A Qualitative Study of Psychological Outcomes in Avalanche First Responders.

Dolan, Nathalia, and Christopher Tedeschi. A qualitative study of psychological outcomes in avalanche first responders. High Alt Med Biol 00:000-000, 2018.

OBJECTIVES: We sought to characterize the mental health morbidity associated with avalanche rescue, and to generate hypotheses as to how such morbidity may be mitigated.

MATERIALS AND METHODS: Avalanche first responders were recruited through online advertisements, social media, direct outreach, and e-mail solicitation. Thirteen subjects were selected for inclusion. Each subject participated in a semistructured interview. Transcripts were coded and thematically analyzed.

RESULTS: Themes identified from interviews fell into three broad categories: long-term effects of rescue participation, assessments of psychological support, and recommendations for change. Symptoms of substance use disorder, depression, anxiety, panic, acute stress disorder, and posttraumatic stress disorder were evident in the interviews, as was evidence of adverse effects on subjects' personal relationships. Many respondents described a deficiency of formal psychological support for avalanche first responders, often limited to after-action debriefs of varying effectiveness. Nevertheless, subjects who received high-quality professional psychological support considered it helpful. Participants' suggestions for improvement focused on formalizing preincident psychological preparation and postincident support.

CONCLUSIONS: Avalanche responders may experience long-lasting, work-related psychological effects. There is a paucity of effective psychological preparation and support for this population of first responders. Formal psychological support is positively received when available. Further study is required to evaluate particular interventions in this specific population.