Publications

I Want Help. But Not From You: Public Safety Personnel and Mental Health Programs and Support

Full Publication

Why was the study done?

Mental health supports for public safety personnel (PSP) are necessary as they are likely to experience traumatic events in their work; however, there is little evidence to explain what helps PSP who are facing mental health challenges. Mental health training programs (e.g., critical incident stress management, debriefing sessions, peer support, mental health first aid) may help to reduce the effects of exposures to traumatic events. PSP may also seek help from professionals (e.g. physicians, psychologists, psychiatrists, chaplains), work-related resources (employee and family assistance plans, leadership teams), and other informal sources of support (spouses, friends, colleagues).

What was done in the study?

PSP, recruited through their employers, organizations, or public announcements, participated in an online survey that assessed mental health symptoms and invited open-ended feedback.  PSP were asked about their experiences with mental health training, their attitudes about mental health, and the types of assistance they were willing to access if they had a workplace mental health problem.

What did we find?

  • PSP are most willing to reach out to spouses and friends for help with mental health problems.
  • Most PSP reported being unwilling to use employee assistance programs or to speak with their leaders about mental health problems, which was consistent with previous reports about workplace stigma.
  • Participation in mental health training appeared to have a small effect on PSP willingness to ask for help.However, most PSP reported that they do have access to professional mental health resources.
  • Participation in mental health training was associated with fewer PSP screening positive for mental health disorders, such as post-traumatic stress disorder, depression, and certain types of anxiety.

Where do we go from here?

If spouses are the first choice for mental health support, then more training and resource support for PSP family members may be very beneficial. If asking for help from an employer is considered a last resort, additional leadership training to create stigma-free workplaces may be helpful. More research is needed to understand PSP concerns about using employee assistance programs, and the effect that mental health training has on specific mental health disorders in PSP.

Contact Us

For more information about this research, please contact CIPSRT@cipsrt-icrtsp.ca.

Carleton, R.N., Afifi, T.O., Turner, S., Taillieu, T., Vaughan, A.D., Anderson, G.S., Ricciardelli, R., MacPhee, R.S., Cramm, H.A., Czarnuch, S., Hozempa, K., & Camp, R.D. (2019). Mental health training, attitudes toward support, and screening positive for mental disorders. Cognitive Behaviour Therapy, pp.1-19. doi.org/10.1080/16506073.2019.1575900

Summary prepared by: Willis-Camp, T. and Carleton, R. N., 12 March 2019- edited by Kossick, E. September 2019.

Symptoms of Mental Disorder among Public Safety Personnel

Full Publication

Why was the study done? 

Individuals employed in public safety jobs are required to respond to high-stress situations as a regular part of their work. Some of the high-stress situations may occur repeatedly and can be traumatic, potentially leaving long-lasting signs of stress. These types of stressors can have a cumulative effect – that is, stressors slowly increase, and the buildup wears down people’s abilities to cope.

From research with the general public, we know that some people do experience mental health concerns after extreme stress. Public safety personnel (PSP) are more likely to experience frequent, potentially traumatizing situations than the general public. Until recently, however, mental health concerns in Canadian PSP have remained relatively unstudied.

What was done in the study?

A survey was designed with questions about on-the-job trauma experiences, as well as mental health symptoms such as PTSD, depression, anxiety, and potentially harmful alcohol use.

A total of 5,813 Canadians working in public safety jobs completed the questions used for the current report. Participants were asked to answer questions about their mental health symptoms within the past month, allowing for a current snapshot of mental health in Canadian public safety careers.

What did we find?

  • Many participants screened positively for symptoms consistent with one or more mental health
  • Participants in different professions reported different rates of mental health concerns. (For example, municipal/provincial police officers and firefighters were less likely to screen positive for mental health disorders than people in the other careers.)
  • All of the participants seem more likely to screen positive for mental health concerns than we might expect for the general
  • Participants who reported being married or common-law had lower levels of mental health concerns.
  • Participants appeared more likely to screen positive for mental health concerns the longer they worked in their public safety jobs.

Where do we go from here?

This research provides an important snapshot of how Canadian PSP are currently coping with the high-stress nature of their jobs. Much research to date has focused on the Canadian Forces, and this new survey provides similar information with a large number of PSP in Canada. The current survey results provide an essential roadmap for researchers and public safety organizations. One next step might be face-to-face interviews to get a better and more interactive account of PSP’s experiences. Hopefully, the results of this study will help to reduce stigma and pave the way for efficient, reliable, and targeted mental health services for people in public safety.


 The original wording of the study was changed and condensed for this lay summary.

For more information about this research contact CIPSRT@cipsrt-icrtsp.ca

Original Article

Carleton, R. N., Afifi, T. O., Turner, S., Tailieu, T., Duranceau, S., LeBouthillier, D. M., Sareen, J., Ricciardelli, R., MacPhee, R. S., Groll, D., Hozempa, K., Brunet, A., Weekes, J.R., Griffiths, C. T., Abrams, K. J., Jones, N. A.,  Beshai, S., Cramm, H. A., Dobson, K. S., Hatcher, S., Keane, T. M., Stewart, S. H., & Asmundson, G. J. G. (2017). Mental disorder symptoms among public safety personnel in Canada. Canadian Journal of Psychiatry, 63 (1), 54-64. doi: 10.1177/0706743717723825


Summary Prepared by  Horswill, S., Lee, V., MacPhee, R.

Edited by Kossick, E. September 2019

Understanding Suicide in Public Safety Personnel in Canada

Full Publication

Why was the study done?

Many public safety personnel (PSP) experience significant symptoms of one or more mental health disorders (e.g., posttraumatic stress disorder [PTSD], Major Depressive Disorder) and recent media attention on suicide among PSP has increased concerns about the effect of public service on the mental health of PSP.

Previous studies on suicide among Canadian PSP were limited (i.e., there were only two studies, and both focused on police and no other sectors of PSP). The previous studies also focused on deaths by suicide, not on suicidal thoughts, planning, or attempts.

What was done in the study?

The study was designed to provide initial estimates of past-year and lifetime suicidal behaviour (defined here as thoughts, plans, and attempts) amongst a diverse group of Canadian PSP. Participants were surveyed using a web-based self-report featuring basic yes or no questions based on questions previously used by Statistics Canada. Over 5,000 PSP completed enough of the survey to be included in the analysis.

What did we find out?

  • Younger PSP (under 30) were more likely to report suicidal behaviours, both in the past year and throughout their lifetimes.
  • Single or divorced/widowed PSP were more likely to report suicidal behaviours than their married/common-law counterparts.
  • Women PSP reported higher levels of suicidal behaviours over their lifetimes.
  • A higher number of PSP service years was associated with decreased lifetime suicidal behaviours.
  • Paramedics, correctional workers, and public safety communications officials (e.g., call centre operators, dispatchers) reported higher levels of suicidal behaviours than their PSP counterparts in policing and firefighting.
  • Levels of suicidal behaviour were higher among PSP than the general public.

Where do we go from here?

The current results underscore the need for increasingly broad strategies to successfully manage suicidal behaviour in PSP personnel; however, future studies should attempt to replicate the current results using different methods (e.g., clinical interviews). The research results are ultimately intended to help efforts to reduce the risk of death by suicide among PSP.


For more information about this research contact CIPSRT@cipsrt-icrtsp.ca

The original wording of the study was changed and condensed for the current lay summary.

Original Study

Carleton, R. N., Afifi, T.O., Turner, S., Taillieu, T., LeBouthiller, D.M., Duranceau, S., Sareen, J., Ricciardelli, R., MacPhee, R. S., Groll, D., Hozempa, K., Brunet, A., Weekes, J. R., Griffiths, C. T., Abrams, K.J., Jones, N. A., Beshai, S., Cramm, H. A., Dobson, K. S., Hatcher, S., Keane, T. M., Stewart, S. H., & Asmundson, G. J. G. (2018). Suicidal ideation, plans, and attempts among public safety personnel in Canada. Canadian Psychology/Psychologie canadienne, 59(3), 220-231. doi: 10.1037/cap0000136

Summary prepared by: Kossick, E., September 2019

Growing Difficulties… Public Safety Personnel and Exposure to Trauma

Full Publication

Why are we doing this study?

Public safety personnel (PSP) in Canada are facing growing difficulties dealing with mental health issues. There is evidence that exposure to traumatic events may be linked to mental health disorders. However, little research has been done to findout which types of traumatic events are potentially more damaging, and how often the different public safety sectors are exposed to different traumatic events.

What was done in the study?

PSP, recruited through their employers, organizations, or public announcements, participated in an online survey that assessed mental health symptoms and invited open-ended feedback.  PSP members were asked to identify: the sector in which they worked (e.g. communications, corrections, fire, paramedicine, policing); which traumatic events they had experienced; and which event was the worst or most distressing. The participants were also asked to complete several mental health assessment questions.

What did we find?

  • Exposure to potentially traumatic events appeared to be a part of the regular workload for
  • Sudden violent deaths, unexpected accidental deaths, and severe transportation accidents appeared to be the events most often considered traumatic for all PSP sectors.
  • The types of potentially traumatic events PSP encountered in their work differs from one public safety sector to another.
  • Different types of potentially traumatic events were associated with different types of mental disorders. For example,screening positive for depression was connected to all types of potentially traumatic events, except for fire or
  • Sudden violent deaths and severe human suffering were reported as especially problematic for PSP.These events are considered critical incidents, which may justify specific support services and programs for PSP who have experienced such events.

Where do we go from here?

The longer a PSP member serves, the greater his or her exposure to potentially traumatic events. The results indicated thatPSP sector category, types of exposure to potentially traumatic events, uncertainty, perceptions about the events, and mental disorders all interact, creating an intricate pattern that may require lots of tailoring to manage successfully. The results highlight the need for critical incident interventions and other mental health supports designed to lessen the effects of such exposure.

Contact Us

For more information about this research, please contact CIPSRT@cipsrt-icrtsp.ca.

Carleton, R. N., Afifi, T. O., Taillieu, T., Turner, S., Krakauer, R., Anderson, G. S., MacPhee, R. S., Ricciardelli, R, Cramm, H. A., Groll, D., & McCreary, D. R. (2019). Exposures to potentially traumatic events among public safety personnel in Canada. Canadian Journal of Behavioural Science / Revue canadienne des sciences du comportement, 51(1), 37-52. doi: 10.1037/cbs0000115


Summary prepared by: Willis-Camp, T. and Carleton, R. N., 11 March 2019. Edited by Kossick, E. September 2019.

 

Mental Health Training, Attitudes Toward Support, and Screening Positive for Mental Disorders (2019)

Full Publication

Lay Summary “I Want Help, But Not From You: Public Safety Personnel and Mental Health Programs and Support

Public safety personnel were asked about their experience with mental health training, their attitudes about mental health, and the types of assistance they were willing to use if they had a workplace mental health issue. Results showed that PSP are most willing to rely on their spouse or friends for mental health support, and would only consider using an Employee Assistance Program as a last resort. There needs to be more research done in order to better understand why PSP access mental health training and the effect it may have on certain types of mental health disorders. This study also shows that more training and resource support for PSP family members and leadership may be needed.

Carleton, R.N., Afifi, T.O., Turner, S., Taillieu, T., Vaughan, A.D., Anderson, G.S., Ricciardelli, R., MacPhee, R.S., Cramm, H.A., Czarnuch, S., Hozempa, K., & Camp, R.D. (2019). Mental health training, attitudes toward support, and screening positive for mental disorders. Cognitive Behaviour Therapy, pp.1-19. doi:10.1080/16506073.2019.1575900

Exposures to Potentially Traumatic Events Among Public Safety Personnel in Canada (2019)

Full Publication

Lay Summary “How Much Trauma is Too Much? Public Safety Personnel and Exposure to Traumatic Events

First responders and other public safety personnel in Canada may be experiencing substantial difficulties with symptoms of mental health disorders. These difficulties may be associated with increased exposure to potentially traumatic events as part of working in public safety, with specific types of events appearing as particularly problematic.

Carleton, R. N., Afifi, T. O., Taillieu, T., Turner, S., Krakauer, R., Anderson, G. S., MacPhee, R. S., Ricciardelli, R, Cramm, H. A., Groll, D., & McCreary, D. R. (2019). Exposures to potentially traumatic events among public safety personnel in Canada. Canadian Journal of Behavioural Science / Revue canadienne des sciences du comportement, 51(1), 37-52. doi: 10.1037/cbs0000115

Association Between a History of Child Abuse and Suicidal Ideation, Plans and Attempts among Canadian Public Safety Personnel: A Cross-Sectional Survey (2018)

Full publication

Public safety personnel experience substantial mental health problems strongly associated with suicide. This study was designed to explore associations between childhood abuse, career-related trauma, and suicidal behaviours. While career-related trauma was significantly associated with suicidal behaviours, experiencing child abuse was found to have an even stronger effect, supporting the recognition of childhood abuse as an important factor related to suicidal behaviours among public safety personnel.

Turner, S., Taillieu, T., Carleton, R. N., Sareen, J., & Afifi, T. (2018). Association between a history of child abuse and suicidal ideation, plans and attempts among Canadian public safety personnel: A cross-sectional survey. Canadian Medical Association Journal Open, 6(4), E463-E470. doi:10.9778/cmajo.20170153

Playing the System: Structural Factors Potentiating Mental Health Stigma, Challenging Awareness, and Creating Barriers to Care for Canadian Public Safety Personnel (2018)

Full Publication

Why does help-seeking for employment-related mental health concerns become unacceptable? This research looks at the open-ended final comments provided by over 828 Canadian PSP as part of a larger online survey designed to assess the prevalence of mental disorders among PSP. Based on these results, it appears that organizational culture and structures may play a role in 1) influencing PSP decision-making to seek mental health care, 2) how PSP who do seek care are viewed by their colleagues, and 3) encouraging PSP to minimize their personal mental health needs. In particular, there was widespread participant suspicion that coworkers who took the time to address their mental health needs were “abusing the system.”

Ricciardelli, R., Carleton, R. N., Mooney, T., & Cramm, H. (2018). Playing the system: Structural factors potentiating mental health stigma, challenging awareness, and creating barriers to care for Canadian public safety personnel. Health. doi:10.1177/1363459318800167

A Longitudinal Assessment of the Road To Mental Readiness Training Among Municipal Police (2018)

Full Publication

Lay Summary “Road to Mental Readiness in a Canadian Police Sample

The current study was designed to evaluate the effects of a single session of R2MR training on municipal police mental health, work engagement, resiliency, mental health knowledge, and stigma. Despite the current results being mixed, leaders may choose to believe any reductions in stigma to be worthwhile and may choose to believe that trainees’ positive perceptions of R2MR regarding attitude change and communication justify any associated investment.

Carleton, R. N., Korol, S., Mason, J. E., Hozempa, K., Anderson, G. S., Jones, N. A., Dobson, K. S., Szeto, A. & Bailey, S. (2018). A longitudinal assessment of the road to mental readiness training among municipal police. Cognitive Behaviour Therapy, 47(6), 508-528. doi: 10.1080/16506073.2018.1475504

Mental Disorder Symptoms Among Public Safety Personnel in Canada (2017)

Full Publication

Lay Summary “Mental Disorder Symptoms among Public Safety Personnel in Canada

Canadian public safety personnel are exposed to potentially traumatic events as a function of their work. Such exposures contribute to the risk of developing clinically significant symptoms related to mental disorders. The current study was designed to provide estimates of mental disorder symptom frequencies and severities for Canadian PSP.

Carleton, R. N, Afifi, T. O., Turner, S., Tallieu, T., Duranceau, S., LeBouthillier, D. M., Sareen, J., Ricciardelli, R., MacPhee, R., Groll, D., Hozempa, K., Brunet, A., Weekes, J. R., Griffiths, C. T., Abrams, K. J., Jones, N. A., Beshai, S., Cramm, H. A., Dobson, K. S., Hatcher, S., Keane, T. M., Stewart, S. H., & Asmundson, G. J. G. (2017). Mental disorder symptoms among public safety personnel in Canada. Canadian Journal of Psychiatry, 63(1), 54-64. doi: 10.1177/0706743717723825

Suicidal Ideation, Plans, and Attempts Among Public Safety Personnel in Canada (2018)

Full Publication

The current study was designed to assess past-year and lifetime suicidal ideation, plans, and attempts amongst a large diverse sample of Canadian PSP. Significant differences were identified across PSP categories in reports of past-year and lifetime suicidal behaviours.

Carleton, R. N., Afifi, T. O., Turner, S., Taillieu, T., LeBouthillier, D. M., Duranceau, S., Sareen, J., Ricciardelli, R., MacPhee, R. S., Groll, D., Hozempa, K., Brunet, A., Weekes, J. R., Griffiths, C. T., Abrams, K. J., Jones, N. A., Beshai, S., Cramm, H. A., Dobson, K. S., Hatcher, S., Keane, T. M., Stewart, S. H., & Asmundson, G. J. G. (2018). Suicidal ideation, plans, and attempts among public safety personnel in Canada. Canadian Psychology/Psychologie canadienne, 59(3), 220-231. doi: 10.1037/cap0000136

Anxiety-Related Psychopathology and Chronic Pain Comorbidity Among Public Safety Personnel (2018)

Full Publication

Lay Summary “A Brief Review of Anxiety-Related Psychopathology and Chronic Pain Comorbidity among Public Safety Personnel

Public safety personnel appear to be at risk for mental disorders and pain. The results indicated PSP who reported chronic pain were significantly more likely to screen positive for posttraumatic stress disorder (PTSD), major depressive disorder, generalized anxiety disorder, social anxiety disorder, or alcohol use disorder. There were differences between PSP categories; but, the most consistent indications of coexistence were for chronic pain, PTSD, and major depressive disorder. Coexistence of chronic pain and mental disorders among PSP is prevalent. Health care providers should regularly assess PSP for both symptom domains.

Carleton, R. N., Afifi, T. O., Taillieu, T., Turner, S., El-Gabalawy, R., Sareen, J., & Asmundson, G. J. G. (2018). Anxiety-related psychopathology and chronic pain comorbidity among public safety personnel. Journal of Anxiety Disorders, 55, 48-55. doi: 10.1016/j.janxdis.2018.03.006

Psychological Health and Safety in the Paramedic Service Organization (2018)

Full Publication

This Standard provides paramedic service organizations and other key stakeholders with requirements and guidance on good practice for the identification and assessment of hazards and management of psychological health and safety (PHS) risks for paramedic service organizations and the promotion of improved psychological health and safety.

Canadian Standards Association. (2018). Psychological health and safety in the paramedic service organization (Standard No. CSA Z-1003.1-18). Toronto, Ont.: Canadian Standards Association.

Qualitatively Unpacking Canadian Public Safety Personnel Experiences of Trauma and Their Well-Being: Physical Manifestations, Psychological Implications, and Fatalistic Attitudes (2018)

Full Publication

Lay Summary “Public Safety Personnel in Their Own Words: Asking for Support with Mental Health

Public safety personnel report experiencing extensive trauma, directly and vicariously, acutely and cumulatively. The effects of this trauma on personnel and their family members are reported as physical, psychological, and social or interpersonal impacts, as well as marital breakdown and relationship dissolution with children, and increased family stress, strain, and anger. PSP also reported they felt that nothing would change, that they had no voice, and that both their employer and the different levels of government did not care about their well-being.

Ricciardelli, R., Carleton, R. N., Groll, D., & Cramm, H. (2018). Qualitatively unpacking Canadian public safety personnel experiences of trauma and their well-being. Canadian Journal of Criminology and Criminal Justice, 60(4), 566-577. doi: 10.3138/cjccj.2017-0053.r2

Chronic Pain Among Public Safety Personnel in Canada (2017)

Full Publication

Lay Summary “Chronic Pain among Public Safety Personnel in Canada

Public safety personnel were asked to evaluate their mental and physical wellbeing, including whether they were currently experiencing chronic pain. Survey results show that not only do Canadian PSP experience more chronic pain than the average Canadian, but experiencing chronic pain appears to be linked to experiencing a mental health disorder, such as PTSD, major depressive disorder, generalized anxiety disorder, social anxiety disorder, and alcohol use disorder.

Carleton, R. N., Afifi, T. O., Turner, S., Taillieu, T., El-Gabalawy, R., Sareen, J., & Asmundson, G. J. G. (2017). Chronic pain among public safety personnel in Canada. Canadian Journal of Pain, 1(1), 237-246. doi: 10.1080/24740527.2017.1410431

An Integrated Approach to Mental Health in First Responders and Other Public Safety Personnel: A Five-Phase Plan – Strathcona County Emergency Services (2017)

Full Publication

Strathcona County Disability Management explored service standards and programs to address an increase in lost hours and costs due to mental illness, including operational stress injuries, in an effort to apply best practices with regards to mental health. Resistance, resiliency and recovery are supported through Disability Management, prompt access to evidence-based care and a culturally competent provider, Peer Support, a Chaplaincy, and Employee and Family Assistance programming, as well as access to counselling services through extended health care benefits and third- party providers. Advancements made to date have prompted significant cultural change with respect to stigma reduction and increasing help-seeking behaviour. Further, costs associated with WCB-AB claims due to Occupational Stress Injury (OSI) were reduced to zero in 2015, in 2016, and in 2017 to date.

Strathcona County Emergency Services. (2017). An integrated approach to mental health in first responders and other public safety personnel: A five-phase plan. Sherwood Park, AB: Strathcona County.

Critical Incident Reintegration Program – Edmonton Police (2017)

Full Publication

A streamlined, peer-driven return-to-work program for police officers and other public safety personnel, featuring an interactive process of dealing with the stress of a critical incident. The program has two variants: short term and long term.

Edmonton Police Service. (2017). Critical incident reintegration program. Edmonton, AB: Edmonton Police Service.

Peer Support and Crisis-Focused Psychological Intervention Programs in Canadian First Responders: Blue Paper (2016)

Full Publication

Executive Summary

There is an urgent need for more research on the effectiveness of peer support and crisis-focused psychological intervention programs designed to help public service personnel cope with work trauma. The operational stressors, which include death, violence, and threats to their own lives, put PSP at risk for psychological challenges, including post-traumatic stress, depression, anxiety, and anger. Such challenges can lead to other problems, such as substance abuse, relationship difficulties, and absenteeism.

Beshai, S., & Carleton, R. N. (2016). Peer support and crisis-focused psychological intervention programs in Canadian first responders: Blue Paper. Regina, SK: University of Regina Collaborative Centre for Justice and Safety. Available from: http://www.justiceandsafety.ca/rsu_docs/blue_paper_full_web_final_production_aug_16_2016.pdf