Improving Mental Health Knowledge and Reducing Mental Health Stigma among Public Safety Personnel: Comparison of Live vs. Online Psychoeducation Training

Can online mental health training reduce stigma in fire and EMS? Yes — a 2024 study of over 900 public safety personnel found that a one-hour online psychoeducation program reduced stigma toward others and improved mental health knowledge at the same rate as in-person delivery.

TL;DR

• A brief, one-hour psychoeducation program improved mental health knowledge and reduced public stigma among firefighters, police, and dispatchers — with no difference between online and in-person delivery.
• Self-stigma did not change after training in either format, suggesting it requires different intervention strategies entirely.
• Police officers carried significantly higher self-stigma and public stigma than firefighters or dispatchers — a gap that generic training alone is unlikely to close.
• For resource-limited agencies, this study supports online video-based training as a viable, scalable first step toward stigma reduction.

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8.4%. In a study of nearly a thousand public safety personnel, that’s how many reported a lifetime mental health diagnosis. Given what the broader literature consistently reports about PTSD, depression, anxiety, and substance misuse rates in this workforce, that number almost certainly reflects underreporting — not low prevalence. Stigma drives that gap.

Providers frequently encounter this dynamic without naming it. A crew member shows signs of burnout or acute stress. Nobody says anything. The unspoken rule across fire, EMS, and law enforcement culture is well-documented: toughness is expected, vulnerability is suspect, and asking for help feels like a career risk. That cultural pressure doesn’t just discourage treatment — it makes people sicker.

A 2024 study out of the University of Central Florida tested whether a short, scalable training could move the needle on at least part of that problem. The findings offer something operationally useful for agency leaders trying to do more with limited budgets.

What Did the Study Actually Test?

Researchers evaluated a one-hour psychoeducation program designed to improve mental health knowledge and reduce mental health stigma among public safety personnel in Florida. The program covered four modules: trauma, responses to critical incidents, when symptoms become disorders, and treatment resources. It was developed by a licensed psychologist and delivered in two formats — live (in-person lecture by doctoral students) and online (video presentation bookended by fire and police chiefs emphasizing that seeking help is part of the job).

In total, 1,686 public safety personnel participated. Of those, 871 completed both pre- and post-training questionnaires in the online group, and 44 completed them in the in-person group. Participants included firefighters, police officers, and dispatchers.

The study measured three things: mental health knowledge (via a 10-item test), stigma toward others with mental health conditions (public stigma), and self-stigma — how participants viewed themselves in relation to mental health problems. Both stigma measures used the Police Officer’s Stigma Scale, adapted for each profession.

How Did Mental Health Knowledge and Stigma Change After Training?

Mental health knowledge increased significantly from pre- to post-test across the full sample. The improvement held regardless of whether participants trained online or in-person, and regardless of profession. That finding alone matters for agencies weighing the cost of live instruction against video-based alternatives.

For public stigma — negative attitudes toward coworkers with mental health conditions — the study found a small but statistically significant reduction after training. Critically, the reduction was equivalent across both delivery formats. There was no interaction between time and modality, meaning online training performed just as well as face-to-face instruction in shifting attitudes toward others.

Self-stigma, on the other hand, did not budge. Neither format produced a statistically significant change in how participants viewed themselves in relation to mental health challenges. This is consistent with findings from multiple other psychoeducation studies. The researchers noted that self-stigma may require more intensive interventions — potentially including direct exposure to individuals living with mental health conditions — rather than information-based training alone.

Where Do Stigma Levels Differ by Profession?

One of the more operationally relevant findings: stigma levels were not uniform across professions.

Police officers reported significantly higher public stigma than both firefighters and dispatchers. They also reported significantly higher self-stigma than firefighters. Dispatchers and firefighters scored comparably on most measures.

That gap deserves attention from anyone designing mental health programs across multi-discipline agencies. A single training delivered identically to all personnel may improve baseline knowledge, but it won’t address the cultural dynamics that make law enforcement personnel less likely to seek care or support a peer who does. Treating all public safety disciplines as a monolith when it comes to stigma is operationally shortsighted — and this data supports that conclusion.

The training improved outcomes equally across professions in terms of pre-to-post change, which is encouraging. But starting points matter. If police officers begin with substantially more stigma, equivalent improvement still leaves them at a higher absolute level than their fire or dispatch counterparts.

What Does This Look Like Operationally?

A common situation in EMS: an agency knows it needs mental health training. Budget is tight. Scheduling live sessions means overtime or reduced coverage. Leadership defaults to doing nothing, or runs a single in-person session that reaches a fraction of the workforce.

This study suggests a more practical path. A one-hour video-based program — front-loaded with credible leadership messaging and grounded in clinical content — can produce measurable gains in knowledge and reduce public stigma. It scales across shifts. It doesn’t require pulling apparatus out of service. And it performs comparably to live instruction on the outcomes measured here.

That said, agencies shouldn’t treat a one-hour video as a complete mental health strategy. The failure to move self-stigma is a clear signal. Information changes what people know. It can even shift how they view others. But changing how someone views themselves in the context of a culture that punishes vulnerability — that requires sustained, layered effort. Peer support programs, leadership modeling, clinical access, and repeated exposure over time all factor in.

How Should Agencies Apply These Findings?

• Deploy online psychoeducation as a baseline. For agencies that currently offer nothing, a one-hour video-based program is a defensible, evidence-supported starting point. It improves knowledge and reduces public stigma at equivalent rates to in-person training.
• Stop assuming one training fits all disciplines. Police officers in this study carried measurably higher stigma on both dimensions. Agencies serving multiple disciplines should consider supplemental or tailored content for law enforcement personnel specifically.
• Don’t expect video training to fix self-stigma. This study — and the broader literature it references — found no change in self-stigma from psychoeducation alone. Agencies that want to reduce self-stigma need to invest in peer support, leadership culture change, and potentially clinical contact-based interventions.
• Use leadership endorsement intentionally. The online version of this program opened and closed with fire and police chiefs normalizing help-seeking. That framing choice matters. Leadership voice in mental health messaging signals institutional permission — not just informational content.
• Build toward sustained exposure, not one-time compliance. A single training satisfies a mandate. Repeated, varied exposure over time builds culture. Agencies should treat this type of program as a floor, not a ceiling.

What Are the Study’s Limitations?

The sample was drawn entirely from Florida, which limits geographic generalizability. Cultural attitudes toward mental health vary significantly by region, and results may differ in other states or rural versus urban contexts.

The in-person sample was small — only 44 completers compared to 871 online. That imbalance makes direct modality comparisons less robust than the overall pre-post findings. Additionally, the study did not collect data on participant satisfaction or perceived usefulness, so acceptability remains unmeasured.

The knowledge test was researcher-created and specific to the training content. It measured learning of presented material, not broader mental health literacy. The adapted stigma scale, while previously validated for firefighters, was not re-evaluated psychometrically in this specific study.

Finally, the study captured immediate post-training effects only. Whether knowledge gains or stigma reductions persist over weeks or months is unknown. Long-term follow-up would strengthen confidence in these findings considerably.

Bottom Line

Agencies should deploy scalable online psychoeducation as a baseline — but pair it with peer support, leadership culture change, and contact-based interventions to address the self-stigma that a one-hour video alone will not move.

References

1. Marks, M.R., Bowers, C., Beidel, D.C., Ortman, J., & Newins, A.R. (2024). Improving Mental Health Knowledge and Reducing Mental Health Stigma Among Public Safety Personnel: Comparison of Live vs. Online Psychoeducation Training Programs. International Journal of Environmental Research and Public Health, 21(10), 1358. https://www.mdpi.com/1660-4601/21/10/1358