Mental health training, attitudes toward support, and screening positive for mental disorders

Abstract

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.

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

“…PSP and FHP are regularly exposed to PPTEs, such as threats, violence, accidents, fatalities, and suicide, as well as occupational stressors (e.g., shift work, public scrutiny, harassment or bullying) [ 1 , 2 , 3 , 5 , 6 ]. PTSIs resulting from PPTEs include symptoms of mood and anxiety disorders, as well as other mental disorders (e.g., PTSD), suicidal behaviors (i.e., ideation, planning, attempts), and maladaptive coping strategies (e.g., drug abuse, alcohol abuse, avoidance) [ 2 , 6 , 7 , 8 ].…”

“…PTSIs resulting from PPTEs include symptoms of mood and anxiety disorders, as well as other mental disorders (e.g., PTSD), suicidal behaviors (i.e., ideation, planning, attempts), and maladaptive coping strategies (e.g., drug abuse, alcohol abuse, avoidance) [ 2 , 6 , 7 , 8 ]. The impact of PTSIs may include a reduction in the quality of occupational performance, increased absenteeism, sleep difficulties, a negative impact on relationships with others, burnout, other physical or psychological illnesses, disability, and early mortality [ 5 , 41 , 42 , 43 ]. The economic burden of PTSIs within PSP and FHP in Canada remains unknown, but productivity losses that result from mental disorders experienced in the Canadian workforce are estimated to be anywhere between $16.6 billion [ 44 ] and $51 billion [ 45 , 46 , 47 ] annually.…”

“…Public safety personnel (PSP; e.g., border services officers, public safety communications officials, correctional workers, firefighters, emergency managers, operational intelligence personnel, paramedics, and police) and frontline healthcare professionals (FHP; e.g., nurses, physicians, and staff in emergency, trauma, surgical, psychiatric, geriatric, and/or intensive care units, social workers and counsellors) are regularly exposed to potentially psychologically traumatic events (PPTEs), such as threats to their own life, witnessing violence, scenes of accidents, fatalities and suicide [ 1 , 2 , 3 , 4 ]. PPTEs are distinct from other occupational stressors that can also impact the mental health of PSP and FHP, such as shift work, extensive public scrutiny, and workplace stigma, harassment, or bullying [ 5 ]. Despite the high rates of PPTE exposure, there are few evidence-based programs or interventions for proactively mitigating the development of post-traumatic stress injuries (PTSIs) in PSP, FHP, and other PPTE-exposed workers.…”

Provincial Correctional Service Workers: The Prevalence of Mental Disorders

“…Third, responses were based on anonymous online self-reporting of current symptoms, making reliability and validity ambiguous [40]; however, the results are consistent with previous Canadian correctional worker responses and increased reliability and validity would require a substantial investment. Fourth, even when anonymous, people may underreport clinical symptoms [41,42], and PSP, including correctional workers, report substantial concerns regarding stigma and confidentiality [5,6,[43][44][45][46]. Fifth, even well-validated and conservative self-report screening tools are only approximations.…”

Sleep Quality and Mental Disorder Symptoms among Canadian Public Safety Personnel

“…Researchers recently revealed that PSP in general are reluctant to access formal care and that PSP with mental health training report somewhat higher levels of perceived access to care and willingness to access services [67,68]. Therefore, treatment and prevention approaches specifically tailored for PSP may be necessary.…”