Researchers from the University of Surrey, University of Dundee, Anglia Ruskin University and Kingston University/St George’s, University of London investigated areas that impacted on the psychological health of call handlers who make critical decisions in assessing what type of emergency response is required.

Examining 16 studies from across the world, researchers identified key factors which cause operatives stress and potentially impact on their psychological health.

Exposure to traumatic and abusive calls was found to negatively affect call handlers, because although they are not physically exposed to emergency situations, evidence demonstrated that they experienced trauma vicariously.

In one study, participants reported experiencing fear, helplessness or horror in reaction to 32 per cent of the different types of calls that they received.

A key stressor for call handlers was a lack of control over their workload due to the unpredictability of calls and a lack of organisational recognition of the demands of managing their assignments.

One study reported that ambulance call handlers felt out of control of their workload after returning from rest breaks, which led them not taking scheduled breaks, leading to exhaustion.

A lack of high quality training in dealing with pressurised calls was identified by some handlers as contributing to stress levels, with police call handlers in one study showing concern about their performance in handling fluid situations such as robberies in progress or suicidal callers, in case they did not make the correct decisions.

Co-author of the paper Mark Cropley, Professor in Health Psychology at the University of Surrey, said: “Call handlers across different emergency services consistently reported their job as highly stressful, which in turn affects their psychological health. This undoubtedly impacts on their overall wellbeing, leading to increased sickness and time away from work, putting additional strain on the service and their colleagues.

“Although handlers are not experiencing trauma first-hand the stress that they experience when responding to such calls should not be overlooked.”

Co-author Professor Patricia Schofield, of Anglia Ruskin University, said: “Call handlers are the front line of emergency care but are often overlooked when it comes to studies about stress affecting the police, fire and ambulance services. This study finds evidence that staff are at risk of burnout, due to high workload, inadequate training and a lack of control.

“It’s important that these staff are considered and interventions made to ensure that they can cope with their workload – these people make vital decisions which affect lives.”

Co-author Professor Tom Quinn from Kingston University & St George’s, University of London, said: “Most people probably don’t recognise the stressful conditions under which emergency call centre staff work. Now that we have explored and summarised the evidence to identify the challenges these important staff face, we plan to develop and test interventions to reduce the burden on them and improve their wellbeing”