Protecting Those Who Protect Us: What Works for Disaster and Emergency Responders?

Disaster and emergency responders are essential to protecting communities during crises, from weather or climate-related disasters to pandemics and conflict. Yet, the very nature of their work places them at heightened risk of experiencing psychological distress. Repeated exposure to trauma, high-pressure environments, and prolonged deployments all have the potential to have significant impacts on mental health and wellbeing. Despite increasing recognition of these risks by international public health and occupational safety bodies, including the World Health Organization and the Health and Safety Executive, a key question remains: what interventions or strategies work best in protecting the mental health of disaster and emergency responders? 

We are leading a systematic review that aims to address this gap by synthesising global evidence on effective interventions for disaster and emergency responders. 

The grant from Lloyd’s Register Foundation will enable the consolidation of key evidence to produce actionable outputs to support the mental health of disaster response workers across the globe. This work complements SOM’s ambition to make better use of published evidence as the basis for the guidance documents it produces which help occupational health professionals carry out their important work.

Why this matters

Mental health is not only a clinical concern, it is also a safety and operational one. It is well known that people who have poor mental health, often associated with reduced concentration and impaired decision-making, are more likely to function poorly and make mistakes. At an organisational level, poor mental health contributes to presenteeism, sickness absence, and workforce attrition.

The broader economic impact is substantial. Poor mental health is estimated to cost the global economy around $1 trillion annually, while in the UK, it represents a major component of the tens of billions lost each year due to poor workforce health. In high-risk occupations such as disaster and emergency response, even small declines in performance can have serious consequences for public safety.

Encouragingly, there is growing evidence from workplace mental health research that workplace mental health interventions can be both effective and cost-efficient. However, the current evidence base is fragmented, making it difficult to determine which interventions are most effective, for whom, and under what conditions.

What this review will examine? 

This systematic review will provide a comprehensive synthesis of interventions designed to support the mental health of disaster and emergency responders.
It aims to explore:

• Types of interventions, such as resilience training, peer support, psychological first aid, and organisational strategies
• Effectiveness of interventions, across different disaster/emergency workers and contexts
• Key components of effective interventions
• Barriers and enablers to implementation, such as organisational culture and delivery models
• Responder perspectives, including acceptability and perceived usefulness of interventions

By taking a whole-system perspective, the review will consider interventions implemented at individual, team, and organisational levels.

A rigorous and inclusive approach

The review will draw on a wide range of evidence, including peer-reviewed studies, and grey literature such as organisational reports. It will include diverse responder groups, from police officers and firefighters to healthcare professionals, humanitarian workers, and community responders.
Using established methodological frameworks, the review will combine quantitative and qualitative evidence. Where possible, meta-analyses will be conducted alongside narrative and thematic synthesis to capture both effectiveness and real-world implementation insights. An explicit equity lens will also be applied to understand how interventions work across different populations and contexts, and to identify gaps in the evidence.

From evidence to action 

This work directly supports the Lloyd’s Register Foundation Global Safety Evidence Centre’s efforts to strengthen the evidence base on disaster management, building on findings from the World Risk Poll and a scoping review on the impact of climate change on safety at work.

By identifying effective and scalable interventions, the review aims to inform policy and practice, support better investment decisions, and enhance workforce sustainability in high-risk settings.

Ultimately, protecting the mental health of responders is not only about individual wellbeing. It is essential to maintaining safe, effective, and resilient systems that protect us all.

Do you have reports or studies on interventions to mitigate the risk of mental health in disaster and emergency responders? Share it here. 

We know that much of the evidence on these interventions is in grey literature, meaning work produced outside of traditional academic databases and peer-reviewed journals. Because of this, we are keen to hear from anyone with relevant reports or articles – including conference proceedings, government reports, non-governmental organisational reports, working papers, theses and dissertations. This can be ongoing or completed studies and may be published or unpublished. We strongly welcome relevant evidence from a wide range of experts in mental health interventions globally, including researchers, practitioners, policymakers, governments, and other stakeholders. 

Please contact Dr Alessandra Casamento from the SOM WHSIC team at Alessandra.Casamento@som.org.uk by 20.07.2026 if you have reports, manuscripts, or data on any of the following: 

• Evaluations of interventions or programmes designed to support the mental health and/or wellbeing of disaster and emergency responders (including effectiveness outcomes)
• Descriptions of intervention or programme models used with disaster and emergency responders (e.g., training, organisational, psychosocial, peer-support, digital, or clinical approaches)
• Comparative evidence on different types of interventions, including what works best, for whom, and under what conditions
• Studies describing the populations served, including responder roles (e.g., police, firefighters, paramedics, volunteers), demographic characteristics, and occupational contexts
• Evidence identifying key components, mechanisms, or features associated with effective interventions (e.g., delivery format, duration, content, theoretical basis)
• Research or reports examining barriers and facilitators to implementation, uptake, sustainability, or scalability of interventions in real-world settings
• Evidence on organisational, cultural, or system-level factors influencing successful implementation (e.g., leadership, resources, stigma, policy context)
• Qualitative or mixed-methods research capturing the views, experiences, and perceived usefulness or acceptability of interventions from disaster and emergency responders
• Case studies or practice-based evidence from organisations delivering interventions in operational settings
• Ongoing, unpublished, or in-progress work (including pilot studies, internal evaluations, or early findings) relevant to responder mental health interventions

If you wish to use and reference the Protecting the Mental Health of Disaster and First Responders: A Systematic Review in your own work, please include the following DOI: https://doi.org/10.60743/5x8n-mb18

Example Citation in IEEE Style:

Lloyd's Register Foundation, “Protecting the Mental Health of Disaster and First Responders: A Systematic Review”, Lloyd's Register Foundation, 2026. doi: 10.60743/5ppn-nc25