Public Safety Personnel (PSP; e.g. correctional workers, dispatchers, firefighters, paramedics, police) are frequently exposed to potentially traumatic events (PTEs). Several mental health training program categories (e.g. critical incident stress management (CISM), debriefing, peer support, psychoeducation, mental health first aid, Road to Mental Readiness [R2MR]) exist as efforts to minimize the impact of exposures, often using cognitive behavioral therapy model content, but with limited effectiveness research. The current study assessed PSP perceptions of access to professional (i.e. physicians, psychologists, psychiatrists, employee assistance programs, chaplains) and non-professional (i.e. spouse, friends, colleagues, leadership) support, and associations between training and mental health. Participants included 4,020 currently serving PSP participants. Data were analyzed using cross-tabulations and logistic regressions. Most PSP reported access to professional and non-professional support; nevertheless, most would first access a spouse (74%) and many would never, or only as a last resort, access professional support (43-60%) or PSP leaders (67%). Participation in any mental health training category was associated with lower (p < .01) rates for some, but not all, mental disorders, with no robust differences across categories. Revisions to training programs may improve willingness to access professional support; in the interim, training and support for PSP spouses and leaders may also be beneficial.
Background Many public safety personnel (PSP) experience trauma directly or indirectly in their occupational role, yet there remain barriers to accessing care or seeking help. Aims To understand how PSP interpret different potentially traumatic events and how perceived eligibility for being traumatized is determined among PSP. Methods We analysed open-ended comments provided by over 800 PSP in a survey designed to assess the prevalence of post-traumatic stress injuries and other mental disorders. Results We found evidence that a trauma hierarchy may exist among PSP. Certain experiences may be interpreted as more traumatic, based on both the event and the PSP role in the actual event. For example, involvement in a shooting may be interpreted as more traumatic than arriving on the scene later. Similarly, a single event may be deemed more traumatic than an accumulation of events. The role of the individual and social context in shaping experiences and interpretations of trauma may be largely ignored in line with confirmation biases. Conclusions The role that individuals and social contexts play in shaping experiences and interpretations of trauma appear suppressed by perceptions of a trauma hierarchy, facilitating systematic discrediting or valuation of some experiences, therein evidencing that trauma is subjective and reinforcing barriers to care seeking. A trauma hierarchy may also propagate stigma and legitimize discrimination regarding mental health. We argue that recognizing, engaging with, and dismantling the perception of a trauma hierarchy may help create a respectful and open occupational culture supportive of mental health needs.
BackgroundThe population of people with dementia is not homogeneous. People with dementia exhibit a wide range of needs, each characterized by diverse factors including age, sex, ethnicity, and place of residence. These needs and characterizing factors may influence the applicability, and ultimately the acceptance, of assistive technologies developed to support the independence of people with dementia. Accordingly, predicting the needs of users before developing the technologies may increase the applicability and acceptance of assistive technologies. Current methods of prediction rely on the difficult collection of subjective, potentially invasive information. We propose a method of prediction that uses objective, unobtrusive, easy to collect information to help inform the development of assistive technologies.MethodsWe develop a set of models that can predict the level of independence of people with dementia during 20 activities of daily living using simple, objective information. Using data collected from a Canadian survey conducted with caregivers of people with dementia, we create an ordered logistic regression model for each of the twenty daily tasks in the Bristol ADL scale.ResultsData collected from 430 Canadian caregivers of people with dementia were analyzed to reveal: most care recipients were mothers or husbands, married, living in private housing with their caregivers, English-speaking, Canadian born, clinically diagnosed with dementia 1 to 6 years prior to the study, and were dependent on their caregiver. Next, we developed models that use 13 factors to predict a person with dementia’s ability to complete the 20 Bristol activities of daily living independently. The 13 factors include caregiver relation, age, marital status, place of residence, language, housing type, proximity to caregiver, service use, informal primary caregiver, diagnosis of Alzheimer’s disease or dementia, time since diagnosis, and level of dependence on caregiver. The resulting models predicted the aggregate level of independence correctly for 88 of 100 total responses categories, marginally for nine, and incorrectly for three.ConclusionsObjective, easy to collect information can predict caregiver-reported level of task independence for a person with dementia. Knowledge of task independence can then inform the development of assistive technologies for people with dementia, improving their applicability and acceptance.
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