Mental Health Safety Challenges Among Pre-Hospital Emergency Medical Service Providers: A Scoping Review.

OCCUPATIONAL APPLICATIONSIn this scoping review, we identified considerable mental health challenges among pre-hospital emergency medical service (EMS) providers, including post-traumatic stress disorder (PTSD) burnout, depression, anxiety, suicidality, and occupational stress. Among the 61 studies we analyzed, sleep disorders emerged as the most prominent contributing factor, frequently associated with PTSD, depression, generalized anxiety, and other poor mental health conditions. Other key risk factors included high workload, years of service, exposure to violence, and insufficient peer or social support. The cumulative toll of chronic stress was evident in increased prevalence rates of mental health disorders and burnout. Organizational and individual factors, such as emotional regulation, fatigue management, and availability of peer support, further shaped these outcomes. These findings emphasize the need for targeted interventions that address the root causes of mental health disorders and occupational stressors in EMS work environments.