What is the problem?
Firefighters are at risk of post-traumatic stress disorder (PTSD). Websites can be an important way to get information about PTSD online. This project evaluated websites on PTSD that firefighters might access to support their mental health.
How did the team study the problem?
We did 4 Google.ca (Google Canada) searches in July 2019 using the terms: ‘firefighter PTSD’, ‘firefighter operational stress’, ‘PTSD symptoms’, and ‘PTSD treatment’. We used tools to assess each website’s quality (DISCERN) and readability (Flesch–Kincaid Grade Level, Flesch reading ease, Simple Measure of Gobbledygook). We recorded the type of information about PTSD on each website. We checked whether websites mentioned if the PTSD treatments had good research evidence, inconclusive evidence, or lack good research evidence.
What did the team find?
We found 75 PTSD websites. None of the websites or treatments discussed were designed just for firefighters. On average, the websites were rated as “fair quality”, and “fairly difficult to read”. The PTSD treatments recommended were not the same as the 10 statements taken from the best research evidence. Some treatments with research support—like exposure therapies or eye movement desensitization and reprocessing—were rarely talked about. Some treatments with research support—like cognitive behavioral therapy—were mentioned. Some treatments where the research support is missing or inconclusive—like medication, non-trauma therapies, and peer support—were discussed as being helpful.
The 10 best PTSD websites are:
1. National Institute of Mental Health (NIMH) – Post-Traumatic Stress Disorder
2. Healthcare British Columbia (BC) – Deciding to Get Treatment for PTSD
3. Phoenix Australia – Australian National Centre for Excellence in Posttraumatic Mental Health
4. U.S. Department of Veterans Affairs – PTSD Treatment
5. U.S. Department of Veterans Affairs | PTSD: National Center for PTSD – PTSD Treatment Basics
6. Everyday Health – What Are the Best Treatments and Therapies for PTSD?
7. Veterans Affairs Canada – Post-traumatic stress disorder (PTSD) and war-related stress
8. Wake Forest University (WFU) – The Critical Role of Counseling for PTSD Treatment
9. Mayo Clinic – Post-traumatic stress disorder
10. Fire Engineering – I’m a Firefighter with PTSD…Now What?
How can this research be used?
Firefighters can use our website list as a starting point for information on PTSD but should be careful as not all the content is based on the best research. Future websites should make it clear what treatments are based on current research and be made easier to read.
We did not evaluate all websites. We did not evaluate social media like Facebook or Twitter, fire department or firefighter association websites that require a password. We used specific search terms so websites with a broad focus on mental health did not show up in our Google search results. However, we can be sure there are problems with the PTSD websites we studied.
Reference: Killip SC, Kwong NKR, MacDermid JC, Fletcher AJ, Carleton RN. The Quality, Readability, Completeness, and Accuracy of PTSD Websites for Firefighters. Int J Environ Res Public Health. 2020, 17, 762
Funding Sources: CIHR FRN: PPS-162539. NKR Kwong was supported by a Hamilton Health Sciences High School Health Research Bursary Award. JC MacDermid was supported by a CIHR Chair in Gender, Work and Health and the Dr. James Roth Research Chair in Musculoskeletal Measurement and Knowledge Translation.