Patterns of Primary Care Use and Clinical Assessment Practices Among Treatment-seeking First Responders.
Journal of occupational and environmental medicine · 2026-03-09 · Observational study
Abstract
OBJECTIVE: To identify the predictors of suicide for law enforcement officers (LEOs), firefighters (FFs), and emergency medical technicians (EMTs). METHODS: We used primary care assessments of posttraumatic stress disorder (Primary Care PTSD Screen for DSM-5), generalized anxiety (Generalized Anxiety Disorder-2), depression (Patient Health Questionnaire-2), substance use (CAGE Adapted to Include Drugs), resilience (Response to Stressful Experiences Scale-4), and suicidality (Patient Health Questionnaire-Suicidal Ideation). We conducted separate logistic regressions predicting suicide for LEOs and FFs/EMTs. RESULTS: Among LEOs, 8% screened positive for suicide, whereas 24% of FFs/EMTs screened positive, respectively. There were no significant predictors of suicide for LEOs. However, for FFs/EMTs, depression was associated with an increase in suicidality, whereas previous mental health treatment was a buffer against it. LIMITATIONS: These data are cross-sectional and require analysis throughout the course of treatment. CONCLUSIONS: We demonstrated the utility of using primary care abbreviated assessments for first responders.