Previous research suggests that ambulance work is often characterised by employee burnout, high stress, work intensification, and exhaustion – physical, mental and emotional. A major contributing factor is that exposure to trauma is an unavoidable feature of the role, and can increase the prevalence of a number of mental health conditions such as depression, anxiety, and post-traumatic stress disorder. There is a significant cost (financial, social and emotional) of mental health conditions to emergency services providers. For emergency services organisations, mental health problems are associated with increased sick leave (Brattberg, 2006), deteriorated health and well-being (Berger et al., 2007) and increased employee turnover (Patterson, Jones, et al., 2010). This study has aimed to better understand the organisational factors that affect paramedic and support staff experiences of work and employment, and the impact of these factors on a range of individual outcomes, particularly associated with psychological health and wellbeing. To achieve the aims of this project, we conducted 1216 surveys and 72 interviews with emergency services employees across Queensland, South Australia and the Northern Territory. Data analysis has directed attention to some key findings, which are expanded upon in this Summary Report, and supported by detailed statistical analysis in the Companion Report. The key findings are summarised as follows: >> A provisional PTSD diagnosis can be made for 10% of Queensland and 8.5% of South Australian staff. An additional 6.6% and 4% of respondents in each state respectively were found to be close to a provisional diagnosis. Recent changes in the measurement instrument for PTSD has meant that many people who would previously had a provisional diagnosis are now excluded (see Appendix A for discussion). >> More symptoms of PTSD are reported by employees with longer tenure of employment. Those with more symptoms have higher intention to quit and poorer ability to do their work. >> Social support is a key factor in these findings, with those reporting greater support also less likely to have symptoms of PTSD. >> Anxiety is at very high levels among the workforce. Those with severe and extremely severe anxiety comprise around 40% of the sample in all jurisdictions. >> Fatigue remains a major problem for more than half of all staff in each jurisdiction, even when controlling for variables such as age, gender, dependents, tenure, work hours and shift length. Interviewees report persistent high fatigue across all geographical areas, affecting their ability to perform and desire to stay in the service for the long term. >> Around one in every five employees are seriously looking for another job. Employees’ intention to quit is higher when they view the human resource management (HRM) system as weak, and when they are regularly exposed to natural disasters and physical assault. This finding highlights the importance of building a strong HRM system where employees are clear about the behaviours that are expected – and rewarded – by the organisation. This point is reinforced by a significant relationship between HRM system strength and employee fatigue. >> The employee support systems in place in these organisations provide vital social and organisational support for employees. Both formal and informal colleague support are fundamental elements of the support systems.