Firefighters, posttraumatic stress disorder, and barriers to treatment: Results from a nationwide total population survey

Jieun E Kim, Stephen R Dager, Hyeonseok S Jeong, Jiyoung Ma, Shinwon Park, Jungyoon Kim, Yera Choi, Suji L Lee, Ilhyang Kang, Eunji Ha, Han Byul Cho, Sunho Lee, Eui-Jung Kim, Sujung Yoon, In Kyoon Lyoo, Jieun E Kim, Stephen R Dager, Hyeonseok S Jeong, Jiyoung Ma, Shinwon Park, Jungyoon Kim, Yera Choi, Suji L Lee, Ilhyang Kang, Eunji Ha, Han Byul Cho, Sunho Lee, Eui-Jung Kim, Sujung Yoon, In Kyoon Lyoo

Abstract

Repeated exposure to traumatic experiences may put professional firefighters at increased risk of developing posttraumatic stress disorder (PTSD). To date, however, the rate of PTSD symptoms, unmet need for mental health treatment, and barriers to treatment have only been investigated in subsamples rather than the total population of firefighters. We conducted a nationwide, total population-based survey of all currently employed South Korean firefighters (n = 39,562). The overall response rate was 93.8% (n = 37,093), with 68.0% (n = 26,887) complete responses for all variables. The rate of current probable PTSD was estimated as 5.4%. Among those with current probable PTSD (n = 1,995), only a small proportion (9.7%) had received mental health treatment during the past month. For those who had not received treatment, perceived barriers of accessibility to treatment (29.3%) and concerns about potential stigma (33.8%) were reasons for not receiving treatment. Although those with higher PTSD symptom severity and functional impairment were more likely to seek treatment, greater symptom severity and functional impairment were most strongly associated with increased concerns about potential stigma. This nationwide study points to the need for new approaches to promote access to mental health treatment in professional firefighters.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Participant response rate throughout recruitment…
Fig 1. Participant response rate throughout recruitment and data analyses.
a Excluded individuals who could be faking good, answering randomly, or lying. b Imputed datasets were generated using the chained equations approach [37]. c Numbers are expressed in range due to the varying numbers of missing values for each variable. d Current probable posttraumatic stress disorder (PTSD) was defined as ≥ 45 on the PTSD checklist. e Those who had not received treatment from any professional during the past month.
Fig 2
Fig 2
Mental health treatment use during the past month from any professional, among firefighters with current probable posttraumatic stress disorder (n = 1,802), according to the symptom severity (a) and perceived functional impairment (b).Note. PTSD = posttraumatic stress disorder.

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