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Raised levels of depression and PTSD in ambulance staff: causes and solutions

02 August 2023
Volume 15 · Issue 8



Ambulance staff are reported to have higher levels of mental health problems, including post-traumatic stress disorder (PTSD), than the general population. Vicarious trauma has been attributed to the increased prevalence of depression and PTSD in ambulance service staff.


This literature review explores the causes of the greater prevalence of PTSD and discusses interventions to lower these high rates.


A literature review was carried out and four relevant studies were selected. A critical appraisal tool was then used to produce a systematic analysis.


PTSD in the ambulance service is up to 10 times greater than in the general public, higher than in both the police and fire services and equal to that in the military. The cause of this higher prevalence of PTSD lies not only in vicarious trauma but also in the toll of shift work and in biological predisposition.


There is a paucity of research on PTSD in ambulance staff; research is needed into post-exposure treatments as well as into pre-exposure interventions.

One in four people have mental health problems (Mind, 2023). This 25% of the population present with a vast array of conditions; the most prevalent presentations include depression and post-traumatic stress disorder (PTSD) (Mind, 2023). The Mental Health Foundation (2022) says that mixed anxiety and depression is the most common mental health condition in the UK, with up to 10% of adults experiencing at least one episode of depression in their lifetime.

The concept of psychological trauma has been evident for centuries; however, PTSD did not become an officially recognised diagnosis until the publication of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) in 1980 (Frueh, 2012); before this, terms such as ‘shell-shock’, ‘battered woman syndrome’ and ‘war-related disorders’ were used. PTSD is unusual in that it is one of very few mental health conditions to have an aetiological explanation (Frueh, 2012).

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