Stakeholder perspectives on internet-delivered cognitive behavioural therapy for public safety personnel: A qualitative analysis.

Abstract

Public safety personnel (PSP)-including border security agents, correctional workers, dispatchers, firefighters, paramedics, and police-have elevated rates of depression, anxiety, and posttraumatic stress. In its Action Plan on Posttraumatic Stress Injuries, the Government of Canada reported that many PSP are unable to access treatment for mental health problems. The Action Plan identified internet-delivered cognitive behavioural therapy (ICBT) as a treatment that can improve access to care for PSP. Nevertheless, little is known about how PSP perceive ICBT and what tailoring PSP deem important to address their needs. We conducted interviews with 126 PSP stakeholders in the Canadian provinces of Saskatchewan and Quebec to explore their perspectives on ICBT. The results confirmed that PSP face many barriers to treatment. Stigma was the most frequently cited barrier. The results also indicated that PSP have positive perceptions of ICBT; most stakeholders reported believing there is a need for ICBT tailored for PSP and that PSP would be likely to use it. Stakeholders provided valuable recommendations regarding how researchers and clinicians should design and deliver ICBT for PSP. Specifically, PSP recommended that tailored ICBT should treat a range of symptoms, address other concerns that are important to PSP, and be delivered in a flexible manner. The results indicate that PSP perceive ICBT as an appropriate treatment option to help address the high prevalence of mental health problems among Canadian PSP. These findings have helped us tailor an existing ICBT program for PSP and may help researchers tailoring interventions to PSP in other contexts. Public Significance StatementThe current results suggest Canadian public safety personnel are amenable to using internet-delivered cognitive behaviour therapy to address their mental health concerns. Public safety personnel identified several ways in which researchers and clinicians can tailor this innovative treatment to meet their needs. The study results are important because evidence shows that Canadian public safety personnel experience high rates of mental health problems, and many are unable to access existing services.

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

“…Our research unit (PSPNET) recently conducted a study [ 8 ] in which we interviewed PSP about several topics, including their perspectives on ICBT. Despite some overlap in research questions and findings between the two studies, the recent study included only a qualitative analysis of the interviews with PSP, while the current study includes quantitative and qualitative analyses of survey data.…”

“…The poster is displayed in Appendix A . The ICBT client story followed a PSP character named Sam, whose story was derived from those of various PSP interviewed in a separate study [ 8 ]. Sam’s story described his experience using an ICBT program, including the knowledge, tools, and resources he received from ICBT and how they helped him manage his wellbeing and mental health as a PSP.…”

“…PSP have experienced high rates of trauma exposure and mental health disorders but have avoided seeking psychological services, due, in part, to concerns about mental health stigma [ 6 ]. Despite successful initiatives to provide resiliency training and reduce the stigma surrounding mental health problems, such as the Road to Mental Readiness for First Responders program [ 7 ], a recent study found that many Canadian PSP still report experiencing limited workplace support for mental health-related problems [ 8 ]. PSP face several other barriers to mental health services, including long waiting times, distance from services, concerns about privacy and confidentiality, and cost of treatment [ 8 , 9 ].…”

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

“…Of concern, PSP face many barriers to accessing mental healthcare, including concerns about stigma, time constraints, and geographic and financial barriers [ 23 , 24 ]. Internet-delivered cognitive behavioral therapy (ICBT) is private, accessible at virtually any time and location, and cost-effective [ 25 , 26 ], which can help PSP overcome most barriers.…”

“…Internet-delivered cognitive behavioral therapy (ICBT) is private, accessible at virtually any time and location, and cost-effective [ 25 , 26 ], which can help PSP overcome most barriers. Indeed, research shows that PSP report favorable attitudes towards ICBT [ 23 , 27 ]. Our research unit, PSPNET, launched a free-to-access ICBT program for PSP in the Canadian province of Saskatchewan in January 2020, which was shortly before the COVID-19 pandemic reached Saskatchewan.…”