Publications

PSP report exposures to diverse and frequent potentially psychologically traumatic events and other occupational stressors, exacerbating risks for developing clinically significant mental health challenges. Multiple mental health disorder diagnoses increase risk for death by suicide and may partially explain the higher suicide risk among PSP. The study was designed to estimate suicidal ideation, planning, and attempts among Canadian PSP, and assesses associations with Emotional Resilience Skills Training (ERST) as part of a Federal Framework on Posttraumatic Stress Disorder (PTSD). Participants included serving PSP (n=186) from four occupational sectors including firefighters, municipal police, paramedics, and public safety communicators. The results indicate suicide-related challenges for PSP, particularly PSP who self-identify as women and females. The results suggest sector-specific differences in suicide attempts, indicating unique sector-specific challenges among PSP. The results evidenced reductions in suicidal ideation and planning directly after ERST; however, attrition impacted analyses at 1-year follow-up.

Public safety personnel (PSP) are frequently exposed to psychologically traumatic events. The exposures potentiate posttraumatic stress injuries (PTSIs), including posttraumatic stress disorder (PTSD). The Royal Canadian Mounted Police (RCMP) Protocol was designed to mitigate PTSIs using ongoing monitoring and PSP delivered Emotional Resilience Skills Training (ERST) based on the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders. The current study pilot-tested ERST effectiveness among diverse PSP. A 16-month longitudinal design engaged serving PSP (firefighters, municipal police, paramedics, public safety communicators) who completed PSP-delivered ERST. Participants were assessed for symptoms of PTSIs, including but not limited to PTSD, at pre- and post-training, and 1-year follow-up using self-report measures and clinical interviews. Improvements were observed among firefighters, police, paramedics, and communicators, indicating that ongoing mental health monitoring and PSP-delivered ERST, can produce small to large mental health improvements among diverse PSP, or mitigate PSP mental health challenges, with variations influenced by pre-training factors and organizational supports. The current results support using the RCMP Protocol to help broadly improve PSP mental health or at least maintained non-clinical status despite compounding challenges associated with COVID-19.

Public safety personnel (PSP; e.g., correctional workers, firefighters, paramedics, police, public safety communicators) are inevitably exposed to potentially psychologically traumatic events (PPTEs; e.g., actual or threatened death, serious injury or sexual violence). Frequent PPTE exposures and other occupational stressors are associated with posttraumatic stress injuries (PTSI) including posttraumatic stress disorder (PTSD), major depressive disorder (MDD), generalized anxiety disorder (GAD), and other physical and psychological comorbidities. PSP senior leadership (i.e., Chiefs, Directors, Deputy Chiefs) are expected to provide effective solutions for frontline personnel mental health. Most efforts have focused on frontline PSP, with minimal mental health support efforts targeted towards senior PSP leadership, despite PSP senior leadership being generally presumed to have experienced PPTEs and other occupational stressors in their previous roles as frontline PSP which may have similarly impacted their mental health. To date, no studies have assessed for differences in occupational stressors, mental health disorder symptoms, and suicidal behaviours (i.e., ideation, planning, attempts) among a diverse sample of Canadian PSP leadership relative to frontline PSP. The current study was designed to assess for differences in screening prevalence proportions for occupational stressors, mental health disorders, and suicidal behaviours among different organizational roles (i.e., PSP senior leadership [Chiefs, Directors, Deputy Chiefs] and PSP in other serving roles) within the paramedicine and policing PSP sectors, with the intent to broadly support the Canadian National Action Plan on Post-Traumatic Stress Injuries. Results indicated that PSP senior leadership were not less likely to screen positive for any mental health disorder, one or more mental health disorders, or suicidal behaviours than frontline PSP within the same PSP sector, underscoring that PSP senior leadership also need tailored mental health supports, particularly given the administrative stressors that will necessarily compound the impact of their frontline service.

Criticisms of Canadian police interactions with the public have escalated since early 2010s, with increasing negative media attention. Police use of force is not inherently wrong, is sometimes necessary to protect citizens, and is prescribed by provincial legislation to prevent further risk of harm to the public. Negative media coverage often focuses on critiquing police causing duty-related bodily harm (DRBH) without sufficient context. The current study quantitatively analysed publicly available Canadian data on DRBH involving use of force exceeding legally-approved standard operating procedures or involving code of conduct violations (FELSOP), relative to total police occurrences. Since 2012, independent provincial civilian oversight agency Crown referrals have been stable at less than 0.08% (i.e., <1/10th of 1%) of all police occurrences. The rate of fatalities of members of the public per police occurrence has remained at less than 0.001% (i.e., less than 1/1000th of 1%) since 2000, with only three Canadian police convicted of DRBH involving FELSOP resulting in a deceased member of the public while on duty. Comparatively, a total of 104 on-duty police officer fatalities were recorded between 2000 and 2023, 47 of which were identified as resulting from intentionally harmful acts committed by members of the public. As a result, police appear ~23.5 times more likely to die by intentionally harmful acts by members of the public than to be convicted of fatal DRBH involving FELSOP against the public. The current proportions of less than 1/10th of 1% raise questions about substantial criticisms and calls for pervasive reforms, and suggest careful considerations are needed regarding reasonable expectations.

Risk factors are modifiable individual factors associated with many different mental health challenges for the general population and public safety personnel (PSP). In the current study, individual resilience describes how a person perceives their own ability to cope with difficult situations. Individual resilience is associated with lower levels of mental health challenges. The current study was designed to assess how effective Emotional Resilience Skills Training (ERST) is at reducing risk factors and increasing individual resilience among PSP from different sectors. Risk and resilience were assessed at three time points: just before completing ERST, just after completing ERST, and one year after completing ERST. Results indicated participants at post-training reported lower scores on measures of risk factors and higher scores on a measure of resilience. The improvements were maintained for at least one year after completing ERST. Therefore, the current results support ERST as effective for lowering risk and increasing individual resilience among PSP, which may in turn reduce their risk for developing mental health challenges.

Risk factors are modifiable individual factors associated with many different mental health challenges for the general population and public safety personnel (PSP). In the current study, individual resilience describes how a person perceives their own ability to cope with difficult situations. Individual resilience is associated with lower levels of mental health challenges. The current study was designed to assess how effective Emotional Resilience Skills Training (ERST) is at reducing risk factors and increasing individual resilience among PSP from different sectors. Risk and resilience were assessed at three time points: just before completing ERST, just after completing ERST, and one year after completing ERST. Results indicated participants at post-training reported lower scores on measures of risk factors and higher scores on a measure of resilience. The improvements were maintained for at least one year after completing ERST. Therefore, the current results support ERST as effective for lowering risk and increasing individual resilience among PSP, which may in turn reduce their risk for developing mental health challenges.

This protocol paper describes the PSP PTSI Study (i.e., design, measures, materials, hypotheses, planned analyses, expected implications, and limitations), which was originally designed to evaluate an evidence-informed, proactive system of mental health assessment and training.