Researcher says treatment 'isn't one size fits all' as field scan identifies gaps in EAPs
First responders face unique occupational hazards, and their risk of post-traumatic stress injuries (PTSI) remains disproportionately high. In a recent Institute for Work & Health (IWH) webinar, Dr. Emile Tompa presented findings from an environmental scan identifying organizational strategies for preventing PTSI-related work disability.
“This is really about understanding what’s happening on the ground,” Tompa says. “We set out to gather field knowledge and synthesize it with research evidence to inform how organizations can better support first responders.”
The project, funded by Alberta’s Supporting Psychological Health in First Responders grant, combines a literature review with qualitative interviews from 35 key informants across Canada, the U.S., the U.K., and Australia. Tompa and his team focus on practices within police, fire, and paramedic organizations, aiming to capture both formal programming and informal supports that shape mental health outcomes for first responders.
Customization is critical
One of the scan’s clearest findings is that generic support programs—especially standard employee assistance programs (EAPs)—often fail to meet the needs of first responders.
“People told us that these programs lack an understanding of the unique culture and experience of first responders,” Tompa explains. “That culture includes this expectation of toughness and stoicism, which creates real barriers to seeking support.”
To break through stigma, Tompa says organizations must develop “specialized programs designed exclusively for this population,” including external services that offer confidentiality. The fear that accessing in-house mental health services could harm one’s career emerges as a recurring concern.
“There’s a real lack of trust,” Tompa notes. “People worry that using internal services will end up on their file and hurt their chances of advancement.”
Training, communication, and whole-person support
Beyond clinical support, the scan identifies 10 key themes that span the employment life cycle. These include leadership training, whole-person wellness, and strong internal communication.
“Training can’t just happen during onboarding,” Tompa stresses. “We need ongoing mental health literacy programs—for frontline staff, supervisors, even families.”
Respondents also highlight the importance of clear communication around available resources. “If workers don’t know what’s out there or how to access it, the support system breaks down before it begins,” he says.
The scan further recommends taking a “total worker health” approach—combining mental health, physical well-being, work-life balance, and social connection. Programs that involve families and create space for peer bonding, such as team barbecues or sporting events, help build the social cohesion necessary for resilience.
Evidence and evolution
Despite the diversity of approaches, Tompa cautions evidence around program effectiveness remains modest. “It’s early days for rigorous evaluation,” he says. “But that doesn’t mean we wait. First responders need support now.”
He suggests organizations conduct internal assessments, adapt to evolving needs, and commit to continuous improvement. “What works today may not work tomorrow,” Tompa says. “The workplace changes, the workforce changes, and so do the stressors.”
Tompa says best practices are still emerging, but the scan surfaces a strong set of “promising practices” rooted in real-world experience. “The most important takeaway,” Tompa says, “is that support systems must be customized. One size doesn’t fit all.”
For health and safety professionals navigating mental health in first responder environments, the findings offer a valuable foundation.
