Dissertation Study Key Takeaways
Topic 1: Stress and Maladaptive Coping among First Responders
First responders experience high stress and traumatic events on their job (Bracken-Scally & McGilloway, 2016; Kragt et al., 2017). This line of work exposes first responders to an increased risk of trauma that may bring symptoms of post-traumatic stress disorder (PTSD), anxiety, and depression (Tuohy et al., 2005). Firefighting ranks number two, and policing ranks number four among most stressful jobs in the United States (Renzulli, 2019). To be a first responder, a person needs to have an excellent ability to manage stress and good teamwork skills crucial for survival (Bracken-Scally & McGilloway, 2016). Mental health stigmatization may be one of the causes of increasing numbers of PTSD cases, depression, and suicides among first responders worldwide (Carleton et al., 2018; Fitzpatrick, 2020; Lawn et al., 2020; Lewis-Schroeder et al., 2018). Before exposure to traumatic events, a higher resilience level can protect first responders from PTSD (Joyce et al., 2019).
First responders experience a high level of identification with their first responder job (Bracken-Scally & McGilloway, 2016). Work in public safety strongly influences identity, and thus, first responders may be at risk for occupational dysadaptation after leaving first responder work (Bracken-Scally & McGilloway, 2016; Brandl & Smith, 2012). Several studies suggest that first responders may suffer from early mortality after retirement (Brandl & Smith, 2012; Kragt et al., 2017). Cameron and Griffiths (2016) studied the involuntary retirement of police officers who served for an average of 30 years and demonstrated the negative impact of lost social connectedness and camaraderie on their health and well-being. For example, early involuntary retirement increased risk factors for anxiety and depression (Tuohy et al., 2005). Kragt et al. (2017) also found that retired first responders, who strongly identified with their jobs, may be more inclined to substance abuse, lower quality of life, and premature death.
Topic 2: Premature Mortality among First Responders
Suicide is one of the mortality causes among first responders. Law enforcement (LE) and fire authority (FA) personnel are three times more likely to die by suicide than in the line of duty (Hillard, 2019). Suicide rates were reported 8.4 times higher in working officers versus retired officers; however, most suicides occur within five years before retirement eligibility when anxiety is high (Violanti et al., 2011). The need for suicide prevention efforts is indicated for veterans (U.S. Department of Veteran Affairs, 2020) and police officers (Violanti et al., 2011). About 85% of suicide deaths among police officers were accompanied by alcohol consumption (Heyman et al., 2018). Interestingly, only 40% of firefighter suicides are reported (Heyman et al., 2018). Easy access to deadly weapons, intense stress, exposure to human devastation, alcohol, and drugs may negatively affect work performance and relationships, leading to depression, substance abuse, and suicide (Hillard, 2019). In addition, being part of an honor-oriented U.S. state culture, having access to weapons, and being older are risk factors for suicide (Bock & Brown, 2019; Brown, Carvallo, & Imura, 2014; Brown, Imura, & Osterman, 2014).
The federal government provides grant funding for police suicide prevention, mental health screenings, and training to identify at-risk officers (Hillard, 2019). Still, police officers are known not to take advantage of mental health care services even though their employers have provided them (Cuadro, 2019). Forfeiting their right to mental health is stigma and shame around seeking mental health care services (Heyman et al., 2018; Sisak & Mustian, 2019). However, the culture has been shifting, and the stigma of seeking mental health services is decreasing (Sisak & Mustian, 2019).
Topic 3: Retirement Planning Matters
Research shows that people may underestimate the complexity of the retirement transition preparation required (Hewitt et al., 2010; Pettican & Prior, 2011). They often prepare financially for retirement while neglecting practice in other areas of life, such as relationships and occupations, and that inadequate preparation may negatively influence their health and well-being in retirement (Hewitt et al., 2010; Pettican & Prior, 2011). Yeung (2013) found that preretirement planning helps with smoother retirement transition by imparting a sense of control and mastery; however, retirement activities need to be personally meaningful. The perception of life in retirement needs to be positive.
While some people transition to retirement well, others approaching retirement may encounter emotional difficulties such as fear, anxiety, and depression (Pepin & Deutscher, 2011; Silver & Williams, 2018; Topa & Alcover, 2015). As a result, the retirement transition may be accompanied by a temporary decrease in happiness and subjective well-being (Luhmann et al., 2012). Preretirement programs may help manage emotions and stress surrounding the exit of the workforce (Rogalla, 2020; Wilson et al., 2013); however, there is a lack of such programs directed to retirees and their families (Loureiro et al., 2015). Retirement needs attention due to being “an existential impetus” (Amabile, 2019, p. 209). Researchers are encouraged to heed Amabile’s call for increased attention in the area of retirement.
There is a positive connection between occupational engagement and health (Reed et al., 2013; Wilcock & Hocking, 2015). In addition to the positive relationship, humans are occupational beings who are innately driven to engage in occupations to survive adversities and thrive (Wilcock & Hocking, 2015). Changing patterns of life, work, and leisure during transitions strongly influence health (Wilcock & Hocking, 2015), and good health is a positive predictor of a smoother retirement transition (van Solinge & Henkens, 2008). Henning et al. (2016) found that while most people maintain their well-being long-term, it is unknown how their well-being is affected by retirement in the short-term and what they do in their everyday lives to adapt to retirement.
Wang and Hesketh (2012) suggested that a high level of physical activity followed by an abrupt decrease in physical activity, which is common in retirement, may adversely affect cardiovascular health. As a result of decreased physical activity, health, well-being, and quality of life may suffer in retirement (Bracken-Scally & McGilloway, 2016; Kragt et al., 2017). First responders may benefit from more structured and more timely evidence-based preparation for retirement to prevent health deterioration and improve retirement outcomes (Bracken-Scally, 2015; Bracken-Scally & McGilloway, 2016; Kragt et al., 2017). Preretirement programs could strengthen self-efficacy before retirement, especially when retirement is early or unexpected when anxiety and depression may be the greatest (Topa & Alcover, 2015).
Full Disseration Reference:
Syrotiak, B. T. (2021). The development of a community-based occupational therapy retirement transition program for first responders and their families. [Unpublished doctoral dissertation]. Texas Women’s University. https://twu.ir.tdl.org/handle/11274/13258