Designing Digital Mental Health Support for Paramedics Exposed to Trauma: Qualitative Study of Lived Experiences and Design Preferences.

Background: Paramedics face frequent exposure to trauma and intense occupational stress, often under conditions of limited psychological support and ongoing stigma. Digital mental health interventions have the potential to offer accessible, confidential, and tailored support. However, their acceptability and design must be informed by the lived experiences of paramedics to ensure effectiveness. Objective: This study aimed to explore the experiences of trauma exposure among UK paramedics in the workplace and their views on the design and delivery of digital mental health interventions. Methods: Semi-structured interviews were conducted with 22 UK paramedics. Participants were recruited through purposive and snowball sampling. Interviews were transcribed verbatim and analyzed using reflexive thematic analysis. Ethical approval was obtained, and trauma-informed principles were applied throughout data collection and analysis. Results: Five key themes were identified: (1) It Has to Feel Easy to Use: highlighting the need for digital tools that reduce cognitive burden and are accessible during unpredictable shifts; (2) Make It Fit My Needs: calling for interventions specifically designed for paramedics, with lived-experience-informed language and delivery; (3) We Need to Talk to Each Other: describing a strong desire for peer connection while recognizing barriers such as stigma and shift pressures; (4) I Need to Know It's Safe: emphasizes the importance of anonymity, data privacy, and psychological safety; and (5) Support Needs to Feel Human: reinforcing the value of integrating digital tools with human connection and professional services. Participants expressed strong support for an app-based solution that offers anonymity, rapid accessibility, and flexibility, while preserving opportunities for human interaction. Conclusions: Paramedics face unique mental health challenges that are not adequately addressed by existing services. Digital mental health tools offer promise if they are carefully co-designed to reflect the realities of frontline work. Anonymity, usability, peer connection, and integration with existing support systems are critical to engagement. These findings offer actionable insights for the development of trauma-informed, context-sensitive digital mental health interventions for emergency service workers.