Mental health of first responders in rural Australia

Australian rural first responders often experience significant mental health effects because of responding to traumatic emergency situations in the pre-hospital setting. Rural first responders may have different experiences and require different mental health interventions than their metropolitan counterparts.

This project used an iterative Delphi study to explore key issues related to mental health for rural first responders and describe how the experience can be overcome or alleviated.

Project summary

First responders, such as police and paramedics, routinely face traumatic and violent situations, contributing to elevated rates of anxiety, depression, and PTSD. Their stress has been intensified by recent crises including natural disasters and pandemics. Rural first responders often encounter unique mental health challenges and may receive different support compared to those in urban areas.

To investigate these disparities, an iterative Delphi study was conducted. Researchers gathered statements from existing literature that highlighted the mental health impacts of trauma on rural Australian first responders, as well as strategies for mitigation. These statements were reviewed by an Advisory Group before being distributed via survey to rural first responders. Further data was collected through interviews and focus groups that built on the results of the initial survey.

The Advisory Group consisted of two expert panels: rural first responders and Australian health professionals experienced in trauma-related intervention. Their insights were used to identify key mental health concerns, propose support strategies, and inform the development of guidelines for government and health agencies. This study generated previously unavailable data, providing a foundation for targeted initiatives to improve rural first responders’ mental wellbeing.

Project details

Project period
1 March 2024 to 1 March 2026

Project funding
$340,000 Medical Research Future Funds (MRFF Early to Mid-Career Researchers)

Field of Research
Mental health services (420313)
Paramedicine (320219)
Workplace wellbeing and quality of working life (350507)

Project objectives

Aims

To identify key issues and initiatives/strategies for first responder mental health, to explore resilience skills to overcome or manage mental health issues for first responders in rural Australia and develop a questionnaire and guidelines that can be used by health clinicians and health care services to deliver mental health care to first responders in rural areas of Australia.

Research question 1: What are the key mental health issues for first responders working in rural Australia?

Research question 2: How is the mental health and resilience of first responders affected by rurality?

Research question 3: What initiatives/strategies or resilience skills can be used to help first responders in rural Australia respond to and better manage their mental health?

Conclusion

The findings of this project identified three key themes: (1) Rural practice involves unique workplace and community challenges that impact mental health, (2) Unique barriers with rural mental health services hinder mental health support and (3) Effective mental health support requires greater cultural sensitivity to rural contexts.

Informed by these findings, recommendations have been developed to support health clinicians, health services and first responder organisations in strengthening mental health support for rural first responders. By improving the evidence base and providing practical guidance for clinicians and services, the project is expected to contribute to more effective mental health care, improved workforce wellbeing and resilience, and better health outcomes for rural first responders and the communities they serve.

Project partners

  • University of New England (UNE) – Lead institution
  • Black Dog Institute
    University of Sydney
  • Griffith
  • University of New South Wales

Our research team

Chief investigator/ Research lead

Professor Rikki Jones

University of New England

Research team

Clare Sutton

Charles Sturt University

Dr Lisa Clegg

Charles Sturt University

Aimee Gayed

Black Dog Institute

Dr Andrew Arena

Black Dog Institute

Dr Kylie Rice

University of New England

Associate investigators

Mentors

Professor Kim Usher

Charles Sturt University

Professor Debra Jackson

University of Sydney

Dr Jamie Ranse

Griffith University

Advisors

Dr Mark Deady

University of New South Wales

Associate Professor Larissa Bamberry

Charles Sturt University

Dr Horas Tze Hoo Wong

University of Sydney

In the media

Hero to zero: Emergency service workers’ heavy burden

New England Times
23 September 2026

Read now

Poor mental health threatens rural emergency workforce

The Senior
16 February 2024

Read now

Publications

Jones, R., Rice, K., Jackson, D., Usher, K., Ranse, J., Gayed, A., Sutton, C., Clegg, L. & Arena, A. (2026). Mental Health of First Responders in Rural Australia: A Qualitative Exploration of Intersecting Individual, Organisational and Contextual Factors on Psychological Wellbeing, International Journal of Mental Health Nursing, https://doi.org/10.1111/inm.70349

Jones, R., Jackson, D., Ranse, J., Arena, A., Clegg, L., Sutton, C., Gayed, A., Rice, K. & Usher, K. (2024). A Scoping Review of Trauma, Mental Health and First Responders in Australia, International Journal of Mental Health Nursing; 0: 1-23 http://doi.org/10.1111/inm.13397

Jones, R., Ranse, J., Rice, K., Usher, K., Jackson, D., Sutton, C., Kabir, H., Gayed, A., Wong, H., Clegg, L. & Arena, A. (2025). Rural contexts: Digital interventions and strategies for first responders' mental health, International Journal of Mental Health Nursing, http://dx.doi.org/10.1111/inm.70046