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Public Safety Personnel: Mental Health and Well-Being

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (28 February 2022) | Viewed by 53035

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Special Issue Editors

Prof. Dr. Rosemary Ricciardelli

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Guest Editor

School of Maritime Studies Fisheries and Marine Institute, Memorial University of Newfoundland, St. John's, NL A1C 5R3, Canada
Interests: correctional services; masculinities and gender; desistance from crime; social health; correctional and police officers; mental health and well-being
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. R. Nicholas Carleton

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Guest Editor

1. Canadian Institute of Public Safety Research and Treatment, University of Regina, Regina, SK S4S 0A2, Canada
2. Department of Psychology, University of Regina, Regina, SK S4S 0A2, Canada
Interests: public safety personnel; biopsychosocial measurement; assessment; treatments of anxiety; mood; somatic disorders; transdiagnostics
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Joy C. MacDermid

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Guest Editor

1. Physical Therapy and Surgery, Western University, London, ON N6G 1H1, Canada
2. Clinical Research Lab, Hand and Upper Limb Centre, London, ON N6A 4V2, Canada
3. Rehabilitation Science, McMaster University, Hamilton, ON L8S 1C7, Canada
Interests: firefighter health; musculoskeletal health; implementation science
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are pleased to invite articles for the Special Issue entitled “Public Safety Personnel: Mental Health and Well-Being”. The collection will include important high-quality papers (original research articles or comprehensive review papers) published in open access form by Editorial Board Members and other prominent scholars.

PSP include border services officers, public safety communicators (e.g., 911, call-takers), correctional workers, firefighters (career and volunteer), Indigenous emergency managers, operational and intelligence personnel, paramedics, police (municipal, provincial, federal), and search and rescue personnel, all of whom are regularly exposed to potentially psychologically traumatic events (PPTE) when fulfilling their occupational responsibilities. In addition, work-related stressors are endemic across PSP groups, and are associated with high rates of clinically significant mental disorder symptoms. A recent national prevalence study conducted with the Canadian Institute of Public Safety Research and Treatment (CIPSRT) indicated that 44.5% of Canadian PSP may screen positive for one or more mental disorders, which is much higher than diagnostic rates from the general population (i.e., ∼10.1%). PSP are critical professionals who commonly protect and serve Canadians (e.g., following motor vehicle accidents or assaults). In addition, PSP are now on the frontline for managing the COVID-19 crisis which involves staffing challenges, extended hours, and the constant threat of contagion for themselves, their families, and their colleagues.

The Special Issue is designed to present new knowledge, as well as develop theoretical and empirical understandings in PSP mental health and well-being. We invite researchers to submit manuscripts on this broad and important topic, either research papers or papers highlighting state-of-the-art developments in PSP mental health and well-being, and encourage potential contributors to send a short abstract and tentative title to the Editorial Office ([email protected]) for review and feedback prior to submission. All included articles in the Special Issue will undergo a rigorous peer-review process.

We look forward to receiving your contribution to this Special Issue.

Prof. Dr. Rosemary Ricciardelli
Prof. Dr. R. Nicholas Carleton
Prof. Dr. Joy C. MacDermid
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

public safety personnel
first responders
mental disorders
mental health
well-being
trauma
operational stress injuries
post-traumatic stress injuries

Published Papers (13 papers)

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Research

Jump to: Review

14 pages, 701 KiB

Open AccessArticle

Mental Disorder Symptoms and the Relationship with Resilience among Paramedics in a Single Canadian Site

by Justin Mausz, Elizabeth Anne Donnelly, Sandra Moll, Sheila Harms and Meghan McConnell

Int. J. Environ. Res. Public Health 2022, 19(8), 4879; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19084879 - 17 Apr 2022

Cited by 7 | Viewed by 3217

Abstract

There is growing recognition in research and policy of a mental health crisis among Canada’s paramedics; however, despite this, epidemiological surveillance of the problem is in its infancy. Just weeks before the emergence of the COVID-19 pandemic, we surveyed paramedics from a single, large, urban paramedic service in Ontario, Canada to assess for symptom clusters consistent with post-traumatic stress disorder (PTSD), major depressive disorder, and generalized anxiety disorder and to identify potential risk factors for each. In total, we received 589 completed surveys (97% completion rate) and found that 11% screened positive for PTSD, 15% screened positive for major depressive disorder, and 15% screened positive for generalized anxiety disorder, with one in four active-duty paramedics screening positive for any of the three as recently as February 2020. In adjusted analyses, the risk of a positive screen varied as a function of employment classification, gender, self-reported resilience, and previous experience as a member of the service’s peer support team. Our findings support the position that paramedics screen positive for mental disorders at high rates—a problem likely to have worsened since the onset of the COVID-19 pandemic. We echo the calls of researchers and policymakers for urgent action to support paramedic mental health in Canada. Full article

(This article belongs to the Special Issue Public Safety Personnel: Mental Health and Well-Being)

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16 pages, 565 KiB

Open AccessArticle

Role Identity, Dissonance, and Distress among Paramedics

by Justin Mausz, Elizabeth Anne Donnelly, Sandra Moll, Sheila Harms and Meghan McConnell

Int. J. Environ. Res. Public Health 2022, 19(4), 2115; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19042115 - 13 Feb 2022

Cited by 10 | Viewed by 3815

Abstract

Role identity theory describes the purpose and meaning in life that comes, in part, from occupying social roles. While robustly linked to health and wellbeing, this may become unideal when an individual is unable to fulfill the perceived requirements of an especially salient role in the manner that they believe they should. Amid high rates of mental illness among public safety personnel, we interviewed a purposely selected sample of 21 paramedics from a single service in Ontario, Canada, to explore incongruence between an espoused and able-to-enact paramedic role identity. Situated in an interpretivist epistemology and using successive rounds of thematic analysis, we developed a framework for role identity dissonance wherein chronic, identity-relevant disruptive events cause emotional and psychological distress. While some participants were able to recalibrate their sense of self and understanding of the role, for others, this dissonance was irreconcilable, contributing to disability and lost time from work. In addition to contributing a novel perspective on paramedic mental health and wellbeing, our work also offers a modest contribution to the theory in using the paramedic context as an example to consider identity disruption through chronic workplace stress. Full article

(This article belongs to the Special Issue Public Safety Personnel: Mental Health and Well-Being)

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14 pages, 495 KiB

Open AccessArticle

Mental Health of Canadian Firefighters: The Impact of Sleep

by Heidi Cramm, Rachel Richmond, Laleh Jamshidi, Megan Edgelow, Dianne Groll, Rose Ricciardelli, Joy Christine MacDermid, Michael Keiley and R. Nicholas Carleton

Int. J. Environ. Res. Public Health 2021, 18(24), 13256; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182413256 - 16 Dec 2021

Cited by 9 | Viewed by 4065

Abstract

Volunteer and career firefighters are at risk of major depressive disorders, posttraumatic stress disorder (PTSD), alcohol use disorder, and other mental health disorders due to the demanding and unpredictable nature of their employment. The mental health risks are exacerbated by the need to work extended hours, night shifts, and/or rotating schedules, or the competing demands of other employment, especially in volunteer firefighters. The mental health disorders and risk factors interact with altered sleeping patterns. In the current study, we examined volunteer and career firefighters regarding the association between mental health and sleep, drawing from a national Canadian mental health survey of 1217 firefighters. Most (69%) of the firefighters reported less than ideal sleep quality and 21% screened positive for clinical insomnia, with no significant difference between volunteer and career subgroups. Firefighters with insomnia had higher odds ratios (OR) and frequencies for PTSD (OR = 4.98), generalized anxiety disorder (OR = 7.15), panic disorder (OR = 6.88), social phobia (OR = 4.98), and major depressive disorder (OR = 7.91), than firefighters without insomnia. The burden of sleep disorders and their association with mental health disorders suggests that sleep should be considered in health monitoring and self-management, environmental design, fire service work-organization policies, and health programming. Full article

(This article belongs to the Special Issue Public Safety Personnel: Mental Health and Well-Being)

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24 pages, 2240 KiB

Open AccessArticle

Canadian Career Firefighters’ Mental Health Impacts and Priorities

by Joy C. MacDermid, Margaret Lomotan and Mostin A. Hu

Int. J. Environ. Res. Public Health 2021, 18(23), 12666; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182312666 - 01 Dec 2021

Cited by 9 | Viewed by 4203

Abstract

Firefighters’ perceptions of mental health can inform management. This qualitative study explored Canadian career firefighters’ experiences, needs, and research priorities with respect to mental health. Thirty-nine career firefighters (33 men, 6 women) of different ranks and geographic locales were interviewed using a semi-structured interview guide. The interviews were recorded, transcribed, and qualitatively analyzed using thematic analysis within an interpretive description approach. Firefighters reported that critical incidents and chronic job stressors contributed to mental health symptoms that led to burnout, compassion fatigue, and mental and physical injury. They were concerned with family impacts, like lack of full openness, reduced financial stability, and risk of divorce; and work impacts, like interpersonal conflict, lack of support to fellow firefighters, task avoidance, and absenteeism. A broad array of barriers and facilitators were found in firefighter work, culture, programs, social supports, health care, and societal factors. Variability in access to help, the changing fire service, and the complexity of knowing what to do to achieve mental health were evident across themes. Firefighters identified the need for research in four areas: awareness and monitoring, understanding etiology of mental health, better prevention and treatment, and access to care. Across domains of inquiry, context, “two sides to the coin”, and uncertainty were overarching themes. Full article

(This article belongs to the Special Issue Public Safety Personnel: Mental Health and Well-Being)

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18 pages, 378 KiB

Open AccessArticle

Meat in a Seat: A Grounded Theory Study Exploring Moral Injury in Canadian Public Safety Communicators, Firefighters, and Paramedics

by Lorraine Smith-MacDonald, Liana Lentz, David Malloy, Suzette Brémault-Phillips and R. Nicholas Carleton

Int. J. Environ. Res. Public Health 2021, 18(22), 12145; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212145 - 19 Nov 2021

Cited by 12 | Viewed by 3859

Abstract

The work of public safety personnel (PSP) is inherently moral; however, the ability of PSP to do what is good and right can be impeded and frustrated, leading to moral suffering. Left unresolved, moral suffering may develop into moral injury (MI) and potential psychological harm. The current study was designed to examine if MI is relevant to frontline public safety communicators, firefighters, and paramedics. Semi-structured interviews (n = 3) and focus groups (n = 3) were conducted with 19 participants (public safety communicators (n = 2); paramedics (n = 7); and firefighters (n = 10)). Interviews and focus groups were audio-recorded, transcribed, coded, and constantly compared in accordance with the grounded theory method. A conceptual theory of “frustrating moral expectations” emerged, with participants identifying three interrelated properties as being potentially morally injurious: chronic societal problems, impaired systems, and organizational quagmires. Participants navigated their moral frustrations through both integrative and disintegrative pathways, resulting in either needing to escape their moral suffering or transforming ontologically. The current study results support MI as a relevant concept for frontline PSP. Given the seriousness of PSP leaving their profession or committing suicide to escape moral suffering, the importance of the impact of MI on PSP and public safety organizations cannot be ignored or underestimated. Understanding the similarities and differences of morally injurious exposures of frontline PSP may be critical for determining mental health and resilience strategies that effectively protect PSP. Full article

(This article belongs to the Special Issue Public Safety Personnel: Mental Health and Well-Being)

14 pages, 2472 KiB

Open AccessArticle

Why Do Public Safety Personnel Seek Tailored Internet-Delivered Cognitive Behavioural Therapy? An Observational Study of Treatment-Seekers

by Hugh C. McCall, Caeleigh A. Landry, Adeyemi Ogunade, R. Nicholas Carleton and Heather D. Hadjistavropoulos

Int. J. Environ. Res. Public Health 2021, 18(22), 11972; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182211972 - 15 Nov 2021

Cited by 4 | Viewed by 2368

Abstract

First responders and other public safety personnel (PSP) experience elevated rates of mental disorders and face unique barriers to care. Internet-delivered cognitive behavioural therapy (ICBT) is an effective and accessible treatment that has demonstrated good treatment outcomes when tailored specifically for PSP. However, little is known about how PSP come to seek ICBT. A deeper understanding of why PSP seek ICBT can inform efforts to tailor and disseminate ICBT and other treatments to PSP. The present study was designed to (1) explore the demographic and clinical characteristics, motivations, and past treatments of PSP seeking ICBT, (2) learn how PSP first learned about ICBT, and (3) understand how PSP perceive ICBT. To address these objectives, we examined responses to online screening questionnaires among PSP (N = 259) who signed up for an ICBT program tailored for PSP. The results indicate that most of our sample experienced clinically significant symptoms of multiple mental disorders, had received prior mental disorder diagnoses and treatments, heard about ICBT from a work-related source, reported positive perceptions of ICBT, and sought ICBT to learn skills to manage their own symptoms of mental disorders. The insights gleaned through this study have important implications for ICBT researchers and others involved in the development, delivery, evaluation, and funding of mental healthcare services for PSP. Full article

(This article belongs to the Special Issue Public Safety Personnel: Mental Health and Well-Being)

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25 pages, 561 KiB

Open AccessArticle

Assessing Relative Stressors and Mental Disorders among Canadian Provincial Correctional Workers

by Katy Konyk, Rosemary Ricciardelli, Tamara Taillieu, Tracie O. Afifi, Dianne Groll and R. Nicholas Carleton

Int. J. Environ. Res. Public Health 2021, 18(19), 10018; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910018 - 23 Sep 2021

Cited by 13 | Viewed by 2102

Abstract

In the current study, we quantified the mean stress levels of 43 occupational stressors for 868 Correctional Workers (CWs) and analyzed the relationships between occupational stressors, exposure to potentially psychologically traumatic events (PPTEs), and mental health disorders. Our findings emphasize the importance of the occupational environment in relation to CW mental health and indicate that occupational stressors (e.g., staff shortages, inconsistent leadership style, bureaucratic red tape) are more salient contributors to CW mental health than exposure to PPTEs. Finding strategies to ameliorate staff shortages, improve leadership style and communication, and support CWs to maintain physical, mental, and social well-being would be interventions tied to significant organizational and operational stressors within the current study. Full article

(This article belongs to the Special Issue Public Safety Personnel: Mental Health and Well-Being)

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16 pages, 362 KiB

Open AccessArticle

“Suck It Up, Buttercup”: Understanding and Overcoming Gender Disparities in Policing

by Andréanne Angehrn, Amber J. Fletcher and R. Nicholas Carleton

Int. J. Environ. Res. Public Health 2021, 18(14), 7627; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18147627 - 18 Jul 2021

Cited by 14 | Viewed by 6271

Abstract

Women police officers report elevated symptoms of mental disorders when compared to men police officers. Researchers have indicated that the occupational experience of policing differs greatly among men and women. Indeed, police culture is characterized by hegemonic masculinity, which appears to negatively impact both men and women. The current study examined the contrast between the experiences of men and women police officers. Police officers (n = 17; 9 women) in Saskatchewan participated in semi-structured interviews. Thematic network analysis identified themes related to the experience of policing for both men and women police officers. There were six organizing themes identified in relation to the global theme of Gendered Experiences: (1) Discrimination; (2) Sexual Harassment; (3) Motherhood and Parental Leave; (4) Identity; (5) Stereotypically Feminine Attributes; and (6) Hegemonic Masculinity. Pervasive gender norms appear detrimental for both men and women police officers, as well as the communities they serve. The current results, coupled with the emerging disposition for progress expressed by police services, offer opportunities to develop tailored and focused interventions and policies to support police officers. Full article

(This article belongs to the Special Issue Public Safety Personnel: Mental Health and Well-Being)

10 pages, 341 KiB

Open AccessFeature PaperArticle

Correctional Work: Reflections Regarding Suicide

by Christine Genest, Rosemary Ricciardelli and R. Nicholas Carleton

Int. J. Environ. Res. Public Health 2021, 18(8), 4280; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18084280 - 17 Apr 2021

Cited by 13 | Viewed by 2818

Abstract

The Public Health Agency of Canada declared suicide a public health problem in Canada (2016). Employees working in correctional services, researchers find, experience high rates of life-time suicidal ideation in comparison to other public safety professionals and the general population. Suicide behaviours (i.e., ideation, planning, attempts, death) are a multifactorial phenomenon, explained in part by the Interpersonal-Psychological Theory of Suicide that suggests attempted suicide is facilitated by perceived burdensomeness, a lost sense of belonging, a feeling of hopelessness, and a progressively reduced fear of death, as well as capacity and planning to engage a lethal attempt. In the current study, we unpack the factors that can influence suicide behaviours as reported by correctional workers. Our intent is to make explicit the experiences of a small sample (n = 25) of correctional workers in relation to suicidal behaviours, highlighting stories of recovery and acknowledging the importance of facilitating psychologically safe workplaces. Analysis entailed an inductive semi-grounded emergent theme approach. Participants identified certain risk factors as being able to induce suicidal ideation, such as marital or family problems as well as difficulties at work (i.e., bullying or difficult working conditions). Having children and a partner may act as factors preventing suicide for those with ideation. Participants sought help from professionals, such as their family doctor, a psychologist, or the Employee Assistance Program (EAP); however, the lack of perceived organisational supports and recognition of the issue of suicide by the employer are two elements that can hinder the search for help. Full article

(This article belongs to the Special Issue Public Safety Personnel: Mental Health and Well-Being)

11 pages, 580 KiB

Open AccessArticle

How Have Public Safety Personnel Seeking Digital Mental Healthcare Been Affected by the COVID-19 Pandemic? An Exploratory Mixed Methods Study

by Hugh McCall, Janine Beahm, Caeleigh Landry, Ziyin Huang, R. Nicholas Carleton and Heather Hadjistavropoulos

Int. J. Environ. Res. Public Health 2020, 17(24), 9319; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17249319 - 13 Dec 2020

Cited by 4 | Viewed by 2905

Abstract

Public safety personnel (PSP) experience unique occupational stressors and suffer from high rates of mental health problems. The COVID-19 pandemic has impacted virtually all aspects of human life around the world and has introduced additional occupational stressors for PSP. The objective of this study was to explore how PSP, especially those seeking digital mental health services, have been affected by the pandemic. Our research unit, PSPNET, provides internet-delivered cognitive behavioral therapy to PSP in the Canadian province of Saskatchewan. When the pandemic spread to Saskatchewan, PSPNET began inquiring about the impact of the pandemic on prospective clients during the eligibility screening process. We used content analysis to analyze data from telephone screening interviews (n = 56) and descriptive statistics to analyze data from a questionnaire concerning the impacts of COVID-19 (n = 41). The results showed that most PSP reported facing several novel emotional challenges (e.g., social isolation, boredom, anger, and fear) and logistical challenges (e.g., related to childcare, finances, work, and access to mental healthcare). Most participants indicated they felt at least somewhat afraid of contracting COVID-19 but felt more afraid of their families contracting the virus than themselves. However, few participants reported severe challenges of any kind, and many (40%) indicated that they had not been significantly negatively impacted by the pandemic. Overall, the results suggest that PSP are not expressing significant concern at this time in meeting the novel challenges posed by COVID-19. Continued research will be required to monitor how diverse PSP populations and treatment outcomes are affected by the pandemic as the situation evolves. Full article

(This article belongs to the Special Issue Public Safety Personnel: Mental Health and Well-Being)

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12 pages, 703 KiB

Open AccessArticle

Buffering PTSD in Canine Search and Rescue Teams? Associations with Resilience, Sense of Coherence, and Societal Acknowledgment

by Milena Kaufmann, Matthias Gelb and Mareike Augsburger

Int. J. Environ. Res. Public Health 2020, 17(17), 6184; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17176184 - 26 Aug 2020

Cited by 2 | Viewed by 2525

Abstract

Rescue workers present an elevated risk for posttraumatic stress disorder (PTSD) and recently, research has begun to focus on coping styles and social support as protective factors in this population. Associations in the particular group of search and rescue dog handlers still lack evidence. The aim of the study is to investigate if functional cognitions and social support also decrease the risk for PTSD. Active voluntary rescue dog handlers (n = 116) rated levels of resilience, sense of coherence, and social acknowledgment (SAQ; subscales general disapproval, familial disapproval, recognition), in addition to a trauma checklist and PTSD symptoms. Linear regression analyses and two different graph models were calculated to explore associations, as well as potential pathways. Controlling for trauma exposure, the SAQ general disapproval emerged as the only significant predictor in the regression model. In the graph models, SAQ familial disapproval was linked to SAQ recognition and SAQ general disapproval. The latter, together with a sense of coherence manageability, affected PTSD re-experiencing symptoms through resilience. The findings are in line with earlier work. The study underlines the importance of targeting resilience and manageability, as well as enhancing social support in prevention programs for PTSD in canine search and rescue teams. Future research is warranted to further investigate model stability and replicate findings. Full article

(This article belongs to the Special Issue Public Safety Personnel: Mental Health and Well-Being)

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17 pages, 4050 KiB

Open AccessArticle

Exploring Perceptions of Internet-Delivered Cognitive Behaviour Therapy among Public Safety Personnel: Informing Dissemination Efforts

by Hugh C. McCall, Angelo P. Sison, Jody L. Burnett, Janine D. Beahm and Heather D. Hadjistavropoulos

Int. J. Environ. Res. Public Health 2020, 17(17), 6026; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17176026 - 19 Aug 2020

Cited by 12 | Viewed by 3677

Abstract

Background Public safety personnel (PSP) experience high rates of mental health disorders but have limited access to treatment. To improve treatment access, there is a growing interest in offering internet-delivered cognitive behaviour therapy (ICBT) to PSP. As attitudes towards ICBT can both impact and inform ICBT implementation efforts, this study examines perceptions of ICBT among PSP who viewed a poster (a commonly used method of advertising ICBT) or a poster supplemented with a story of a PSP who benefitted from ICBT. Methods Participants (N = 132) from various PSP sectors were randomly assigned to view a poster or a poster and a story. Participants then completed an online survey assessing their perceptions of ICBT using both qualitative and quantitative questions. We used a mixed-methods approach to analyze the data. Results No differences in perceptions of ICBT were identified between the conditions. Ratings of credibility, treatment expectancy, anticipated treatment adherence, and acceptability suggested that PSP had positive perceptions of ICBT. Most participants (93%) reported that they would access ICBT if they needed help with mental health concerns. Participants ranked therapist-guided ICBT as their second most preferred treatment, with psychologists ranked first. Female participants found ICBT more credible than male participants. More experienced PSP reported lower acceptability and anticipated adherence to ICBT. Conclusions The findings suggest that many PSP are likely to be receptive to ICBT even when a simple poster is used as a method of informing PSP of this treatment option. Further attention to improving the perceptions of ICBT among certain groups may be warranted. Full article

(This article belongs to the Special Issue Public Safety Personnel: Mental Health and Well-Being)

Review

Jump to: Research

16 pages, 706 KiB

Open AccessReview

Peer Support and Crisis-Focused Psychological Interventions Designed to Mitigate Post-Traumatic Stress Injuries among Public Safety and Frontline Healthcare Personnel: A Systematic Review

by Gregory S. Anderson, Paula M. Di Nota, Dianne Groll and R. Nicholas Carleton

Int. J. Environ. Res. Public Health 2020, 17(20), 7645; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17207645 - 20 Oct 2020

Cited by 52 | Viewed by 9592

Abstract

Public safety personnel (PSP) and frontline healthcare professionals (FHP) are frequently exposed to potentially psychologically traumatic events (PPTEs), and report increased rates of post-traumatic stress injuries (PTSIs). Despite widespread implementation and repeated calls for research, effectiveness evidence for organizational post-exposure PTSI mitigation services remains lacking. The current systematic review synthesized and appraised recent (2008–December 2019) empirical research from 22 electronic databases following a population–intervention–comparison–outcome framework. Eligible studies investigated the effectiveness of organizational peer support and crisis-focused psychological interventions designed to mitigate PTSIs among PSP, FHP, and other PPTE-exposed workers. The review included 14 eligible studies (n = 18,849 participants) that were synthesized with qualitative narrative analyses. The absence of pre–post-evaluations and the use of inconsistent outcome measures precluded quantitative meta-analysis. Thematic services included diverse programming for critical incident stress debriefing, critical incident stress management, peer support, psychological first aid, and trauma risk management. Designs included randomized control trials, retrospective cohort studies, and cross-sectional studies. Outcome measures included PPTE impacts, absenteeism, substance use, suicide rates, psychiatric symptoms, risk assessments, stigma, and global assessments of functioning. Quality assessment indicated limited strength of evidence and failures to control for pre-existing PTSIs, which would significantly bias program effectiveness evaluations for reducing PTSIs post-PPTE. Full article

(This article belongs to the Special Issue Public Safety Personnel: Mental Health and Well-Being)

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