Psychological effects of disaster response on emergency medical services workers

Abstract Emergency Medical Services (EMS) personnel frequently operate in high-stress environments, particularly during disaster deployments, placing them at heightened risk of psychological distress. Evidence describing symptom burden, coping behaviours, and the utilisation of organisational support among EMS workers in the Middle East remains limited. This cross-sectional study surveyed 294 EMS personnel in the Makkah region of Saudi Arabia. A structured questionnaire assessed psychological symptoms (anxiety, depression, PTSD-related distress, emotional exhaustion, sleep and appetite disturbances), coping strategies, and organisational support. Symptom prevalence percentages reflect the proportion of participants endorsing “agree” or “strongly agree” on the corresponding items. Analyses included descriptive statistics, bivariate tests with False Discovery Rate (FDR) correction, and multivariable regression models adjusting for demographic, occupational, and exposure-related variables. A considerable proportion of participants reported psychological symptoms following disaster deployments, including anxiety (26%), depression (22%), emotional exhaustion (25%), sleep disturbances (26%), and appetite changes (28%). Access to counselling (p = 0.008) and medication (p = 0.003) was associated with lower symptom scores, whereas general well-being programmes showed weaker associations (p = 0.026). Coping strategies such as physical activity and peer support were inconsistently utilised. Awareness and uptake of organisational mental-health resources were low, and no significant differences in coping or support utilisation were observed across demographic or occupational groups. EMS workers in the Makkah region experience substantial psychological burden during disaster response, compounded by limited engagement in coping strategies and low utilisation of organisational support services. The findings highlight the need for accessible, context-appropriate mental health interventions embedded within routine EMS operations.