Programs Addressing Psychological Health and Resilience in the U.S. Department of Homeland Security

Farmer, Carrie M.; Whipkey, Katie; Chamberlin, Margaret

doi:10.7249/rr1952

Cited by 6 publications

(6 citation statements)

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“…Stress First Aid (SFA) is a self-care and coworker support model that operates in alignment with this recommendation. It was developed for those in high-stress occupations where values like selflessness, loyalty, a strong moral code, and excellence give strength but also potentially create vulnerabilities (e.g., prioritizing other's need above one's own) [3,[77][78][79][80][81][82][83][84][85] . SFA offers simple, practical actions to identify and address stress reactions in oneself and others in an ongoing way.…”

Section: Disaster Mental Health-informed Principles For High-stress O...mentioning

confidence: 99%

Stress, PTSD, and COVID-19: the Utility of Disaster Mental Health Interventions During the COVID-19 Pandemic

Watson

2022

Curr Treat Options Psych

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Purpose of review In the context of an ongoing, highly uncertain pandemic, disaster mental health measures can increase community capacity for resilience and well-being, support formal mental health treatment, and help address the risk for mental health reactions in high-stress occupations. The purpose of this review is to summarize the literature on disaster mental health interventions that have been helpful both prior to and during the pandemic in a broad range of applications, including for use with high-stress occupations in an effort to mitigate risk for post-traumatic stress disorder (PTSD) and other mental health sequelae. Recent findings Evidence-based and evidence-informed disaster mental health interventions, frameworks, and treatments have been studied in pilot studies, non-randomized trials, and randomized clinical trials prior to and in the context of the current COVID-19 pandemic. The studies have demonstrated feasibility and acceptability of these modalities and improved perceived support, as well as significant reductions in distress, and mental health symptoms such as depression, anxiety, and PTSD. Summary A disaster mental health approach to the COVID-19 pandemic can generate opportunities for prevention and support at multiple levels with timely interventions tailored for different concerns, cultures, and available resources.

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Section: Disaster Mental Health-informed Principles For High-stress O...mentioning

confidence: 99%

Stress, PTSD, and COVID-19: the Utility of Disaster Mental Health Interventions During the COVID-19 Pandemic

Watson

2022

Curr Treat Options Psych

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“…On its own, the intervention cannot heal or prevent burnout in the absence of the systemic change needed to fundamentally improve the environment in which HCWs function. 38 While this peer-to-peer support intervention should be helpful based on prior studies in non-HCW populations, 19,25,26 brief training sessions and heightened awareness of stress without longer-term, purposeful support could paradoxically increase stress in the short-term, [39][40][41] especially if systemic challenges either are not addressed or are ever-changing.…”

Section: Discussionmentioning

confidence: 99%

“…On its own, the intervention cannot heal or prevent burnout in the absence of the systemic change needed to fundamentally improve the environment in which HCWs function. 38 While this peer-to-peer support intervention should be helpful based on prior studies in non-HCW populations, 19 , 25 , 26 brief training sessions and heightened awareness of stress without longer-term, purposeful support could paradoxically increase stress in the short-term, 39 , 40 , 41 especially if systemic challenges either are not addressed or are ever-changing. Brief trainings during a lunch hour, for example, without systemic commitment to ongoing support, may worsen HCW stress, especially if the training identifies problems but is not seen as helpful in resolving those problems.…”

Section: Discussionmentioning

confidence: 99%

“…Stress First Aid is a promising evidence-informed intervention for mitigating the psychosocial effect of COVID-19 on HCWs. 19 , 20 , 21 , 22 , 23 , 24 Initially developed for the US Navy and US Marine Corps, 19 , 25 , 26 this intervention is a framework of actions for peer support delivered by individuals without mental health training to mediate and mitigate the effect of atypically stressful circumstances, but it was not designed to prevent any particular mental health disorder. Additionally, this peer-to-peer support intervention has been adapted to integrate seamlessly into the health care environment for HCW self-care and to help HCWs support patients and families.…”

Section: Introductionmentioning

confidence: 99%

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Testing an Intervention to Improve Health Care Worker Well-Being During the COVID-19 Pandemic

Meredith,

Ahluwalia,

Chen

et al. 2024

JAMA Netw Open

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ImportanceStress First Aid is an evidence-informed peer-to-peer support intervention to mitigate the effect of the COVID-19 pandemic on the well-being of health care workers (HCWs).ObjectiveTo evaluate the effectiveness of a tailored peer-to-peer support intervention compared with usual care to support HCWs’ well-being at hospitals and federally qualified health centers (FQHCs) during the COVID-19 pandemic.Design, Setting, and ParticipantsThis cluster randomized clinical trial comprised 3 cohorts of HCWs who were enrolled from March 2021 through July 2022 at 28 hospitals and FQHCs in the US. Participating sites were matched as pairs by type, size, and COVID-19 burden and then randomized to the intervention arm or usual care arm (any programs already in place to support HCW well-being). The HCWs were surveyed before and after peer-to-peer support intervention implementation. Intention-to-treat (ITT) analysis was used to evaluate the intervention’s effect on outcomes, including general psychological distress and posttraumatic stress disorder (PTSD).InterventionThe peer-to-peer support intervention was delivered to HCWs by site champions who received training and subsequently trained the HCWs at their site. Recipients of the intervention were taught to respond to their own and their peers’ stress reactions.Main Outcomes and MeasuresPrimary outcomes were general psychological distress and PTSD. General psychological distress was measured with the Kessler 6 instrument, and PTSD was measured with the PTSD Checklist.ResultsA total of 28 hospitals and FQHCs with 2077 HCWs participated. Both preintervention and postintervention surveys were completed by 2077 HCWs, for an overall response rate of 28% (41% at FQHCs and 26% at hospitals). A total of 862 individuals (696 females [80.7%]) were from sites that were randomly assigned to the intervention arm; the baseline mean (SD) psychological distress score was 5.86 (5.70) and the baseline mean (SD) PTSD score was 16.11 (16.07). A total of 1215 individuals (947 females [78.2%]) were from sites assigned to the usual care arm; the baseline mean (SD) psychological distress score was 5.98 (5.62) and the baseline mean (SD) PTSD score was 16.40 (16.43). Adherence to the intervention was 70% for FQHCs and 32% for hospitals. The ITT analyses revealed no overall treatment effect for psychological distress score (0.238 [95% CI, −0.310 to 0.785] points) or PTSD symptom score (0.189 [95% CI, −1.068 to 1.446] points). Post hoc analyses examined the heterogeneity of treatment effect by age group with consistent age effects observed across primary outcomes (psychological distress and PTSD). Among HCWs in FQHCs, there were significant and clinically meaningful treatment effects for HCWs 30 years or younger: a more than 4-point reduction for psychological distress (−4.552 [95% CI, −8.067 to −1.037]) and a nearly 7-point reduction for PTSD symptom scores (−6.771 [95% CI, −13.224 to −0.318]).Conclusions and RelevanceThis trial found that this peer-to-peer support intervention did not improve well-being outcomes for HCWs overall but had a protective effect against general psychological distress and PTSD in HCWs aged 30 years or younger in FQHCs, which had higher intervention adherence. Incorporating this peer-to-peer support intervention into medical training, with ongoing support over time, may yield beneficial results in both standard care and during public health crises.Trial RegistrationClinicalTrials.gov Identifier: NCT04723576

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“…Psychological debriefing, defined as "a structured, singlesession, group intervention for early intervention after trauma" is discouraged and should be replaced by psychological first aid (Nash and Watson, 2012). Other evidence based programs include collaborative care models, EAPs, and cognitive behavioral therapy if acute stress disorder has been diagnosed (Farmer, Whipkey, and Chamberlin, 2019). Other programs, such as resilience training and mindfulness, can decrease levels of distress and absenteeism but not the symptoms of mental health disorders (Maglione et al, 2021).…”

Section: Best Practices For Preventing and Responding To Self-directe...mentioning

confidence: 99%

Strengthening Workforce Resilience in U.S. Space Command

2024

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Space Command (USSPACECOM) was reestablished as a combatant command in 2019 and has a diverse workforce. Its main goals are to achieve full operational capabilities and to maintain space superiority. To ensure this command's success, it is important to enhance the resilience of its personnel. In this report, we offer best practices to enhance resilience by preventing harmful individual behaviors that reduce resiliency, identify some challenges and barriers to resilience program implementation, and propose recommendations to address these challenges and barriers in the future.The research reported here was completed in January 2024 and underwent security review with the sponsor and the Defense Office of Prepublication and Security Review before public release.

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Programs Addressing Psychological Health and Resilience in the U.S. Department of Homeland Security

Cited by 6 publications

References 59 publications

Stress, PTSD, and COVID-19: the Utility of Disaster Mental Health Interventions During the COVID-19 Pandemic

Stress, PTSD, and COVID-19: the Utility of Disaster Mental Health Interventions During the COVID-19 Pandemic

Testing an Intervention to Improve Health Care Worker Well-Being During the COVID-19 Pandemic

Strengthening Workforce Resilience in U.S. Space Command

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