Protecting Emergency Responders with Evidence-Based Interventions (PEREI)

First responders are ordinary people facing extraordinary situations in their day-to-day work to keep the community safe. While there are many rewarding aspects of being a first responder, it is a high-pressure role with increased exposure to traumatic events. There may also be aspects of the role that impact life outside of work, such as shift work and being on call.

It has been estimated that emergency service personnel are twice as likely to develop anxiety, depression, and posttraumatic stress disorder and understandably, a great deal of work focuses on helping with recovery from these mental health conditions. But what if we can build on first responders’ skills and resources so that they can reduce the impact of trauma and other stressors and identify earlier when things aren’t going well?

This is where PEREI can help.

PEREI was designed to assist emergency responders to build skills, boost support, and help look after themselves early in their early careers. It aims to improve resilience to the potentially negative effects of stressors, whether that’s exposure to traumatic events or organisational and operational challenges.

What is PEREI?

PEREI delivers targeted wellbeing and resilience programs aimed to prevent the onset of mental health conditions linked to trauma exposure and stress at work. This is important because mental ill health can take its toll on relationships, work performance, physical health and individual wellbeing.

Our program offers a three pronged approach covering key areas critical to maintaining good mental health – an individual’s coping strategies, support network, and supervisor’s knowledge and communication around mental health.

PEREI goes above and beyond existing wellbeing programmes, extending support to families of first responders and training to supervisors.

Families and close friends of first responders can be affected by the role, so it is important that significant others implement strategies to care for themselves, in addition to supporting the first responder.

Since research indicates that supervisors have a critical role in creating a positive workplace environment, including making it comfortable to seek help when needed, PEREI reaches supervisors with key training in this area.

PEREI is unique in that it not only directly helps the first responder, but can also include their significant supports (i.e., family members, close friends, partners) and their supervisors, through three interconnected programs:

First responder wellbeing and resilience program
Wellbeing program tailored for first responders’ significant others
Supervisor program

These three programs are underpinned by evidence-based interventions that have been proven to be effective both internationally and within Australia. We have further tailored these programs to suit Australian first responders and their significant supports and supervisors so that they are more relevant and accessible, and to maximise wellbeing outcomes.

Although it’s never too late to build our resilience and wellbeing, PEREI is funded to support early career first responders (in their first five years of service). This is because research indicates that the earlier you can intervene in building resilience, the better the impacts are over time.

PEREI uses a randomised controlled design, which means that participants will be randomised by service location into one of two groups. Group 1 will be able to take part in the program immediately, and Group 2 will be on a waiting list to take part in the program after 12 months. This is so the research team can compare the effects of the program for those who take part immediately and those who do not. No one will miss out though as all participants will be able to access the programs over the two years that the project will be running.

Participation in the PEREI project is voluntary and confidential; in that no information about participants will be shared with services.

If you would like to know more or get involved, please contact the team at PEREI@flinders.edu.au or call us on (08) 8201 5978.

There is also a form at the bottom of this page where you can submit your details and the program you are interested in and the PEREI team will contact you.

Access our contact form

Who We Are - Flinders Research Team

Professor Reg Nixon

Professor Reg Nixon is the Chief Investigator for the PEREI project and has worked as a psychologist since 1998 and been involved in the research and treatment of posttrauma mental health problems with a focus on posttraumatic stress disorder (PTSD) for the past 20 years. He regularly provides training and supervision in evidence-based therapies for PTSD.

Dr Marja Elizabeth

Dr Marja Elizabeth is the Project Manager for the PEREI project and is a registered psychologist, a teacher and a lawyer and has a particular interest in working with first responders, military service personnel and veterans. She also provides training and supervision for clinicians working with PTSD and therapy for clients with PTSD.

PEREI has been designed in collaboration with co-investigators Professor Jennifer Wild who is affiliated with the University of Oxford and the University of Melbourne; Dr Dan Fassnacht from the College of Education, Psychology and Social Work at Flinders University and Joep van Agteren from the South Australian Health and Medical Research Institute (SAHMRI) Be Well Program.

PEREI Programs

First Responder Wellbeing and Resilience Program

The aim of this program is to further enhance your resilience for the kind of stress that is unique in your job and to teach you ways to deal with that stress so that it does not affect your mental or physical health in the future. The course is made up of seven modules released over seven weeks. Each of the modules takes about 20-40 minutes to complete, and includes information about a core concept, linked exercises, videos and key points. The strategies covered in each module are cutting edge, tried and tested, and aim to change the processes that have been shown to cause problems in the long run, as well as teaching practical skills we know strengthen resilience and good mental wellbeing, and which can help you bounce back after challenging situations.

When you start the course, you will also be assigned a Wellbeing Coach, who will be at hand to answer any questions. Your Wellbeing Coach will make suggestions to help you get the most out of the program, and you can get in touch with them for more information and help at any time throughout the online program, and for six months after you complete.

Who can participate?

This program is available to current members of the South Australian Country Fire Service, South Australian Metropolitan Fire Service and South Australia Police in their first five years of service.

If you are a first responder/member of an emergency service not listed above, please contact us for potential ways of participating at PEREI@flinders.edu.au or on (08) 8201 5978.

What will I learn in the program?

Strategies to address mental health issues commonly experienced by first responders, as well as strategies to help ‘bounce-back’ following exposure to traumatic events
How to deal with unwanted memories
Adaptive problem-solving and skills to manage organisational and operational stressors
Promotion of engagement in social and other meaningful behaviours known to foster good mental health and assist work-life balance

More about the program and structure

This program is based on the program, Protecting First Responders with Evidence-Based Interventions (P-FREI), at Oxford University in the United Kingdom and has been implemented with police, firefighters and paramedics in the UK and Singapore. It has been further refined based on feedback from current Australian emergency service employees and volunteers, to ensure the content is relevant to Australian first responders.

As this research uses a randomised controlled design, members will be randomised by service location to either take part in the program immediately, or after a 12-month period. This is so the research team can compare the longer-term effects of the program for those who complete and those who do not. All participants will be able to access the programs over the two-year period of the research project.

To evaluate program outcomes, there are some brief questionnaires about symptoms of anxiety, depression, PTSD, general wellbeing, and job stress to complete before, during and after the program and at follow-up time points.

If you would like to know more or get involved, please contact the team at PEREI@flinders.edu.au or call us on (08) 8201 5978.

Be Well Plan Wellbeing Program for Significant Others of First Responders

Living with or supporting a first responder can hold its own unique challenges, with the work also potentially impacting upon the wellbeing of partners, parents, family members, and close friends. These significant others of first responders will have access to a six week Be Well Plan delivered weekly, by trainers who have experience of or understanding of what it can be like for first responders and their families.

The aim of the Be Well Plan for significant others is to enable family members or friends to increase their own resilience and wellbeing, as well as learn strategies to assist in supporting the first responder in their lives, for example, to notice and respond to early signs of lower wellbeing, and to learn skills to minimise the impact on other family members including children.

The Be Well Plan is an evidence-based mental health wellbeing program which includes psychological and behavioural strategies that aim to improve mental states of wellbeing. Participants can identify wellness goals and choose from several strategies and skills to foster resilience and wellbeing.

The program is approximately two hours per session delivered either face to face or via video conference. Like the members program, significant others will have access to their own Wellbeing Coach who will provide support and information for a six-month period following the completion of the Be Well program.

Who can participate?

This program is available to significant supports (i.e., parents, partners, adult children, family members, close friends) of current members of the Country Fire Service, Metropolitan Fire Service and South Australia Police. There is no limitation on how many significant others of a serving member may take part, however in order for a significant other to be eligible, the first responder must be taking part or have taken part in the PEREI First Responder Wellbeing and Resilience Program for members.

What will I learn in the program?

Setting and prioritising goals
Focusing on targets and skills most relevant for themselves
Strategies to put these into practice
Healthy habits
Impacts of living with and/or supporting a first responder

More about the program and structure

The Be Well Plan was developed by Be Well Co which is linked to the South Australian Health and Medical Research Institute (SAHMRI). The Be Well Plan has been further refined to include content and strategies tailored to individuals living with and/or supporting a first responder (e.g., their role in the member’s life and managing their own reactions to diverse occupational stressors experienced by the first responder).

As this research uses a randomised controlled design, first responder participants will be randomised by service location to either take part in the program immediately, or after a 12-month period. This is so the research team can compare the effects of the program for those who complete and those who do not. A significant other is able to participate immediately if their first responder is able to participate immediately. Otherwise, significant others will be able to access the Be Well Plan after a period of 12-months when the first responder is participating in the members program. All participants will be able to participate over the two-year period of the research project.

To evaluate program outcomes, there are some brief questionnaires about symptoms of anxiety, depression, PTSD, general wellbeing, and job stress to complete before, during and after the program and at follow-up times points.

If you would like to know more or get involved, please contact the team at PEREI@flinders.edu.au or call us on (08) 8201 5978.

Supervisor Program

Supervisors have a very important role in reducing the impact of traumatic stress, as well as identifying issues in their members and providing early intervention and support.

PEREI will be offering training for supervisors to better equip them with skills to support members around wellbeing and mental health; to ensure the ongoing promotion of a culture that reduces stigma and encourages help-seeking; and to address organisational and operational factors that influence first responder’s mental health. This training will be conducted through four 1-hour seminars, offered face to face or via video conference by trainers who are experienced in working with first responders.

Who can participate?

This program is available to supervisors of current members of the South Australian Country Fire Service, the South Australian Metropolitan Fire Service and South Australia Police.

In addition, supervisors can access the First Responder Wellbeing and Resilience program.

What does this training involve?

Education about common mental health conditions in first responders
Identifying and reducing stigma and promoting help-seeking behaviour
Communicating about mental health and supporting yourself and members
Understanding the importance of organisational and operational factors, and the role of positive working relationships, in the support of mental health in the workplace

More about the program and structure

These seminars target known factors of supervisor-member relationships associated with first responders’ wellbeing and build on existing research that shows good outcomes from such training. For example, research has associated supervisor training with reduced sick leave in fire and rescue members and behaviour changes by supervisors associated with members’ wellbeing including improved responsiveness to a member who might be suffering mental health challenges and proactive behaviours that can reduce the risk of poor mental health.

As this research uses a randomised controlled design, supervisors will be randomised by service location to either take part in the program immediately, or after a 12-month period. This is so the research team can compare the effects of the program for those who complete and those who do not. All supervisors will be able to access the program over the two-year period of the research project.

To evaluate program outcomes, there are some brief questionnaires about symptoms of anxiety, depression, PTSD, general wellbeing, and job stress to complete before, during and after the program and at follow-up times points.

If you would like to know more or get involved, please contact the team at PEREI@flinders.edu.au or call us on (08) 8201 5978.

Partnerships

PEREI is a partnership between Flinders University and the South Australian Country Fire Service, South Australian Metropolitan Fire Service and South Australia Police.

PEREI is funded by the Movember Foundation, the Breakthrough Mental Health Research Foundation and the Flinders University College of Education, Psychology and Social Work.

Resources and Information

Below are some helpful online resources and information for first responders and their significant others:

Flinders University Posttraumatic Stress Clinic offers evidence-based treatment for PTSD in the context of research trials and clinician education and training for Cognitive Processing Therapy.
Phoenix Australia's Response Assist program helps emergency services workers improve their mental health and recover from trauma.
MESHA aims to improve the health and wellbeing of current and former military and emergency service personnel and their families.
FORTEM supports first responders and their families through wellbeing programs, clinical support and employment support.
First Responder Centre for Excellence provides information and resources related to the health and wellbeing of first responders.
Beyond Blue provides information and support for anxiety, depression and suicide prevention.
Mind provides support and advice for people experiencing mental health difficulties.
Be Well Co is a research centre designed to promote resilience and wellbeing through its Be Well Plan and online wellbeing tools.