“Public safety personnel” (PSP) is a term that broadly encompasses front-line personnel who ensure the safety and security of Canadians across all jurisdictions. Examples can include tri-services police – including the Royal Canadian Mounted Police, firefighters and paramedics, correctional employees, border services personnel, operational and intelligence personnel, search and rescue personnel, Indigenous emergency managers, and dispatch personnel.
In its 2018 budget, the Government of Canada identified providing greater access to care and treatment of post-traumatic stress injuries (PTSI) for public safety officers, including those in rural and remote areas, as a priority. “Public Safety Canada has invested $10 million over 5 years to work with the Canadian Institute for Public Safety Research and Treatment (CIPSRT) to develop an Internet-based Cognitive Behaviour Therapy (ICBT) pilot as a means of providing greater access to care and treatment for public safety officers across Canada.”
As part of the federal government’s commitment under the recently released national Action Plan on Post-Traumatic Stress Injuries, “to support prevention, early intervention, stigma reduction, care and treatment for all public safety personnel, across the country”, CIPSRT is now developing an Internet-delivered cognitive behaviour therapy program for public safety personnel (called PSPNET).
The project is being led by Dr. Heather Hadjistavropoulos, Executive Director of the “Online Therapy Unit” at the University of Regina, in collaboration with Dr. Nicholas Carleton, Scientific Director of the Canadian Institute of Public Safety Research and Treatment (CIPSRT). The project was launched in 2018 and is currently funded to 2023.
Internet-based Cognitive Behaviour Therapy (ICBT) provides public safety personnel who are suffering from PTSI with access to treatment which focuses on changing patterns of thoughts, behaviours and feelings that cause distress or lead to difficulties in everyday functioning. ICBT provides access to online materials (text, images, audio and video) on a weekly basis which is supplemented by therapist supports through a combination of secure e-mails or phone calls.
The ICBT project goals include developing and testing a scalable ICBT service tailored for PSP. Specifically, ICBT will be tailored for PSP who self-report problems with anxiety, depression, or trauma, and report geographic barriers (e.g., difficulty accessing care while posted to remote locations), logistical barriers (e.g., shift work limits access to standard service hours), stigma barriers (e.g., perceptions of being evaluated negatively for having mental health concerns), limited resources (e.g., insufficient access) or simply preference for this type of service.
PSP who are accepted into the ICBT pilot program will be able to learn strategies that are typically covered in face-to-face cognitive behaviour therapy (CBT) for depression, anxiety, or trauma. The project team is working to adapt ICBT programs that were developed in Australia at Macquarie University and have been used successfully for over five years in Saskatchewan. These programs present lesson materials online on a weekly basis over 8 weeks. Participants are typically sent automated emails that encourage them to complete the lessons. Lessons are presented in an engaging manner and assignments are given at the end of each lesson to help with learning strategies. The program will be offered with weekly therapist support in the form of emails and/or phone calls.
Recruitment and confidentiality will be governed by professional practice guidelines for the provinces involved, Canadian Psychological Association Code of Ethics, as well as the Research Ethics Board at the University of Regina. All recruitment will be performed and managed solely by the clinical research team and participant employers will not be informed. All responses will be kept confidential within the legal boundaries of consent. None of the research team members will confirm or deny participation in the study without the written consent of the participant. Consent forms for participation will be stored separately from the completed and anonymized questionnaires and interviews. Participants will be provided with a nondescript identification code that will allow the researchers to analyze de-identified patient outcomes.
The ICBT project will provide a secure infrastructure to aggregate data for statistical purposes and regional specificity. Special attention will be given to all privacy and security requirements. Information will be collected and stored on a server within a firewall-protected environment. Personal information collected by PSPNET will be used for research purposes; the information will be anonymized for this purpose, meaning that information will be analyzed and presented in a way that individuals will not be identifiable.
For the first five years of the project (2018-2023), the ICBT program will be offered and evaluated in both English and in French, and in two provinces. By the end of the first five years, the project team will deliver an evidence-based model for how to deliver ICBT to PSP across all of Canada, informing future treatments for PSP.
Following the pilot testing of the ICBT model for PSP, the project outcomes will be shared with Public Safety Canada. The ICBT project will contribute valuable evidence to support its broader implementation within the mental healthcare field and among provinces and territories.
In 2019-2020, the key project deliverables will be to:
- Hire necessary project personnel;
- Secure relevant licences and ethics applications;
- Build collaborative relationships with various organizations and personnel needed to successfully develop and evaluate ICBT for PSP including organizations that currently offer services to PSP and the ministries of health;
- Conduct local PSP stakeholder interviews and focus groups within Saskatchewan, and Quebec to inform adaptation of ICBT to the specific needs of PSP;
- Adapt ICBT materials, procedures and web design for implementation;
- Complete the setup of technical infrastructure and ensure its ongoing maintenance;
- Begin offering ICBT for PSP in the first province of delivery, Saskatchewan; and
- Undertake efforts to identify and engage with a second provincial jurisdiction, namely Quebec, in order to be able to offer and evaluate ICBT for PSP in Quebec.
During the pilot testing of the ICBT model for PSP, it is important to note that participation will be limited to PSP located within Saskatchewan and Quebec.
The current “Online Therapy Unit” and the “CIPSRT website” will be updated on a regular basis to reflect progress made.
At this time, if you are interested in learning more information about the project, please contact the ICBT principal investigator, Dr. Heather Hadjistavropoulos at firstname.lastname@example.org
University of Regina
3737 Wascana Parkway
Regina, SK Canada S4S 0A2