Games for health & mHealth apps for police & blue light personnel: A research review
| Author | Robin Hadley,Hannah R. Marston,Graham Pike,Ian Hesketh |
| Published date | 01 September 2021 |
| DOI | 10.1177/0032258X20937327 |
| Date | 01 September 2021 |
| Subject Matter | Articles |
2021, Vol. 94(3) 372 –387
Article
Games for health
& mHealth apps for police
& blue light personnel:
A research review
Hannah R. Marston
Health and Wellbeing Priority Research Area, School of Health,
Wellbeing and Social Care, The Open University, Walton Hall, Milton
Keynes, UK
Robin Hadley
Independent Researcher, Manchester, UK
Graham Pike
School of Psychology & Counselling, Faculty of Arts and Social Sciences,
The Open University, Walton Hall, Milton Keynes, UK
Ian Hesketh
SRO–National Police Wellbeing Service, College of Policing; Faculty of
Business and Law, The Open University, Walton Hall, Milton Keynes, UK
Abstract
Previous research has reported adverse health outcomes for emergency services per-
sonnel (ESP), outcomes that research more broadly has shown can be improved using a
gamification and mobile health (mhealth) apps approach. We conducted a review of
research on gamification and mhealth apps for ESP that had been published in the last 19
years using 6 major research databases. The results demonstrated that virtually no
relevant research has been published, suggesting a significant gap in the evidence base of
an approach that could potentially have significant benefits for the health of ESP.
Corresponding author:
Hannah R. Marston, Health and Wellbeing Strategic Research Area, School of Health, Wellbeing and Social
Care, Stuart Hall Building, Ground Floor, The Open University, Walton Hall, Milton Keynes, Buckinghamshire
MK7 6AA, UK.
Emails: Hannah.Marston@open.ac.uk; marstonhannah@hotmail.com
The Police Journal:
Theory, Practice and Principles
ªThe Author(s) 2020
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DOI: 10.1177/0032258X20937327
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Marston et al. 373
Keywords
Health and well-being, resilience, first-line responders, PTSD
Introduction
There is an ever-growing body of research ev idence that demonstrates the negative
health and well-being of emergency services personnel (ESP) and that suggests that
health outcomes for ESP are worse than that of the general population (Arble and Arnetz,
2017; Brooks et al., 2019; Counson et al., 2019; Mildenhall, 2019; Varker et al., 2018).
Recently it has become clear that ESPs may experience disproportionate negative out-
comes through specific situations, as well as more general working, for example see
Mildenhall (2020)’s guidance in the area of psychosocial and mental well-being target-
ing managers of ambulance personnel during the COVID-19 pandemic and Hesketh
et al. (2018) for guidance associated to post-traumatic stress disorder (PTSD) and com-
plex PTSD for police officers in the UK.
Although ‘emergency services’ covers a wide range of agencies, there are important
commonalities in terms of the highly demanding nature of the work involved (Pen
˜alba
et al., 2008), including exposure to significant psychological (Duran et al., 2018;
Milligan-Saville et al., 2018; Petrie et al., 2018) and job-related (Stanley et al., 2016)
stressors. These stressors inevitably and understandably result in significant negative
health outcomes, including depression (Wild et al., 2018) and PTSD (Ahmed et al.,
2017), which can lead to an increased risk of alcohol use (Gulliver et al., 2018) and
suicidal ideation and behaviours (Milligan-Saville et al., 2018).
The key question of whether the incidence of these negative health outcomes is higher
than in the broader population has been explored through largescale surveys of the health
of ESP. This has included a 2019 survey of 5,081 ESP (staff and volunteers) conducted
by the UK charity MIND (Mind, 2019), which revealed that 67%of respondents reported
they had lived experience of mental health problems (a rise from 55%in 2015), more
than double that of the workforce in general. Moreover, the survey revealed ESP were
less likely to take time off work as a result of mental health issues than the general
workforce. Hesketh, Cooper and Ivy (2014) also noted this issue, describing how it can
lead to ‘leaveism’, whereby policing personnel were found to hide health problems by
using annual and other leave, rather than sick leave. More recently, an online survey of
16,857 serving UK police officers and staff in 2018 conducted by the University of
Cambridge and sponsored by Police Care UK (Miller, 2018) found that 90%of respon-
dents reported being exposed to trauma (98%of which was work related). Worryingly,
analysis suggested that of the officers/staff who had experienced trauma, about 20%
would be diagnosable as suffering from PTSD (8%) or complex PTSD (12%) yet only
5%will have been told someone and only 1 or 2%clinically diagnosed.
Although PTSD in ESPs has been the subject of research, estimations of incidence
have varied greatly and it is not clear how this varies across the various services. For
example, one review (Skogstad et al., 2013) reported that PTSD in the police is less than
10%, whereas 20%of paramedics and firefighters are thought to have PTSD. However,
Miller (2018) suggests symptoms of PTSD and Complex PTSD are present in as many as
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