First responders are at high risk of posttraumatic stress disorder (PTSD), yet little research has examined PTSD prevalence within this population after individuals retire or resign from service. The current study is the first systematic review and meta-analysis aiming to describe the evidence available on point and lifetime PTSD prevalence among former first responders, estimate pooled PTSD prevalence, and examine differences between subgroups. Searches were conducted across the PsycInfo, Web of Science, Embase, PubMed, and Google Scholar databases in November 2025. Peer reviewed observational studies were included. Separate random effects meta-analyses were run on point PTSD prevalence among studies assessing PTSD related to any (general) exposures and PTSD related to single disasters. A total of 10 studies (12 unique samples) were included in the analyses. Studies were exclusively conducted within high-income, English-speaking countries among nonvolunteer former first responders and predominantly focused on firefighter and police samples. A pooled point PTSD prevalence of 15.4% was found among eight general exposure studies, and a pooled prevalence of 11.8% was found among two single-disaster exposure studies. No subgroup differences were significant, although these analyses were constrained by the restricted pool of available studies. Insufficient data were obtained to examine lifetime PTSD prevalence. The limited attention this population has received in the literature does not reflect their high level of need. Former first responders constitute a high priority for further research and mental health intervention, particularly given their loss of access to systems, services, and social support available to them through their prior roles.
Arena et al. (Wed,) studied this question.