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22 August 2025
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A systematic review identifies the reasons why ambulance employees do not seek support at work for their mental health
Emergency medical service (EMS) personnel routinely face high-stress, emotionally intense situations that can impact their mental health, and yet, many ambulance staff do not seek help. A recent systematic review identifies practical ways to improve access to mental health resources.
The review synthesises findings from 34 studies, highlighting key barriers to support uptake. Workplace stigma, particularly a culture that values resilience and self-reliance, often deters individuals from acknowledging their struggles. This issue is further reinforced by machismo within the profession, where toughness and emotional suppression are seen as markers of competence. Organisational efforts to provide mental health resources can also be perceived as performative rather than genuinely beneficial, reducing staff trust in such initiatives. Additionally, generic support programmes may fail to meet the specific needs of ambulance personnel, contributing to low engagement.
Despite these challenges, the review identifies effective enablers that encourage EMS workers to seek help. Tailoring mental health initiatives to the unique pressures of emergency response roles increases their relevance and uptake. Education and training programmes that normalise discussions around mental wellbeing help dismantle stigma and challenge outdated attitudes about masculinity and vulnerability. Crucially, allowing ambulance staff dedicated time during work hours to access support could improve engagement, demonstrating the importance of embedding mental health initiatives into operational structures.
This study is the first of four within Sasha Johnston’s NIHR funded DPhil in Experimental Psychology, supported by Professors Jennifer Wild and Polly Waite at the University of Oxford. The wider research programme will explore the feasibility of implementing protected time in ambulance work schedules to support mental health and wellbeing. By addressing both systemic and cultural barriers, these studies aim to establish more accessible and effective pathways for EMS personnel to prioritise psychological wellbeing.
Source: University of Oxford
The review synthesises findings from 34 studies, highlighting key barriers to support uptake. Workplace stigma, particularly a culture that values resilience and self-reliance, often deters individuals from acknowledging their struggles. This issue is further reinforced by machismo within the profession, where toughness and emotional suppression are seen as markers of competence. Organisational efforts to provide mental health resources can also be perceived as performative rather than genuinely beneficial, reducing staff trust in such initiatives. Additionally, generic support programmes may fail to meet the specific needs of ambulance personnel, contributing to low engagement.
Despite these challenges, the review identifies effective enablers that encourage EMS workers to seek help. Tailoring mental health initiatives to the unique pressures of emergency response roles increases their relevance and uptake. Education and training programmes that normalise discussions around mental wellbeing help dismantle stigma and challenge outdated attitudes about masculinity and vulnerability. Crucially, allowing ambulance staff dedicated time during work hours to access support could improve engagement, demonstrating the importance of embedding mental health initiatives into operational structures.
This study is the first of four within Sasha Johnston’s NIHR funded DPhil in Experimental Psychology, supported by Professors Jennifer Wild and Polly Waite at the University of Oxford. The wider research programme will explore the feasibility of implementing protected time in ambulance work schedules to support mental health and wellbeing. By addressing both systemic and cultural barriers, these studies aim to establish more accessible and effective pathways for EMS personnel to prioritise psychological wellbeing.
Source: University of Oxford