Critical Connections: The Front Lines of Supporting EMS Clinician Mental Health

Emergency Medical Services (EMS) clinicians are often hailed as heroes, delivering life-saving care in the most challenging and unpredictable circumstances. Yet, the demands of the job come with a heavy toll. Enzo Plaitano, a licensed paramedic and third-year PhD candidate in the Center for Technology and Behavioral Health (CTBH) at Dartmouth College, is on a mission to address the unique and difficult challenges faced by EMS clinicians. Through innovative research and lived experience, Enzo is working to create tools and strategies that support the mental health and well-being of his peers. 

For Enzo, this mission is deeply personal. “I routinely experience how this tough profession impacts our stress and mental health, but I also recognize how extremely rewarding it is to play a part in people’s individual life-changing moments,” he says. “However, I’ve seen the stress of this job contribute to serious mental health and substance use ramifications in my coworkers which can really affect their entire lives.” These experiences inspired Enzo to pursue his line of research aimed at understanding and eventually improving coping strategies and health risk behaviors in EMS clinicians.  

Enzo and his mentors at Dartmouth College were recently awarded a prestigious National Research Fellowship Award (1F31DA062393-01) from the National Institute on Drug Abuse (NIDA), one of the key institutes at the National Institutes of Health (NIH). This NIH fellowship provides Enzo with expanded access to an interdisciplinary team of experts at the National Registry of EMTs and the National Center for PTSD to support his structured research training. It also gives Enzo the opportunity to lead his own study. 

With funding from the NIH, Enzo’s research focuses on understanding the relationships between stress, emotion-regulation, and health risk behaviors in the daily lives of EMS clinicians. In collaboration with researchers at the National Registry of EMTs, Enzo’s longitudinal study recruited 110 full-time EMS clinicians from across the country. Over the course of an entire month, participants completed brief surveys five times per day to understand relationships between real-time changes in stress, emotion-regulation, and health-risk behaviors. This cutting-edge approach, known as ecological momentary assessments, offered a unique window into the challenges faced by EMS professionals. 

Dr. Ashish Panchal, Research and Fellowship Director at the National Registry of EMTs, is a mentor on Enzo’s study and NIH-funded Research Fellowship Training Award. Dr. Panchal emphasizes the importance of this research for the entire EMS community. “Enzo’s work is groundbreaking,” says Dr. Panchal. “By examining how changes in stress and emotion-regulation impact health-risk behaviors before, during, and after an EMS shift, we can use this data to develop future tools that provide real-time support and promote healthier coping strategies for EMS clinicians in this high-stress career.” 



Enzo’s ultimate goal is to design a data-informed digital health application tailored to EMS clinicians. This app would offer real-time resources to help manage stress as it occurs, improving emotion-regulation and reducing health risk behaviors. “Stress is inevitable in our high-risk profession,” Enzo explains. “My overall goal is to give EMS clinicians tools to navigate those moments and improve their ability to cope effectively.” 

This work builds on Enzo’s decade-long experience in EMS, currently as a nationally registered paramedic, and his passion for advancing the overall health of his peers. This EMS journey began at the age of 16 years old when he was encouraged to complete a local EMT course during highschool. Currently, Enzo still runs calls as a paramedic and believes that his time out in the field with his coworkers is integral to his research efforts. “I have this really unique opportunity where I often experience these challenges of EMS firsthand and can bring these experiences back to my research to help find solutions.” 

Enzo’s long-term career goal is to continue this line of research as an NIH-funded investigator at a large, academic institution. He plans to continue learning how different risk factors impact EMS clinicians across time and in real-life environments, then using these findings to develop and test robust digital health interventions in this population. The National Registry’s collaboration ensures that these findings will reach the broader EMS community, and make a lasting and national impact on the entire EMS profession. 

Enzo’s story is a powerful reminder of the dedication and innovation within the EMS profession. By combining his personal EMS experience with cutting-edge research and training, he is helping to pave the way for a healthier and more resilient EMS workforce. “There are many challenges in EMS that we cannot change, but this research will allow us to better understand how variation in stress may impact health risk behaviors, and if improving emotion regulation through a future digital health app might reduce risky behaviors.” Through our initiatives supporting Enzo’s research, education, and training, EMS clinicians can look forward to a future where their mental health and well-being are prioritized, enabling them to continue their life-saving work with confidence and support.