U.S. flag

An official website of the United States government, Department of Justice.

Understanding Work-Related Stress among Medicolegal Death Investigators: A National Survey and Mixed-Methods Impact Study

NCJ Number
Date Published
October 2023
129 pages

This report lays out the state of extant research on medical death investigators’ stress and the two-part research study that involved a national survey, noting study design and results, and an impact study, and emphasizes the need for the scientific community and medico-legal practitioners to find ways to better support the MDI community and reduce work-related stress.


This document reports on a two-part study of short- and long-term mental health challenges and stress among medicolegal death investigators (MDIs) as a result of their work. In Phase 1, the researchers conducted a national survey that was fielded among members of American Board of Medicolegal Death Investigators (ABMDI) and U.S.-based members of the International Association of Coroners and Medical Examiners (IACME); in Phase 2, the researchers implemented an impact study in which MDIs used a wellness mobile app specifically designed for MDIs. Self-reported and physiological data were collected at baseline and throughout the duration of the impact study to evaluate the app’s effects on health and well-being metrics. Survey results showed that top sources of MDI stress were the following: aspects of interacting with family members of decedents; lack of understanding from political stakeholders and community leaders about their work; fatigue; staff shortages; and working more than 24 consecutive hours to complete work assignments. This report provides detailed discussion of the results of the survey as well as the impact study as well as recommendations for research and practice.

Date Published: October 1, 2023