An Assessment of Depression, Anxiety, and Stress Among Nationally Certified EMS Professionals

Among EMS professionals, occupational exposures in mental illness literature are not well-represented.Currently, no literature exists examining the prevalence of mental illness in a large national cohort of EMS professionals.As such, the purpose of this study is to address the lack of scientific knowledge and evidence in the field of mental illness among EMS professionals.The objectives of this master's thesis are three fold.The first objective is to estimate the prevalence and severity of depression, anxiety, and stress among a cohort of nationally certified EMS professionals.Because other healthcare professions may have similar occupational exposures related to mental illness, the second objective of this study is a comparison of nationally certified EMS professionals' depression, anxiety, and stress prevalence to other healthcare professions.The third objective of this master's thesis is the determination of differences between cases and controls (defined by the 21question Depression, Anxiety, and Stress Scale (DASS-21)) from the same cohort with respect to clinical depression, anxiety, stress, and demographic and work-life characteristics.In accordance with previous methodologies, a questionnaire was included as part of the 2009 biennial recertification paperwork mailed to all nationally certified EMS iii professionals prior to their 2009 expiration date.This questionnaire contained demographic and work-life characteristic items as well as the DASS-21.Three outcome variables of interest were derived from the DASS-21: clinical depression, clinical anxiety, and clinical stress.Any scores above "normal" for each of the outcomes were determined to be a case and controls were defined as those whose scores fell below the case cutpoint.A complete case-control analysis was performed for each of the three outcome variables.Independent variables were chosen based on previous methodologies and plausibility.A total of 15 independent variables were assessed.The prevalence of depression among the cohort was found to be 6.8%, the prevalence of anxiety was found to be 6.0%, and the prevalence of stress was 5.9%.In the final logistic regression models, certification level, service type, general health, exercise, smoking status, and age were found to be statistically significant in each of the depression, anxiety, and stress models.Further, years of experience, race, and education level was found to be unique only to the depression and stress models.Marital status was found to be statistically significant in only the depression and anxiety models.Lastly, gender was unique to the depression logistic model.This study was able to identify statistically significant demographic and work-life characteristic variables that predicted depression, anxiety, and stress.Future research should attempt to follow EMS professionals prospectively to determine specific characteristics associated with occupational traumatic exposure and the development of clinical depression, anxiety, and stress.Likewise, specific research efforts should be