Socioecological Dynamic Models of Mental Health: Complex Crisis Burden among Professions of Critical Importance for the Society

The project Socioecological Dynamic Models of Mental Health: Crisis Burden among Professions of Critical Importance for the Society systematically analyses the socioecological context of the first responders’ (FRs) mental health (MH) in critical professions (health, military, police) in Slovenia and Austria in complex crisis by considering risk and protective factors at individual, micro, meso and macro level. FRs are at high risk for mental disorders such as stress, burnout, anxiety, depression, PTSD, as they are first at the crisis and must deal with it immediately, usually with high time restraints for assessing, responding and adapting to the situation. They are repeatedly exposed to different types of crisis situations, stressful and traumatic events. Their response affects the overall response of the society and country. The Covid-19 pandemic is an example of the most recent complex crisis that affected societies in various domains of societal life. There is a research gap in understanding social determinants for FRs’ mental health in both countries. Therefore, a multidimensional perspective on risks for critical professions is needed to improve future preparedness and support resilience among the FRs, as a societal backstones in each crisis. We will observe socioecological context for FRs’ current and over time MH, with the aim to develop and test a model of the risk and protective factors influencing the MH outcomes (stress, burnout, anxiety, depression, PTSD) among the FRs in the critical professions in crisis. The study focuses on two main objectives: 1) To assess MH of FR in times of complex crises and to identify risk and protective factors using the socio-ecological model. 2) To consider the importance of the structurally based gender inequalities in observed gendered organizations and how they relate to FRs’ MH in crisis. Gender is used as an analytic category in combination with other factors within the socioecological model. To examine factors influencing MH of FRs on the individual, micro, meso and macro level, we use interdisciplinary research methods and include quantitative and qualitative data analyses. We follow a sequential exploratory design; in the first phase, we collect and analyze qualitative data, followed by quantitative data collection and analysis in the second phase. Interviews with FRs will be analyzed in a two-step process using an inductive and semantic approach informed by thematic analysis and multi-level analysis. Research process is as follows: 1) Examine factors that predict MH at the individual, micro, meso, and macro levels, using state-of-the-art research methods to examine each level separately and in interaction with each other. 2) Apply socio-ecological modelling and build on the model developed in previous study (MilFam) and extend it to measure risk and protective factors for MH of FR. 3) Analyze MH of FR from a feminist perspective, considering the gendered nature of military, health, and police professions, which is a result of structural and societal characteristics. 4) Examine the relationships between various levels of preventive measures, and preparedness in the observed organizations, as well as organizational culture and individual ability to cope with crisis situations. The project consists of six work packages and will be carried out jointly by a Slovenian and an Austrian research team. At key milestones the advise will be provided by the Advisory team of experts.  The two-country design allows for policy-level analysis and integrates retrospective and prospective research designs to examine MH and crisis exposure within and across countries and occupations, which has not been done before.  This project has the potential to lead to an innovative understanding of FRs’ MH in times of crisis by improving previous research designs through systematic integration and coordination of multiple levels of analysis that are often neglected in MH research.