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Emergency medical services in the United States currently rely primarily on audio calls and location data to respond to emergencies. With the increasing use of other means of communication such as text messages and video calls, however, communications centers are moving towards incorporating Next-Generation 911 (NG911) technology that allows callers to share texts, photos, and video with communications personnel. This enhanced medium of communication has potential advantages and disadvantages, just as the expansion of other media platforms have increased accessibility to information while also potentially increasing psychological distress related to these events (see previous Media Matters in StressPoints for review: Massa & Jones, 2020).

Although the rollout of NG911 technology is in planning phases (NENA: The 9-1-1 Association, 2018), agencies in select states, including most recently Louisiana, have tested systems incorporating this technology (Gunderson, 2019; Ickes, 2020; Nethers, 2020; Williams, 2020). These systems allow communications personnel to send a caller’s cellphone a one-time link to activate a livestream that can be shared with responding agencies and saved to a secure database (Ickes, 2020; Williams, 2020). Location accuracy is also improved, with some systems able to identify a caller location that is accurate within five meters (Nethers, 2020).

First responders’ initial reactions to the sharing of video between callers and communications personnel have been largely positive. Many have noted the potential to acquire more detailed and accurate information. Video calls may allow communications personnel to rapidly collect environmental, medical and situational details of a scene such as the number of patients involved or the color of a fire’s smoke (Neustaedter et al., 2018; Neustaedter et al., 2019; Seeman et al., 2015). Such details may not be collected via audio calls if a caller does not notice or know how to describe them, or if the caller is distressed, unconscious or otherwise unable to communicate (Neustaedter et al., 2018). Furthermore, it is possible that allowing communications personnel to connect with callers via video could help them to build rapport, which can be critical on emergency calls. First responders have also noted that information from video calls could help them to more effectively and efficiently allocate resources and prepare responders prior to arriving at a scene (Ickes, 2020; Neustaedter et al., 2019). Additionally, it is possible that viewing a scene may help reduce stress experienced from hearing details of or responding to potentially traumatic events. Some communications personnel have noted that it would be preferable to see a scene rather than imagine it as they listen to it play out via phone (Neustaedter et al., 2018). Similarly, firefighters have indicated the possible utility of using visuals from communications personnel to psychologically prepare themselves for a scene while driving to it (Neustaedter et al., 2019).

Although first responders have suggested that viewing video from callers may help alleviate or better prepare them to experience operational stress, little research to date has evaluated the effects of NG911 technology on first responders’ mental health. Three qualitative studies of first responders’ perspectives on NG911 technology have demonstrated that first responders express significant concerns about seeing disturbing images without warning and potentially developing posttraumatic stress disorder (PTSD; Grace & Kropczynski, 2020; Neustaedter et al., 2018; Neustaedter et al., 2019). Given that rates of PTSD are higher among first responders than the general population (Kleim & Westphal, 2011; Petrie et al., 2018), it will be critical to examine whether exposure to caller video impacts the development or the severity of PTSD symptoms in different types of first responders. The Association of Public-Safety Communications Officials (APCO) recognizes this potential stressor and lists “[processing] incoming photos/video that may contain graphic details” as a core competency (APCO, 2018), but individual agencies are responsible for determining the appropriate trainings and mental health supports. It is therefore important that agencies assess their members’ needs and tailor mental health services accordingly as the use of NG911 technology expands. Existing services such as peer support programs or Psychological First Aid may be helpful (Marks et al., 2017; Feuer, 2021), though additional research and program evaluations of agencies that incorporate NG911 technology will better inform ways to continue supporting first responder mental health.

About the Authors

Victoria Steigerwald is a clinical psychology doctoral student at the University of Central Florida. She is currently part of UCF RESTORES, a treatment clinic and clinical research center serving individuals with PTSD. Her research focuses on identifying ways to improve the effectiveness of PTSD treatments and to integrate mental health services into the work and culture of first responders and military personnel.
David Rozek, PhD, is an assistant professor at UCF RESTORES and the Department of Psychology at the University of Central Florida. Dr. Rozek’s research examines cognitive and behavioral interventions for posttraumatic stress disorder (PTSD), suicidal thoughts and behaviors, and depression. He works primarily with military members and first responders and uses a multimethod approach, including randomized controlled trials, laboratory experiments and observational studies. He regularly provides training to clinicians and medical professionals about managing suicidal patients and is an active researcher focusing on how to best improve clinical care.


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