Post-Critical Incident Mental Health Support Programs and Services for U.S. First Responders: A Scoping Review

Abstract: Provide a summary (250-300 words) of the research, including objectives, methods, results, and conclusions.
Background: First responders routinely experience occupational exposure to potentially traumatic events, placing them at increased risk for adverse mental health outcomes. Although numerous post-critical incident mental health support programs have been implemented within first responder organizations, the extent to which these programs have been described and evaluated in the United States remains unclear.
Objective: This scoping review aimed to identify and characterize post-critical incident mental health support programs and services implemented for U.S. first responders, summarize program characteristics and reported outcomes, and identify gaps in the current evidence base.
Methods: A scoping review was conducted following the methodological framework of Arksey and O'Malley, refined by Levac and colleagues, and reported according to PRISMA-ScR guidelines. PubMed, Scopus, and PsycINFO were searched for peer-reviewed U.S. studies describing, implementing, or evaluating post-critical incident mental health support programs for law enforcement officers, firefighters, emergency medical services personnel, and other first responders. Data were extracted using a standardized form and synthesized descriptively through narrative analysis and evidence mapping.

Include 3-5 keywords relevant to your study

1. Johnson, C. C., Vega, L., Kohalmi, A. L., Roth, J. C., Howell, B. R., & Van Hasselt, V. B. (2020). Enhancing mental health treatment for the firefighter population: Understanding fire culture, treatment barriers, practice implications, and research directions. Professional Psychology: Research and Practice, 51(3), 304–311. https://doi.org/10.1037/pro0000266 [Google Scholar] [Crossref]

2. Klimley, K. E., Van Hasselt, V. B., & Stripling, A. M. (2018). Posttraumatic stress disorder in police, firefighters, and emergency dispatchers. Aggression and Violent Behavior, 43, 33–44. https://doi.org/10.1016/j.avb.2018.08.005 [Google Scholar] [Crossref]

3. Ryan, M., Hasan, F., Molina, L., Cervoni, C., Palladino, J., Vujanovic, A. A., & Gonzalez, A. (2022). First Responders and Mental Health. In Comprehensive Clinical Psychology, Second Edition (pp. 66–80). Elsevier. https://doi.org/10.1016/B978-0-12-818697-8.00161-8 [Google Scholar] [Crossref]

4. Wagner, S. L., White, N., Fyfe, T., Matthews, L. R., Randall, C., Regehr, C., White, M., Alden, L. E., Buys, N., Carey, M. G., Corneil, W., Fraess-Phillips, A., Krutop, E., & Fleischmann, M. H. (2020). Systematic review of posttraumatic stress disorder in police officers following routine work-related critical incident exposure. American Journal of Industrial Medicine, 63(7), 600–615. https://doi.org/10.1002/ajim.23120 [Google Scholar] [Crossref]

5. Fallon, P., Jaegers, L., & ElGhaziri, M. (2023). Peer Support Programs to Reduce Organizational Stress and Trauma for Public Safety Workers: A Scoping Review. Workplace Health and Safety. https://doi.org/doi/10.1177/21650799231194623 [Google Scholar] [Crossref]

6. Lynch, S., Muibu, D., Ferguson, E., & Kreutzer, W. (2025). Peer support programs and law enforcement psychological strain: A systematic review. Policing: An International Journal, 48(6), 1207–1226. https://doi.org/10.1108/PIJPSM-01-2025-0003 [Google Scholar] [Crossref]

7. Price, J. A. B., Ogunade, A. O., Fletcher, A. J., Ricciardelli, R., Anderson, G. S., Cramm, H., & Carleton, R. N. (2022). Peer Support for Public Safety Personnel in Canada: Towards a Typology. International Journal of Environmental Research and Public Health, 19(9), 5013. https://doi.org/10.3390/ijerph19095013 [Google Scholar] [Crossref]

8. 8. Wild, J., El-Salahi, S., & Esposti, M. D. (2020). The Effectiveness of Interventions Aimed at Improving Well-Being and Resilience to Stress in First Responders. European Psychologist, 25(4), 252–271. https://doi.org/10.1027/1016-9040/a000402 [Google Scholar] [Crossref]

9. Psychological Variables Associated With Post-Traumatic Stress Disorder in Firefighters: A Systematic Review—Elena R. Serrano-Ibáñez, Tania Corrás, Mirtha del Prado, Javier Diz, Carmen Varela, 2023. (n.d.). Retrieved July 6, 2026, from https://journals-sagepub-com.proxy006.nclive.org/doi/10.1177/15248380221082944 [Google Scholar] [Crossref]

10. Bowers, C., Beidel, D. C., & Steigerwald, V. L. (2025). Peer Support Programs for First Responders: A Critical Review and Research Roadmap. International Journal of Environmental Research and Public Health, 22(10), 1532. https://doi.org/10.3390/ijerph22101532 [Google Scholar] [Crossref]

11. Arksey, H., & O’Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19–32. https://doi.org/10.1080/1364557032000119616 [Google Scholar] [Crossref]

12. Levac, D., Colquhoun, H., & O’Brien, K. K. (2010). Scoping studies: Advancing the methodology. Implementation Science, 5(1), 69. https://doi.org/10.1186/1748-5908-5-69 [Google Scholar] [Crossref]

13. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation | Annals of Internal Medicine. (n.d.). Retrieved July 6, 2026, from https://www.acpjournals.org/doi/full/10.7326/M18-0850 [Google Scholar] [Crossref]

14. Maloney LM, Hoffman J, Peralta E, Princi R, Thode HC Jr, Tomlin M, DiDonato C, LaBarbera A, Lambert E, King J, Johnson DG, Edouard S, & Williams S. (2024). Supporting Emergency Medical Services Clinicians Through Acute and Sustained Crises With Informal Peer Support and Intentional Acts of Kindness: The Emergency Medical Services Code Lavender Program. Air Med J, 43(4), 313–320. https://doi.org/10.1016/j.amj.2024.02.003 [Google Scholar] [Crossref]

15. Addo-Yobo, A., Uhl, A., Baloch, R. G., Stewart, T. K., Parrish, R., Johnson, R., Watkins, R., & Salami, T. (2025). Investigating the Perceptions of EMDR Among Law Enforcement Officers Attending a 3-Day Post Critical Incident Seminar in Texas. Journal of Police and Criminal Psychology, 40(3), 589–598. https://doi.org/10.1007/s11896-025-09743-9 [Google Scholar] [Crossref]

16. Arble E, Lumley MA, Pole N, Blessman J, & Arnetz BB. (2017). Refinement and Preliminary Testing of an Imagery-Based Program to Improve Coping and Performance and Prevent Trauma among Urban Police Officers. J Police Crim Psychol, 32(1), 1–10. https://doi.org/10.1007/s11896-016-9191-z [Google Scholar] [Crossref]

17. Ramey SL, Perkhounkova Y, Hein M, Chung S, Franke WD, & Anderson AA. (2016). Building Resilience in an Urban Police Department. J Occup Environ Med, 58(8), 796–804. https://doi.org/10.1097/JOM.0000000000000791 [Google Scholar] [Crossref]

18. O’Dare K, Mathis A, Tawk R, Atwell L, & Jackson D. (2024). State Level Policies on First Responder Mental Health in the U.S.: A Scoping Review. Adm Policy Ment Health, 51(4), 579–596. https://doi.org/10.1007/s10488-024-01352-8 [Google Scholar] [Crossref]

19. Bonner, H. S., & Crowe, A. (2022). Mental health programming for law enforcement: A first look at trends and perceptions of effectiveness. Journal of Crime and Justice, 45(5), 552–566. https://doi.org/10.1080/0735648X.2022.2045209 [Google Scholar] [Crossref]

20. Katzman JG, Tomedi LE, Everly G, Greenwood-Ericksen M, Romero E, Rosenbaum N, Medrano J, Menking P, Archer GRD, Martin C, Dow KA, McCoy-Hayes S, & Katzman JW. (2021). First Responder Resiliency ECHO: Innovative Telementoring during the COVID-19 Pandemic. Int J Environ Res Public Health, 18(9). https://doi.org/10.3390/ijerph18094900 [Google Scholar] [Crossref]

21. Cacciatore, J., Carlson, B., Michaelis, E., Klimek, B., & Steffan, S. (2011). Crisis intervention by social workers in fire departments: An innovative role for social workers. Social Work, 56(1), 81–88. https://doi.org/10.1093/sw/56.1.81 [Google Scholar] [Crossref]

22. O’Toole M, Mulhall C, & Eppich W. (2022). Breaking down barriers to help-seeking: Preparing first responders’ families for psychological first aid. Eur J Psychotraumatol, 13(1), 2065430. https://doi.org/10.1080/20008198.2022.2065430 [Google Scholar] [Crossref]

23. Ramchand, R., Saunders, J., Osilla, K. C., Ebener, P., Kotzias, V., Thornton, E., Strang, L., & Cahill, M. (2019). Suicide Prevention in U.S. Law Enforcement Agencies: A National Survey of Current Practices. Journal of Police and Criminal Psychology, 34(1), 55–66. https://doi.org/10.1007/s11896-018-9269-x [Google Scholar] [Crossref]

24. Sarabia, J., Arroyo-Rojas, F., & Kieninger, K. (2025). Firefighters’ perspectives on critical incident stress debriefing as a post-critical incident intervention. International Journal of Workplace Health Management, 1–17. https://doi.org/10.1108/IJWHM-08-2024-0160 [Google Scholar] [Crossref]

25. Taillac, P., Hammond, R., & Miller, K. (2015). At-risk EMS employees: A model of assessment and intervention. International Journal of Emergency Mental Health, 17(2), 453–458. https://doi.org/10.4172/1522-4821.1000194 [Google Scholar] [Crossref]

26. Uhl, A., Addo-Yobo, A., Boland, G., Watkins, R., Senegal, J., & Salami, T. (2023). Mental Health Providers and Peers Help Enhance the Effectiveness of Law Enforcement Mental Health Interventions. Journal of Police and Criminal Psychology, 38(3), 774–781. https://doi.org/10.1007/s11896-023-09604-3 [Google Scholar] [Crossref]

27. White RW, Knauff JK, & Kverno KS. (2023). Empowering law enforcement officers to engage effectively with individuals in crisis. Arch Psychiatr Nurs, 47, 1–5. https://doi.org/10.1016/j.apnu.2023.08.005 [Google Scholar] [Crossref]

28. Proctor, E. K., Powell, B. J., & McMillen, J. C. (2013). Implementation strategies: Recommendations for specifying and reporting. Implementation Science: IS, 8, 139. https://doi.org/10.1186/1748-5908-8-139 [Google Scholar] [Crossref]

29. Proctor, E., Silmere, H., Raghavan, R., Hovmand, P., Aarons, G., Bunger, A., Griffey, R., & Hensley, M. (2011). Outcomes for Implementation Research: Conceptual Distinctions, Measurement Challenges, and Research Agenda. Administration and Policy in Mental Health and Mental Health Services Research, 38(2), 65–76. https://doi.org/10.1007/s10488-010-0319-7 [Google Scholar] [Crossref]

30. Wheldon, K. (2025). Developing a Comprehensive Fire Service Psychology Program Within a Fire Department or EMS Agency. In K. Wheldon (Ed.), Fire Service Psychology: A Comprehensive Approach to Enhancing Firefighter Health, Safety, and Longevity (pp. 249–269). Springer Nature Switzerland. https://doi.org/10.1007/978-3-032-02126-7_12 [Google Scholar] [Crossref]

31. National Academies of Sciences, Engineering, and Medicine; National Academy of Medicine; Committee on Systems Approaches to Improve Patient Care by Supporting Clinician Well-Being. (2019). Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being. National Academies Press (US). http://www.ncbi.nlm.nih.gov/books/NBK552618/ [Google Scholar] [Crossref]

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