“Playing the system”: Structural factors potentiating mental health stigma, challenging awareness, and creating barriers to care for Canadian public safety personnel

2018 ◽  
Vol 24 (3) ◽  
pp. 259-278 ◽  
Author(s):  
Rosemary Ricciardelli ◽  
R Nicholas Carleton ◽  
Taylor Mooney ◽  
Heidi Cramm
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Public Safety ◽  
Barriers To Care ◽  
Health Needs ◽  
System Level ◽  
Care Seeking ◽  
Mental Health Needs ◽  
Public Safety Personnel ◽  
Safety Personnel

There are growing concerns about the impact of public safety work on the mental health of public safety personnel; as such, we explored systemic and individual factors that might dissuade public safety personnel from seeking care. Public safety personnel barriers to care-seeking include the stigma associated with mental disorders and frequent reports of insufficient access to care. To better understand barriers to care-seeking, we thematically analyzed the optional open-ended final comments provided by over 828 Canadian public safety personnel as part of a larger online survey designed to assess the prevalence of mental disorders among public safety personnel. Our results indicated that systematic processes may have (1) shaped public safety personnel decisions for care-seeking, (2) influenced how care-seekers were viewed by their colleagues, and (3) encouraged under-awareness of personal mental health needs. We described how public safety personnel who do seek care may be viewed by others; in particular, we identified widespread participant suspicion that coworkers who took the time to address their mental health needs were “abusing the system.” We explored what constitutes “abusing the system” and how organizational structures—systematic processes within different public safety organizations—might facilitate such notions of abuse. We found that understaffing may increase scrutiny of injured public safety personnel by those left to manage the additional burden; in addition, cynicism and unacknowledged structural stigma may emerge, preventing the other public safety personnel from identifying their mental health needs and seeking help. Finally, we discuss how system-level stigma can be potentiated by fiscal constraints when public safety personnel take any leave of absence, inadvertently contributing to an organizational culture wherein help-seeking for employment-related mental health concerns becomes unacceptable. Implications for public safety personnel training and future research needs are discussed.

scholarly journals Sleep Quality and Mental Disorder Symptoms among Canadian Public Safety Personnel

2020 ◽  
Vol 17 (8) ◽  
pp. 2708
Author(s):  
Andréanne Angehrn ◽  
Michelle J. N. Teale Sapach ◽  
Rosemary Ricciardelli ◽  
Renée S. MacPhee ◽  
Gregory S. Anderson ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Sleep Quality ◽  
Mental Disorder ◽  
Public Safety ◽  
Sleep Disturbances ◽  
Poor Sleep ◽  
Public Safety Personnel ◽  
Safety Personnel ◽  
Screening Measures

Poor sleep quality is associated with numerous mental health concerns and poorer overall physical health. Sleep disturbances are commonly reported by public safety personnel (PSP) and may contribute to the risk of developing mental disorders or exacerbate mental disorder symptoms. The current investigation was designed to provide estimates of sleep disturbances among PSP and explore the relationship between sleep quality and mental health status. PSP completed screening measures for sleep quality and diverse mental disorders through an online survey. Respondents (5813) were grouped into six categories: communications officials, correctional workers, firefighters, paramedics, police officers, and Royal Canadian Mounted Police (RCMP). Many PSP in each category reported symptoms consistent with clinical insomnia (49–60%). Rates of sleep disturbances differed among PSP categories (p < 0.001, ω = 0.08). Sleep quality was correlated with screening measures for post-traumatic stress disorder (PTSD), depression, anxiety, social anxiety disorder, panic disorder, and alcohol use disorder for all PSP categories (r = 0.18–0.70, p < 0.001). PSP who screened positive for insomnia were 3.43–6.96 times more likely to screen positive for a mental disorder. All PSP reported varying degrees of sleep quality, with the lowest disturbances found among firefighters and municipal/provincial police. Sleep appears to be a potentially important factor for PSP mental health.

scholarly journals When Our Work Hits Home: Trauma and Mental Disorders in Correctional Officers and Other Correctional Workers

2021 ◽  
Vol 11 ◽  
Author(s):  
Nina Fusco ◽  
Rosemary Ricciardelli ◽  
Laleh Jamshidi ◽  
R. Nicholas Carleton ◽  
Nigel Barnim ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Public Safety ◽  
Online Survey ◽  
Mental Health Problems ◽  
Correctional Officers ◽  
Well Being ◽  
Public Safety Personnel ◽  
Psychiatric Staff ◽  
Safety Personnel

Background: International estimates suggest that up to one in three public safety personnel experience one or more mental disorders, including post-traumatic stress disorder (PTSD). Canadian data have been sparse until very recently, and correctional officers and forensic psychiatric staff have rarely been included. Working as a correctional officer is associated with negative health outcomes and increased work-related stress, with several variables affecting reported levels of stress. Healthcare staff also report higher rates of PTSD, especially those who are exposed to aggression in their workplace. In the present study, we compare current symptoms of diverse staff working in correctional occupations.Method: Data were collected from a Canadian national online survey of public safety personnel, including employees of correctional services at the federal level. Correctional officers and wellness services staff were compared for prevalence of mental disorders and suicidal ideation.Results: Correctional officers self-reported statistically significantly more exposure to potentially psychologically traumatic events than wellness services employees. Correctional officers also self-reported higher rates of symptoms of mental disorders, including PTSD, social anxiety, panic disorder, and depression. There were no statistically significant differences in reports of suicidal thoughts, plans, or attempts.Contribution to Society: Correctional and forensic staff contribute to society by working with justice-involved individuals in correctional institutions. Trauma-related disorders and other mental health problems threaten the well-being of correctional and forensic staff. Mental health likely impacts the ability of correctional and forensic staff to develop a therapeutic or working alliance with persons in custody. Staff well-being must be recognized and addressed to ensure that prisoners and staff receive optimal treatment in prison.Conclusion: Our results add to the limited knowledge about the well-being of staff, particularly wellness staff in prisons, who provide daily treatment and care for prisoners with serious mental disorders. Our work is a step toward identifying avenues for promoting staff well-being.

Efficacy, effectiveness, and quality of resilience-building mobile health apps for military, veteran and public safety personnel populations: a scoping literature review and app evaluation (Preprint)

2021 ◽  
Author(s):  
Melissa Voth ◽  
Shannon Chisholm ◽  
Hannah Sollid ◽  
Chelsea Jones ◽  
Lorraine Smith-MacDonald ◽  
...  
Keyword(s):  
Mental Health ◽  
Literature Review ◽  
Mobile Health ◽  
Public Safety ◽  
Evidence Based ◽  
Inclusion Criteria ◽  
Public Safety Personnel ◽  
Scoping Literature Review ◽  
Mhealth Apps ◽  
Safety Personnel

BACKGROUND Globally, military members (MM) and public safety personnel (PSP) are vulnerable to occupational stress injuries (OSIs) due to their job demands. Consequently, when MM and PSP transition out of these professions, they may continue to experience mental health challenges. In response to this, resilience building programs are being developed and implemented with the goal of promoting empowerment and primary stress regulation. The development of mobile health (mHealth) applications (apps) as an emergent mental health intervention platform has allowed for targeted, cost effective, and easily accessible treatment when in-person therapy may be limited or unavailable. However, current mHealth app development is not regulated, and often lacks both clear evidence-based research and the input of healthcare professionals. OBJECTIVE The purpose of this manuscript is to evaluate the evidence-based quality, efficacy, and effectiveness of resilience building mobile apps targeted towards MM, PSP, and veteran populations via: (1) a scoping literature review of the current evidence-base regarding resilience apps for these populations, and; (2) evaluation of free resilience apps designed for use amongst these populations. METHODS Studies were selected using a comprehensive search of MEDLINE, CINAHL Plus, PsycINFO, SocINDEX, Academic Search Complete, Embase, and Google and was guided by Preferred Reporting Items for Systematic Reviews and Meta-Analysis for scoping reviews (PRISMA-ScR). The Alberta Rating Index for Apps (ARIA) was utilized to conduct a review of each of the identified apps. Inclusion criteria consisted of apps: 1) free to download in either Google Play or the App Store; 2) updated within the last 3 years; 3) available in English and in Canada; and 4) intended for use by MM and/or PSP. RESULTS Twenty-two apps met the inclusion criteria for evaluation. The resilience strategies offered by the majority of apps included psychoeducation, mindfulness, Cognitive Behavioural Therapy (CBT), and Acceptance and Commitment Therapy (ACT). Eleven apps (50%) had been tested with randomized controlled trials, seven (31.8%) were evaluated using other research methods, and five (22.7%) had not been researched. Using the ARIA, apps scores ranged from 37 to 56 out of 72 with higher rated apps demonstrating increased useability and security features. CONCLUSIONS The mHealth apps reviewed are well suited to providing resilience strategies for MMs, PSP and veterans. They offer easy accessibility to evidence-based tools while working to encourage the use of emotional and professional support with safety in mind. While not intended to function as a substitute for professional services, research has demonstrated that mHealth apps have the potential to foster a significant reduction in symptom severity for PTSD, depression, anxiety, and other stress-induced concerns. Within clinical practice, apps can be utilized to supplement treatment as well as provide clients with population-specific, confidential tools to increase engagement in the treatment process. CLINICALTRIAL N/A

scholarly journals Mental health and social support among public safety personnel

2020 ◽  
Vol 70 (6) ◽  
pp. 427-433
Author(s):  
K D Vig ◽  
J E Mason ◽  
R N Carleton ◽  
G J G Asmundson ◽  
G S Anderson ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Police Officers ◽  
Public Safety ◽  
Protective Factor ◽  
Perceived Social Support ◽  
Post Traumatic Stress ◽  
Logistic Regression Models ◽  
Public Safety Personnel ◽  
Safety Personnel

Abstract Background Social support may be a protective factor for the mental health of public safety personnel (PSP), who are frequently exposed to potentially psychologically traumatic events and report substantial post-traumatic stress disorder (PTSD) and major depressive disorder (MDD) symptoms. Research examining perceived social support and its association with PTSD and MDD in different PSP categories (e.g. firefighters, paramedics) is limited. Aims To examine differences in perceived social support across PSP and determine whether perceived social support is associated with differences in rates of MDD and PTSD. Methods We asked Canadian PSP, including correctional workers and officers, public safety communications officials, firefighters, paramedics, municipal and provincial police officers, and Royal Canadian Mounted Police (RCMP) officers, to complete an online anonymous survey that assessed socio-demographic information (e.g. occupation, sex, marital status, service years), social supports and symptoms of mental disorders, including PTSD and MDD. Analyses included ANOVA and logistic regression models. Results Perceived social support differed by PSP occupation. RCMP officers reported lower social support than all other PSP except paramedics. For most PSP categories, PSP who reported greater social support were less likely to screen positive for PTSD (adjusted odds ratios [AORs]: 0.90–0.93). Across all PSP categories, greater perceived social support was associated with a decreased likelihood of screening positive for MDD (AORs: 0.85–0.91). Conclusions Perceived social support differs across some PSP categories and predicts PTSD and MDD diagnostic status. Studies involving diagnostic clinical interviews, longitudinal designs and social support interventions are needed to replicate and extend our results.

scholarly journals Public Safety Personnel’s interpretations of potentially traumatic events

2020 ◽  
Vol 70 (3) ◽  
pp. 155-161 ◽  
Author(s):  
R Ricciardelli ◽  
S Czarnuch ◽  
T O Afifi ◽  
T Taillieu ◽  
R N Carleton
Keyword(s):  
Mental Health ◽  
Public Safety ◽  
Traumatic Events ◽  
Social Contexts ◽  
Care Seeking ◽  
Occupational Culture ◽  
Post Traumatic Stress ◽  
Potentially Traumatic Events ◽  
Public Safety Personnel ◽  
The Individual

Abstract 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.

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