The role of group formation and interpersonal connections in support: A qualitative analysis of social structures in emergency services organizations and hospital-based emergency settings

Professionals in emergency services organizations (firefighters, paramedics, police, military) and professionals in hospital-based emergency settings (emergency rooms, operating rooms, intensive care units) are frequently exposed to potentially traumatic events. They are at higher risk for the development of trauma-related mental health problems than the general population. To maintain mental health, it is essential for individuals to be embedded in a social environment with supportive relationships. We employed ethnographical research that explored the social environment of seven high-risk professional groups in the Netherlands through observational fieldwork, interviews, and document analysis. We analyzed the data using Chie Nakane’s social anthropological model of Group formations and interpersonal connections as a heuristic lens. Findings indicate that in the social environments of these various high-risk occupational groups, two different social structural tendencies can be distinguished: vertical versus horizontal group formation and interpersonal connections. In our discussion, we suggest how these different social structures in which the professional is embedded might explain inconsistent results in current studies, and how knowledge of these different social structures might be relevant for support and prevention of trauma-related mental health problems.