Social Psychiatry and Psychiatric Epidemiology

, Volume 53, Issue 9, pp 897–909 | Cite as

Prevalence of PTSD and common mental disorders amongst ambulance personnel: a systematic review and meta-analysis

  • Katherine Petrie
  • Josie Milligan-Saville
  • Aimée Gayed
  • Mark Deady
  • Andrea Phelps
  • Lisa Dell
  • David Forbes
  • Richard A. Bryant
  • Rafael A. Calvo
  • Nicholas Glozier
  • Samuel B. Harvey
Original Paper



There is increasing concern regarding the mental health impact of first responder work, with some reports suggesting ambulance personnel may be at particularly high risk. Through this systematic review and meta-analysis we aimed to determine the prevalence of mental health conditions among ambulance personnel worldwide.


A systematic search and screening process was conducted to identify studies for inclusion in the review. To be eligible, studies had to report original quantitative data on the prevalence of at least one of the following mental health outcome(s) of interest (PTSD, depression, anxiety, general psychological distress) for ambulance personnel samples. Quality of the studies was assessed using a validated methodological rating tool. Random effects modelling was used to estimate pooled prevalence, as well as subgroup analyses and meta-regressions for five variables implicated in heterogeneity.


In total, 941 articles were identified across all sources, with 95 full-text articles screened to confirm eligibility. Of these, 27 studies were included in the systematic review, reporting on a total of 30,878 ambulance personnel. A total of 18 studies provided necessary quantitative information and were retained for entry in the meta-analysis. The results demonstrated estimated prevalence rates of 11% for PTSD, 15% for depression, 15% for anxiety, and 27% for general psychological distress amongst ambulance personnel, with date of data collection a significant influence upon observed heterogeneity.


Ambulance personnel worldwide have a prevalence of PTSD considerably higher than rates seen in the general population, although there is some evidence that rates of PTSD may have decreased over recent decades.


Ambulance personnel Emergency services Paramedic Common mental disorder Meta-analysis Post-traumatic stress disorder Prevalence 



The systematic review reported in this study was funded by Ambulance Victoria in collaboration with Phoenix Australia. SBH, JMS, AG and MD are supported by funding from NSW Health and the iCare Foundation. This project also benefited from funding from beyondblue and the Movember Foundation.

Author contributions

SBH and KP conceptualized the study, KP and JMS undertook search and screening processes, KP completed data extraction, KP and SBH carried out statistical analysis, and wrote subsequent versions of the manuscript. All other authors reviewed and approved the final submission.

Compliance with ethical standards

Conflict of interest

There are no conflicts of interest to report regarding this publication.

Supplementary material

127_2018_1539_MOESM1_ESM.pdf (257 kb)
Supplementary material 1 (PDF 256 KB)


References marked with an asterisk are those studies included in the meta-analysis

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Katherine Petrie
    • 1
    • 2
  • Josie Milligan-Saville
    • 1
    • 2
  • Aimée Gayed
    • 2
  • Mark Deady
    • 1
    • 2
  • Andrea Phelps
    • 3
    • 4
  • Lisa Dell
    • 3
    • 4
  • David Forbes
    • 3
    • 4
  • Richard A. Bryant
    • 5
  • Rafael A. Calvo
    • 6
  • Nicholas Glozier
    • 7
  • Samuel B. Harvey
    • 1
    • 2
  1. 1.Black Dog InstituteUniversity of New South WalesRandwickAustralia
  2. 2.School of PsychiatryUniversity of New South WalesSydneyAustralia
  3. 3.Phoenix Australia, Centre for Posttraumatic Mental HealthCarltonAustralia
  4. 4.Department of PsychiatryThe University of MelbourneCarltonAustralia
  5. 5.School of PsychologyUniversity of New South WalesSydneyAustralia
  6. 6.School of Electrical and Information EngineeringUniversity of SydneySydneyAustralia
  7. 7.Brain and Mind CentreUniversity of SydneySydneyAustralia

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