Overdose and overwork: First responder burnout and mental health help-seeking in Missouri's overdose crisis.

As the overdose crisis continues to spiral, high volume and intensity of drug poisoning calls are impacting first responders' mental health. This study examined burnout and attitudes towards mental health help-seeking among first responders in Missouri. The study included 3059 participants, of which 76.4 % were law enforcement officers (LEO) and 23.6 % were emergency medical services personnel/firefighters (EMS/FF). Participants mainly comprised of men (80 %), and a majority had witnessed an overdose fatality (53 %). A descriptive analysis and Structured Equation Model (SEM) of field experience, mental health help-seeking, and burnout indicate that [1] emotional exhaustion and depersonalization levels were higher among LEO than EMS/FF (β= 0.25 and β = 0.28, respectively, p < .001), [2] EMS/FF had higher personal accomplishment scores than LEO (β = -0.10, p = .046), [3] higher levels of depersonalization and emotional exhaustion were associated with lower levels of mental health help-seeking (β = 0.27 and β = 0.50, respectively, p < .001), [4] higher levels of personal accomplishment was associated with higher levels of mental health help-seeking (β = -0.37, p < .001), and 5) there was lower burnout among EMS/FF than LEO. This study highlights important differences in burnout within and across first responder professions. Additionally, this study sets the foundation for targeted research to focus on how burnout manifests itself within these individuals, how it affects their work, and how work environments are impacted. Moving forward, research and practice should prioritize exploring how mental-health help seeking influences burnout.