PTSD in retired or resigned first responders: A global meta-analysis of prevalence
Tracks
Monarch Room - In Person Only
| Tuesday, March 3, 2026 |
| 10:45 AM - 11:05 AM |
| Monarch Room |
Overview
Dr Andrew Arena, Black Dog Institute
Details
Three Key Learnings:
1 in 6 retired or resigned first responders are likely to be suffering from PTSD, a rate higher than what has been found for active first responders. This high risk is likely due to several factors, including the accumulation of traumatic exposures, medical retirement, loss of help-seeking avenues, and a less busy lifestyle that may allow traumas to resurface. With the loss of access to services and social support available through their prior role, there’s a need for accessible external services targeted to former first responders.
1 in 6 retired or resigned first responders are likely to be suffering from PTSD, a rate higher than what has been found for active first responders. This high risk is likely due to several factors, including the accumulation of traumatic exposures, medical retirement, loss of help-seeking avenues, and a less busy lifestyle that may allow traumas to resurface. With the loss of access to services and social support available through their prior role, there’s a need for accessible external services targeted to former first responders.
Speaker
Dr Andrew Arena
Postdoctoral Research Fellow
Black Dog Institute
PTSD in retired or resigned first responders: A global meta-analysis of prevalence
Presentation Overview
While much is known about PTSD prevalence in active first responders, very little research has examined PTSD prevalence after they retire or resign from service. We conducted the first systematic review and meta-analysis on this topic, with the goal of identifying what evidence is available, estimating overall PTSD prevalence, and examining differences between these workers. This presentation will use these findings to explore what is needed moving forward to better support first responders after they transition out of service.
Searches were conducted across five databases in January 2025, including peer-reviewed observational studies. Random effects meta-analyses were run on current PTSD prevalence, separating out studies assessing PTSD related to single large-scale disasters.
A total of nine studies (11 unique samples) were included in analyses. Studies were exclusively conducted within high-income, English-speaking countries on non-volunteer former first responders, and predominantly focused on firefighter and police samples. An overall PTSD prevalence of 17% was found, which increased to 20% among the highest quality studies. Only two additional studies assessed PTSD related to specific disasters. No subgroup differences were significant, although these analyses were constrained by the restricted pool of available studies.
The prevalence of PTSD among former first responders appears higher than what has been found for active emergency workers, yet the limited attention that this population has received in the literature does not reflect their high level of need. Likely reasons for this heightened risk include the accumulation of traumatic exposures, medical retirement, loss of help-seeking avenues, and a less busy lifestyle that may allow traumas to resurface. This population is a high priority for further research and mental health intervention. With a loss of support available through their prior role, service models that are targeted and prioritise accessibility are required, such as Black Dog Institute’s National Emergency Worker Support Service.
Searches were conducted across five databases in January 2025, including peer-reviewed observational studies. Random effects meta-analyses were run on current PTSD prevalence, separating out studies assessing PTSD related to single large-scale disasters.
A total of nine studies (11 unique samples) were included in analyses. Studies were exclusively conducted within high-income, English-speaking countries on non-volunteer former first responders, and predominantly focused on firefighter and police samples. An overall PTSD prevalence of 17% was found, which increased to 20% among the highest quality studies. Only two additional studies assessed PTSD related to specific disasters. No subgroup differences were significant, although these analyses were constrained by the restricted pool of available studies.
The prevalence of PTSD among former first responders appears higher than what has been found for active emergency workers, yet the limited attention that this population has received in the literature does not reflect their high level of need. Likely reasons for this heightened risk include the accumulation of traumatic exposures, medical retirement, loss of help-seeking avenues, and a less busy lifestyle that may allow traumas to resurface. This population is a high priority for further research and mental health intervention. With a loss of support available through their prior role, service models that are targeted and prioritise accessibility are required, such as Black Dog Institute’s National Emergency Worker Support Service.
Biography
Dr Andrew Arena received his PhD in psychology at the University of Sydney in 2020, focusing on how people can cope more or less positively with stressful life circumstances. Andrew is now a postdoctoral researcher in the Workplace Mental Health team at the Black Dog Institute. He is currently investigating how to better promote wellbeing, prevent, and treat mental health issues for first responders. This includes work to inform and enhance the National Emergency Worker Support Service.
