Disaster Medicine and Public Health Preparedness

Original Research

Mental Health of Protective Services Workers: Results From the National Epidemiologic Survey on Alcohol and Related Conditions

Christopher N. Kaufmann, Lainie Rutkow, Adam P. Spira and Ramin Mojtabai c1


Objectives To determine the prevalence of mental disorders in a nationally representative sample of protective services workers (PSWs), compare it to that of adults in other occupations, and determine if an association exists between trauma exposure and 3-year incident psychiatric disorders in PSWs.

Methods Data from the longitudinal US National Epidemiologic Survey on Alcohol and Related Conditions waves 1 (fielded 2001-2002) and 2 (fielded 2004-2005) were used to compare the prevalence of mental disorders at baseline in a representative sample of PSWs to that of adults in other occupations. Among PSWs, we also explored the association between recent exposure to potentially traumatic events and the development of mood, anxiety, and alcohol-use disorders over a 3-year follow-up period.

Results At baseline, PSWs had a lifetime prevalence of mental and alcohol-use disorders similar to that of adults in other occupations. However, PSWs experienced a greater variety of potentially traumatic events between baseline and follow-up. Exposure to a greater number of different trauma types was associated with increased odds of incident mood (adjusted odds ratio [AOR] = 1.87, 95% CI = 1.09-3.22, P = .024), and alcohol-use disorders (AOR = 1.84, 95% CI = 1.16-2.91, P = .011). These associations were particularly strong among early career PSWs who joined the profession between waves 1 and 2 (AOR = 2.30, 95% CI = 1.26-4.19, P = .008, for mood disorders; AOR = 2.44, 95% CI = 1.30-4.58, P = .007, for alcohol-use disorders).

Conclusions While PSWs do not appear to have a higher prevalence of mental health problems than workers in other occupations, they are more likely to experience multiple types of potentially traumatic events. PSWs who are exposed to multiple types of potentially traumatic events are at increased risk of developing new mental disorders, particularly in the early stages of their careers. Developing curricula in coping skills and providing timely interventions for early career PSWs may help reduce future psychiatric morbidity in these workers. (Disaster Med Public Health Preparedness. 2013;7:36-45)

(Received August 29 2011)

(Accepted July 18 2012)

Key Words

  • protective services workers;
  • prevalence;
  • mental disorders;
  • depression;
  • anxiety;
  • alcohol-use disorders


c1 Address correspondence and reprint requests to Ramin Mojtabai, MD, PhD, MPH, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Hampton House Room 797, Baltimore, MD 21205 (e-mail rmojtaba@jhsph.edu).