017-01-01
影响因子：
11.3
通讯作者：
Joiner, Thomas E.
中科院分区：
文献类型：
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作者：
Stanley, Ian H.;Boffa, Joseph W.;Joiner, Thomas E.
消防员面临心理健康问题的风险增加。然而，很少有人知道志愿者和职业消防员之间的精神症状的差异。这项研究旨在（1）描述美国消防员在志愿者和职业消防员之间精神症状和精神卫生保健障碍的差异;（2）确定是否有更大的自我报告的精神卫生保健结构性障碍（例如，成本、资源的可获得性）解释了精神症状水平的差异。共有525名美国消防员参加。协方差分析和逻辑回归分析被用来评估志愿者（n=204）和职业（n=321）消防员之间的组间差异，调整人口和职业特征。志愿消防员报告说，与职业消防员相比，抑郁症、创伤后应激障碍和自杀症状的水平显著升高。职业消防员报告说，有问题的酒精使用水平相对较高。志愿消防员还报告说，精神卫生保健存在更大的结构性障碍（例如，成本，资源的可用性），这些障碍解释了志愿者和职业消防员之间心理健康变量的差异。研究结果表明，志愿消防员报告的精神症状升高相比，职业消防员和更大的结构性障碍，心理健康治疗可以解释这种联系。需要加大努力，制定针对消防员的干预措施，并加强心理健康服务的利用。
Firefighters are at increased risk for mental health problems. However, little is known about differences in psychiatric symptoms between volunteer and career firefighters. This study aimed to (1) describe differences in psychiatric symptoms and barriers to mental health care between U.S. firefighters in volunteer-only and career only departments; and (2) determine if greater self-reported structural barriers to mental health care (e.g., cost, availability of resources) explain the differences in psychiatric symptom levels. Overall, 525 current U.S. firefighters participated. Analyses of covariance and logistic regression analyses were used to evaluate group differences between volunteer (n=204) and career (n=321) firefighters, adjusting for demographic and occupational characteristics. Volunteer firefighters reported significantly elevated levels of depression, posttraumatic stress, and suicidal symptoms compared to career firefighters. Career firefighters reported relatively elevated levels of problematic alcohol use. Volunteer firefighters additionally reported greater structural barriers to mental health care (e.g., cost, availability of resources), and these barriers accounted for the differences in mental health variables between volunteer and career firefighters. Findings suggest that volunteer firefighters report elevated psychiatric symptoms compared to career firefighters and greater structural barriers to mental health treatment may explain this link. Increased efforts are needed to develop firefighter-specific interventions and bolster mental health service utilization.