Assessing the Mental Health Impact of the COVID-19 Pandemic on US Fire-Based Emergency Medical Services Responders

Objective Examine the COVID-19 pandemic's impact on fire service safety culture, behavior and morale, levers of well-being, and well-being outcomes. Methods Two samples (SAVER, consisting of three metropolitan departments, and FOCUS, a geographically stratified random sample of 17 departments) were assessed monthly from May to October 2020. Fire department-specific and pooled scores were calculated. Linear regression was used to model trends. Results We observed concerningly low and decreasing scores on Management Commitment to Safety, Leadership Communication, Supervisor Sensegiving, and Decision Making. We observed increasing and concerning scores for Burnout, Intent to Leave the Profession, and percentage at high risk for Anxiety and Depression. Conclusions Our findings suggest that organizational attributes remained generally stable but low during the pandemic and impacted well-being outcomes, job satisfaction, and engagement. Improving safety culture can address the mental health burden of this work.