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The purpose of this study is to explore mental health difficulties, including risk and protective factors, which may impact on symptom severity after exposure to crisis situations (war, terrorism and/or natural disasters), among first responders from uniformed services.

Peer-reviewed journal articles published in English between January 2012 and March 2022 were searched in ProQuest, Wiley, Google Scholar and PubMed databases. In total, 12 articles were obtained from an original screening of 94,058 articles. Full article texts were screened for content and quality by two reviewers, with high agreeability.

Post-traumatic stress disorder and depression were the most common diagnoses. Risk factors identified were pre-deployment factors of overweight, low cognitive ability and social support, existing emotional difficulties, negative childhood experiences and stressful life events; during crisis situations factors of higher frequency and subjective severity of combat, increased rates of combat stress reaction, high levels of concerns for life and family, more stressful mission position, threat of death/severe injury and high rate of killing the enemy; and post-deployment factors, such as low social support and physical health, lack of coping mechanisms and use of avoidance strategies and social stigma. Protective factors increasing resilience and lessening symptom severity were reported as pre-deployment cognitive ability, high social support, stable physical health, effective coping, post-traumatic growth and high levels of perceived adequacy in pre-deployment preparation and training. In addition to main findings, data about author(s), publication type, population, age, type of crisis and evaluation measures were extracted. Key findings and related theories, gaps in literature and recommendations are discussed.

As yet, however, research into the factors that could serve as risk and/or protective factors are not clearly indicated in terms of post-crisis recovery. As per the authors’ knowledge, this study is an initial approach to considering this area.