Prevalence of PTSD, Depression and Anxiety Disorders in Correctional Officers: A Systematic Review

Sleep quality and mental disorder symptoms among correctional workers in Ontario, Canada

Correctional workers (CWs) report high levels of work stressors, frequent exposures to potentially psychologically traumatic events (PPTEs), and substantial mental health challenges. There is evidence of associations between sleep disturbances and diverse mental health challenges, including preliminary evidence from public safety personnel; however, replications and extensions would better inform interventions to support mental health. The current study was designed to examine associations between quality of sleep, work stress, and mental health disorders in a sample of diverse CWs employed in a provincial correctional service in Ontario, Canada. Data were analyzed from 943 CWs who participated in the cross-sectional, web-based Ontario Provincial Correctional Worker Mental Health and Well-Being Study conducted from December 2017 to June 2018. Sleep quality indicators included symptoms of insomnia, total hours of sleep per night on work nights and off-shift nights, number of days feeling rested per week, and overall sleep quality. Descriptive statistics, analyses of variance, correlational analyses, and logistic regression were used to examine relationships among sleep quality, stress of shift work, and mental health disorder symptoms. CWs slept an average of 6.0 h per night when working and 7.2 h during off-shift nights. CWs reported waking up feeling rested an average of 2.6 days per week and rated their overall quality of sleep in the fair to poor range. Many CWs (64.9%) screened positive for clinically significant symptoms of insomnia. There were also differences across occupational groups such that CWs working as correctional officers reported the most sleep problems. There were statistically significant relationships between insomnia and mental health disorder symptoms. Higher levels of stress from shift work were associated with worse sleep quality. CWs, especially those working as correctional officers in a provincial prison, reported many indicators consistent with poorer quality of sleep. Poor quality of sleep was also associated with work stress and mental health disorders.

Prison and forensic mental health staff after suicides in their care. A narrative review of international and German national evidence

There is a growing body of international research investigating the impact of patient suicide on mental health professionals. The experience of losing a patient to suicide can have a significant and, in some cases, long-lasting (negative) impact on mental health professionals. However, the nature and extent of the impact on prison staff or forensic mental health professionals in particular is less clear. This narrative review summarises both quantitative and qualitative studies and key findings in this area, focusing on the above professions. A literature search was conducted using PsychInfo and Google Scholar, covering the period from 2000 onwards. The vast majority of findings relate to mental health professionals in general. We were unable to identify any published reports on the responses of forensic psychiatric staff. The majority of identified studies in the prison context are qualitative. Studies from German-speaking countries are particularly scarce in both the prison and mental health contexts. We conclude that there is a profound lack of knowledge about the impact of client/patient suicide on the subgroups of (German) prison and forensic psychiatric staff. Clearly, more research is needed on both the nature and extent of the impact, as well as on the specific organisational and supportive factors that help to mitigate the negative effects of suicide.

Work outcomes in public safety personnel after potentially traumatic events: A systematic review

BACKGROUND

It is well documented that public safety personnel are exposed to potentially traumatic events (PTEs) at elevated frequency and demonstrate higher prevalence of trauma-related symptoms compared to the general population. Lesser studied to date are the organizational consequences of workplace PTE exposure and associated mental health outcomes such as acute/posttraumatic stress disorder (ASD/PTSD), depression, and anxiety.

METHODS

The present review synthesizes international literature on work outcomes in public safety personnel (PSP) to explore whether and how PTE and trauma-related symptoms relate to workplace outcomes. A total of N = 55 eligible articles examining PTE or trauma-related symptoms in relation to work outcomes were systematically reviewed using best-evidence narrative synthesis.

RESULTS

Three primary work outcomes emerged across the literature: absenteeism, productivity/performance, and costs to organization. Across n = 21 studies of absenteeism, there was strong evidence that PTE or trauma-related symptoms are associated with increased sickness absence. N = 27 studies on productivity/performance demonstrated overall strong evidence of negative impacts in the workplace. N = 7 studies on cost to organizations demonstrated weak evidence that PTE exposure or trauma-related mental health outcomes are associated with increased cost to organization.

CONCLUSIONS

Based on available evidence, the experience of workplace PTE or trauma-related symptoms is associated with negative impact on PSP occupational functioning, though important potential confounds (e.g., organizational strain and individual risk factors) remain to be more extensively investigated.

Relationship between trauma, psychological distress and help-seeking among corrective service workers

BACKGROUND

Corrective service workers (CSWs) are at high risk of post-traumatic stress disorder (PTSD) and other mental health problems. Prevalence rates and help-seeking behaviours are under-researched within this population.

AIMS

To assess rates of PTSD and distress, and identify predictors of intention to seek help, among workers at an Australian corrective service agency.

METHODS

A cross-sectional online survey was used to collect data on staff demographics, employment, PTSD symptoms and current distress. Participants received a tailored feedback report including referral to relevant mental health services (where applicable) and were asked to indicate their likelihood of seeking help. Prevalence data are reported. Binary logistic regression was used to examine relationships between participant characteristics and help-seeking for those with probable PTSD and/or high psychological distress.

RESULTS

Participants (n=1001) were predominantly men (56.8%) with a mean age of 46.72 (SD=11.00). Over half (58.0%) were classified as probable PTSD cases, and one-third (33.0%) were experiencing high psychological distress. Around a third (34.3%) of participants with probable PTSD and/or elevated distress indicated they were likely to seek help. Older age and fewer years of service were associated with increased help-seeking intentions.

CONCLUSIONS

CSWs were found to be experiencing probable PTSD at higher rates than reported in previous studies. Relatively few intended to seek help from mental health services, despite being provided with personalised screening and feedback along with access to specialised care. Future research should investigate the potential role of organisational support as a facilitator of help-seeking within this population.

A participatory and comprehensive intervention to improve violence prevention in two high-risk occupations: effect and process evaluation of a stepped wedge cluster randomised trial

BACKGROUND

Work-related violence committed by clients, patients, and customers represents a major occupational health risk for employees that needs to be reduced.

METHODS

We tested a comprehensive violence prevention intervention involving active participation of both employees and managers in the Prison and Probation Service (PPS) and on psychiatric wards in Denmark. We used a stepped wedge cluster randomised controlled trial design. We measured the degree of implementation of the intervention by registration of fidelity, reach, and dose and used a mixed-effects regression analysis to estimate the effects of the intervention.

RESULTS

We recruited 16 work units for the intervention, but three work units dropped out. The average implementation rate was 73%. In the psychiatric wards, the intervention led to statistically significant improvements in the primary outcome (an increase in the degree to which managers and employees continuously work on violence prevention practices based on their registration and experiences), but none statistically significant improvements in any of the secondary outcomes. In the PPS units, the intervention did not lead to a statistically significant improvement in the primary outcome, but to statistically significant improvements in three secondary outcomes.

CONCLUSION

Most work units were able to carry out the intervention as planned. The intervention showed mixed results regarding the primary outcome. Nevertheless, the results indicate improvements also in the sector where a change in the primary outcome was not achieved. The results point at that a participatory and comprehensive approach could be a viable way of working with violence prevention in high-risk workplaces.

TRIAL REGISTRATION

ISRCTN86993466: 20/12/2017.

"We must be mentally strong": exploring barriers to mental health in correctional services

Introduction

The inherent nature of work in correctional services can have negative effects on correctional worker mental health and well-being.

Methods

The current study, a replication, analyzes survey data collected from provincial and territorial correctional workers staffed in six regions across Canada (n = 192). Specifically, participants were asked at the end of an extensive mental health and well-being survey an open-ended question requesting any additional feedback or information.

Results

Four predominant themes were identified in the data: (1) stigma pertaining to a need to recognize mental health concerns within correctional services; (2) the idea that correctional services wear on the mind and body; (3) a need for better relationships with and support from correctional supervisors, upper management, and ministerial leadership; and (4) suggestions to improve correctional services to help the sector realize its full potential and maximize workplace health.

Discussion

We discuss the implications of these findings, with an emphasis on finding ways to promote positive organizational and cultural change in correctional services.

Relationship between work-family conflict and anxiety/depression among Chinese correctional officers: a moderated mediation model of burnout and resilience

BACKGROUND

Correctional officers tend to have high levels of work-family conflict (WFC). WFC has been found associated with various forms of psychological distress and to affect the overall well-being of correctional officers. Burnout and resilience may affect the relationship between WFC and psychological distress, however, this association still remains unclear. This study aimed to examine the mediating effect of burnout on the relationship between WFC and anxiety/depression and the moderating role of resilience, within the context of correctional officers.

METHODS

A cross-sectional online survey was conducted in China from October 2021 to January 2022. WFC, burnout, resilience, anxiety, and depression were evaluated using the Work-Family Conflict Scale (WFCS), Maslach Burnout Inventory-General Survey (MBI-GS), 10-item Connor-Davidson Resilience Scale (CD-RISC-10), and the Depression Anxiety Stress Scale (DASS). Mediation and moderation models were then tested using the PROCESS macro in SPSS, with burnout being a mediator and resilience playing a moderating role in the relationship between WFC and anxiety/depression.

RESULTS

A total of 472 correctional officers were included. Burnout was found to mediate the relationship between WFC and anxiety (b = 0.14, 95%CI [0.10, 0.19]) and the relationship between WFC and depression (b = 0.23, 95%CI [0.18, 0.28]). Additionally, resilience played a moderating role in the direct effect of WFC on anxiety (b = - 0.02, p < 0.01) and the first half of the indirect effect of WFC on anxiety (b = - 0.007, p < 0.05). Furthermore, resilience was also found to moderate the first half of the indirect effect of WFC on depression (b = - 0.02, p < 0.01), but not the direct effect of WFC on depression (b = - 0.005, p > 0.05).

CONCLUSION

The findings of the present study may improve our understanding by elucidating the fundamental mechanisms of the connection between WFC and psychological distress among correctional officers. The results have significant implications for policymakers and individuals, as they suggest that diverse interventions may help promote the mental well-being of correctional officers.

The Implications of Stress Among Correctional Officers: A Summary of the Risks and Promising Intervention Strategies

This paper provides a detailed summary and discussion of the concept of stress and how it relates to the health, wellbeing, and performance of corrections officers. In line with these objectives, we focus on three areas: (1) providing a more detailed definition of the concept of stress; (2) a discussion of the ways that increased exposure to stress may impact corrections officers' physical and mental health; and (3) a summary of prevention and intervention strategies that are relevant for corrections officers and have shown promise in dampening the consequences of increased stress exposure. More in-depth knowledge of the concept of stress and the underlying processes that link stress to negative outcomes will provide policy makers and corrections departments with an understanding of the characteristics of prevention and intervention strategies that are expected to be most effective in limiting the consequences of stress.

Prevalence and factors associated with anxiety and depression among Chinese prison officers during the prolonged COVID-19 pandemic

Objective

This study examined the prevalence of anxiety and depression-along with the potential risk and protective factors-among Chinese prison officers during the prolonged COVID-19 pandemic.

Method

A cross-sectional survey of 1,268 officers from five prisons in western and southern China was administered between June and July 2022. The questionnaires comprised two sections. In the first section, the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) were used to evaluate the prevalence of anxiety and depression, respectively, among prison officers. In the second section, the potential influencing factors were examined. Categorical data were compared using χ2 tests and t-tests; binary logistic regression analysis was performed to identify factors associated with anxiety and depression.

Results

The prevalence rates of anxiety and depression among the prison officers were 72.6% and 69.8%, respectively. Risk factors for anxiety were older age, being unmarried, work-family conflicts, job demands, and COVID-19 burnout; protective factors were exercise, positive family relationships, and group cohesion. Work-family conflicts, job demands, intolerance of uncertainty regarding COVID-19, and COVID-19 burnout were risk factors for depression, whereas annual income >150,000 RMB, exercise, positive family relationships, group cohesion, and job autonomy were protective factors against depression.

Conclusion

The prevalence of anxiety and depression among Chinese prison officers was relatively high during the prolonged COVID-19 pandemic, and more targeted measures should be implemented to improve their mental health. This study offers a reference for improving prison officers' mental health in response to similar public health emergencies in the future.

COVID-19 Vaccine Refusal and Medical Distrust Held by Correctional Officers

This study explores COVID-19 vaccine acceptance among prison security staff and the extent to which they trust varied sources of information about the vaccines. Cross-sectional survey data were obtained from a state-wide sample of corrections officers (COs, hereafter; n = 1208) in February 2021. Group differences, disaggregated by demographic characteristics, were examined using F-tests and t-tests. Despite the comparatively limited risk of contracting the virus, non-security staff reported they would accept a COVID-19 vaccine at no cost (74%), compared to their more vulnerable CO counterparts (49%). We observed vaccine refusal correlations between COs' reported gender, age, and length of time working as a CO, but none with their self-reported race. Vaccine refusal was more prevalent among womxn officers, younger officers, and those who had spent less time working as prison security staff. Our findings also suggest that the only trusted source of information about vaccines were family members and only for officers who would refuse the vaccine; the quality of trust placed in those sources, however, was not substantially positive and did not vary greatly across CO racial groups. By highlighting characteristics of the observed gaps in COVID-19 vaccine acceptance between COs and their non-security staff coworkers, as well as between corrections officers of varied demographic backgrounds, these findings can inform the development of responsive and accepted occupational health policies for communities both inside and intrinsically linked to prisons.

Post-traumatic stress disorder burden among female Syrian war refugees is associated with dysmenorrhea severity but not with the analgesics

Dysmenorrhea association with post-traumatic stress disorder (PTSD) has not been studied in refugees. We aimed to examine the associations between dysmenorrhea severity, dysmenorrhea analgesics self-medications, and PTSD in a cohort of Syrian war refugees residing in Jordan.<br /> This is a cross-sectional study based on predetermined inclusion criteria held at Caritas primary care centers in Jordanian districts between September and October 2022. The participants’ demographics and analgesic self-medication type were recorded through a structured questionnaire. The dysmenorrhea severity was measured by (working ability, location, intensity, days of pain, and dysmenorrhea) WaLiDD scale, PTSD was measured by Davidson trauma scale (DTS)-DSM-IV.<br /> Data from 347 Syrian female war refugees were analyzed. The multivariate analysis showed that dysmenorrhea severity demonstrated significantly higher estimates for PTSD (10.48 [6.72-14.23], p=0.001), however, the analgesic type was not associated with PTSD burden.<br /> In conclusion, dysmenorrhea severity, but not self-medication, was associated with a higher PTSD burden.

Study protocol for a controlled trial of a resilience program on psychological distress in correctional officers in Australia

BACKGROUND

The mental health impacts of workers within correctional settings has been of increasing focus over the past number of years. This paper outlines the study protocol for a trial that tests the efficacy of a brief resilience program, relative to a no intervention control in reducing general psychological distress and absenteeism in a cohort of correctional personnel in NSW, Australia.

METHODS

A, parallel, randomized controlled trial will be carried out in a small group format. Following informed consent, corrective personnel within prisons across NSW will volunteer to either attend a clinician delivered resilience program on stress management skills or not (N = 600). The primary outcome will be change in psychological distress including anxiety and depression at 2-months post intervention. Secondary outcomes include help-seeking behaviours and absenteeism.

DISCUSSION

This prevention focused treatment trial will assess whether a brief clinician delivered resilience program will reduce absenteeism and mitigate psychological distress in a cohort of corrective personnel within NSW, Australia. This study will yield insights into the role of a brief psychological program in mitigating the psychological distress reported by personnel in correctional settings.

TRIAL REGISTRATION

This trial was prospectively registered on the Australian New Zealand Clinical Trials Registry (ACTRN12622000029796).

ETHICS AND DISSEMINATION

Ethics approval has been obtained from University of New South Wales Human Research Ethics Committee. Results of the trial will be submitted for publication in peer reviewed journals and findings presented at scientific conferences and to key service providers and policy makers.

Methodological correlates of variability in the prevalence of posttraumatic stress disorder in high-risk occupational groups: A systematic review and meta-regression

BACKGROUND

Although numerous studies have reported on PTSD prevalence in high-risk occupational samples, previous meta-analytic work has been severely limited by the extreme variability in prevalence outcomes.

METHODS

The present systematic review and meta-regression examined methodological sources of variability in PTSD outcomes across the literature on high-risk personnel with a specific focus on measurement tool selection.

RESULTS

The pooled global prevalence of PTSD in high-risk personnel was 12.1% [6.5%, 23.5%], and was similar to estimates obtained in other meta-analytic work. However, meta-regression revealed that PTSD prevalence differed significantly as a function of measurement tool selection, study inclusion criteria related to previous traumatic exposure, sample size, and study quality. PTSD prevalence estimates also differed significantly by occupational group and over time, as has also been reported in previous work, though exploratory examination of trends in measurement selection across these factors suggests that measurement strategy may partially explain some of these previously reported differences.

CONCLUSIONS

Our results highlight a pressing need to better understand the role of measurement strategies and other methodological choices in characterizing variable prevalence outcomes. Understanding the role of methodological variance will be critical for work attempting to reliably characterize prevalence as well as risk and protective factors for PTSD.

Prison officers' experiences of aggression: implications for sleep and recovery

BACKGROUND

Prison officers are at high risk of assault that can impair their mental as well as physical health. Such experiences can also disrupt sleep, with negative implications for well-being and job performance. To manage this risk, insight is needed into the mechanisms by which experiencing aggression from prisoners can affect officers' sleep quality. By impairing recovery processes, work-related hypervigilance and rumination might be key factors in this association.

AIMS

To examine prison officers' personal experiences of aggression and associations with sleep quality. Also, to consider whether work-related hypervigilance and rumination mediate the relationship between exposure to aggression and sleep.

METHODS

We assessed prison officers' experiences of aggression and violence, work-related hypervigilance and rumination via an online survey. The PROMIS was used to measure the quality of sleep.

RESULTS

The study sample comprised 1,806 prison officers (86.8% male). A significant relationship was found between the frequency of experiences of aggression at work and the quality of sleep. Work-related hypervigilance and rumination were significantly associated with sleep quality and mediated the relationship between workplace aggression and sleep quality.

CONCLUSIONS

Our findings suggest that enhancing the safety climate in prisons might improve officers' quality of sleep that, in turn, could benefit their wellbeing and performance. Implementing individual-level strategies to help prison officers manage hypervigilance and rumination, and therefore facilitate recovery, should also be effective in improving their sleep.

Working conditions and common mental disorders in prison officers in the inland region of the state of São Paulo, Brazil

Abstract The prison officer profession is characterized by working in risky situations, which can harm officers’ mental health. This research aimed to analyze prison officers’ working conditions associated with Common Mental Disorders (CMD). This cross-sectional study was conducted with prison officers in four penitentiary units in the inland region of the State of São Paulo, Brazil, from January to August 2019. The Self-Reporting Questionnaire (SRQ-20) tool was employed to quantify the presence of CMDs. Poisson regression verified the association between variables with robust variance and adjusted for confounding factors to estimate the prevalence ratio (PR) and 95% confidence interval (CI). The study population comprised 331 prison officers (ASP), with a 33.5% frequency of CMDs. CMDs were higher among prison officers with a worse perception of working conditions (PR: 1.13; 95%CI%: 1.03-1.24), who suffered insults (PR: 1.18; 95%CI: 1.08-1.29), psychological harassment (PR: 1.23; 95%CI: 1.11-1.36) and sexual harassment (PR: 1.20; 95%CI: 1.03-1.40) in the last 12 months. CMDs were associated with work-related variables, such as worse environmental conditions within the prison and psychological and sexual violence.

Condições de trabalho e transtornos mentais comuns em agentes penitenciários do interior do estado de São Paulo, Brasil

Resumo A profissão de agente de segurança penitenciária (ASP) se caracteriza pelo trabalho em situações de perigo, o que pode desencadear prejuízos à sua saúde mental. O objetivo desta investigação foi analisar as condições de trabalho associadas aos transtornos mentais comuns (TMC) em ASP. Trata-se de um estudo transversal, realizado com ASP de quatro unidades prisionais do interior do estado de São Paulo, de janeiro a agosto de 2019. Para mensurar a presença de TMC, utilizou-se o instrumento Self-Reporting Questionnaire (SRQ-20). A associação entre as variáveis foi verificada por meio de regressão de Poisson com variância robusta, ajustada por fatores de confusão para a estimação da razão de prevalência (RP) e intervalo de confiança (IC) de 95%. A população de análise foi constituída por 331 ASP, com frequência de TMC de 33,5%. A presença de TMC foi mais elevada entre os ASP com pior percepção sobre as condições de trabalho (RP: 1,13; IC95%: 1,03-1,24), que sofreram insultos (RP: 1,18; IC95%: 1,08-1,29), assédio moral (RP: 1,23; IC95%: 1,11-1,36) e assédio sexual (RP: 1,20; IC95%: 1,03-1,40), nos últimos 12 meses. O TMC apresentou associação com variáveis relacionadas ao trabalho, tais como piores condições do ambiente no interior do cárcere e ocorrência de violências psicológica e sexual.

The COVID-19 pandemic behind bars: Experimental evidence showing higher support for decarceration when framed as risk to correctional staff

This study examined the effect of framing COVID-19 spread in correctional facilities as impacting imprisoned individuals or impacting correctional staff on public support for decarceration. I employed an experiment in the 2021 Empire State Poll (n = 765) in which participants were randomly assigned to a treatment condition, which highlighted information about the number of COVID-19 cases among imprisoned individuals, or a control condition, which highlighted correctional staff instead. Participants reported how supportive or unsupportive they are of releasing imprisoned individuals to curb the spread of COVID-19. Overall, 35% of New Yorkers supported decarceration. A higher percentage of respondents supported decarceration when the impact on correctional staff was highlighted (40%) relative to imprisoned individuals (31%). There was also higher support among non-Hispanic Black (54%) and Hispanic (51%) participants relative to non-Hispanic White (28%) participants. Within racial/ethnic groups support for decarceration was higher when the impact on correctional staff was highlighted among non-Hispanic Whites, Hispanics, and those of another race, but not among non-Hispanic Blacks where support for decarceration was higher when the impact on imprisoned individuals was highlighted. Inferential analysis using log binomial regression found that the association between treatment condition assignment and support for decarceration was not significant. Public health practitioners and policy makers should consider leveraging the higher support associated with concerns over the health and wellbeing of correction staff found among some racial/ethnic groups to fight the COVID-19 pandemic.

Mental Health Disorders and Suicidal Behaviors Among Provincial Correctional Workers

OBJECTIVE

We examined the prevalence ofmental health disorders and suicidal behaviors (ideation, planning, and attempts) among a sample of provincial correctional workers in Manitoba.

METHODS

Self-reported mental health data from a survey on correctional worker mental health and well-being were analyzed for 491 correctional workers.

RESULTS

Over half (57%) of respondents screened positive for mental health disorder, most commonly major depressive disorder, and over one-third of respondents (37%) screened positive for more than one disorder. Positive mental health screens for all mental health disorders were associated with statistically significantly increased odds of lifetime suicidal ideation, and positive screens for most disorders were associated with past year suicidal ideation.

CONCLUSIONS

Relative to other public safety personnel and the general public, correctional workers appear have a higher prevalence of mental health disorders and suicidal behaviors. The association between positive screens for mental health disorders and suicidal behaviors highlights the vulnerability of correctional workers in regards to mental well-being.

Operational and organisational stressors in community correctional work: Insights from probation and parole officers in Ontario, Canada

In the current article, we investigate the occupational stressors parole and probation officers working in provincial correctional services in Ontario, Canada experience. We examine four specific stressors that emerged thematically from participants' open-ended survey responses, and conceptualize these as operational factors (i.e., the duties of the job) or organisational factors (i.e., structural aspects of the organisation in which parole or probation officers work). Participants identified the operational stressor of exposure to potentially psychologically traumatic events and secondary trauma, as well as three predominant organisational stressors: paperwork and administrative tasks, insufficient human resources, and workplace relationships and tensions. Drawing from literatures on parole and probation, workplace stress, and organisational cultures and behaviours, we analyse how these stressors have detrimental impacts on the mental health and well-being of community correctional workers, which in turn compromises their ability to effectively supervise and support individuals on their caseload. Policy and well-being implications are discussed.

A qualitative exploration of the mental health challenges and therapeutic needs of Canadian correctional workers

PURPOSE

Correctional work is described as a high-stress environment associated with increased prevalence of mental health disorders in employees. Identifying appropriate healthcare services necessitates investigating the mental health challenges and needs of correctional workers (CWs).

METHODS

Individual interviews (n = 9; 5 M and 4 W) and a mixed gender focus group (n = 6; 3 M and 3 W) were conducted to gather a general sense of the mental health landscape. Data were analyzed to develop a targeted and comprehensive question guide for gender-specific focus groups (n = 14 unique participants; 6 M and 8 W).

RESULTS

Eight themes emerged from the gender-specific focus groups. Themes focusing on work culture described the negative repercussions of job stress and the inability to discuss challenges openly due to confidentiality concerns and feelings of seclusion associated with the CW profession. Men were more likely to be subjected to physical violence and women to emotional and sexual harassment from staff and inmates. Themes related to mental health care described the benefits and limitations of the current services and digital mental healthcare. Stigma and accessibility were notable treatment barriers. Lastly, sector-specific therapy was seen as an important component in enhancing engagement and therapist interaction.

CONCLUSION

The study demonstrates the interconnection between work culture and CW mental health that needs to be acknowledged when addressing mental health care.

Job stress and depression among Malaysian anti-drug professionals: The moderating role of job-related coping strategies

Depression can cause negative consequences to workers' health and social functioning, such as poor work productivity, mental disorders, and suicide. Existing studies have argued that job stress is closely related to depression in many professions. Yet, information on how coping strategies play a significant role in the relationships among Malaysian anti-drug professionals is still scarce. Thus, the aim of this study was to examine to what extent coping strategies moderate the relationship between job stress and depression among Malaysian anti-drug professionals. A total of 3,356 National Antidrug Agency (NADA) officers aged between 21 and 59 years completed online self-report measures of depression, job stress, and job-related control coping and avoidant coping behaviors. The results showed that job stress was strongly correlated with depression, and both coping strategies were found to significantly moderate the correlations. The correlations between stress and depression were stronger among participants who had higher levels of avoidant coping or those who had lower levels of control coping. To conclude, this study highlights the importance of considering job stress and coping behaviors to understand anti-drug professionals' mental health during this challenging COVID-19 pandemic.

Benefits of Digital Mental Health Care Interventions for Correctional Workers and Other Public Safety Personnel: A Narrative Review

Chronic exposure to stressors and potentially psychologically traumatic events contributes to the high prevalence of mental health disorders in correctional workers (CWs) and other public safety personnel (PSP). Digital mental health interventions are an accessible and scalable method of improving and maintaining the mental health of this population. The current review explores the benefits of digital mental health interventions for PSP-with a focus on CWs-and how these innovations can address the limitations in in-person mental health care. A systematic literature search of five databases (Medline, PsycInfo, Embase, CINAHL, Google Scholar) was conducted until March 2022. The search yielded 16 publications that focused on digital mental health interventions or care available to CWs and other PSP. The benefits of digital innovations were summarized into five categories which discussed (1) their ability to enhance accessibility and reduce stigma; (2) the provision of evidence-based and structured psychotherapy programs; (3) variability in the degree of therapist engagement; (4) the integration of proactive interventions; and (5) enhancing engagement by acknowledging unique experiences and interpersonal relationships. Although digital mental health technologies for CWs are still in their infancy, there is strong evidence to support their effectiveness in ameliorating symptoms of mental distress. Future research should consider how ethnicity, gender, culture, sexual orientation, and socioeconomic status can be integrated into these therapies and how the interplay between different stakeholders and organizations can impact the effectiveness of online therapies and programs.

"We just needed to open the door": a case study of the quest to end solitary confinement in North Dakota

Solitary confinement is a widespread practice in US correctional facilities. Long-standing concerns about the physical and mental health effects of solitary confinement have led to litigation, legislation, and community activism resulting in many prison systems introducing policies or implementing legal mandates to reduce or eliminate its use. Yet little is known about the nature and effectiveness of policies that states have adopted to reduce their use of solitary confinement and exactly how various reforms have actually impacted the lives of people living and working in the prisons where these reforms have taken place.

METHODS

We conducted an embedded case study, analyzing changes in policies and procedures, administrative data, and focus groups and interviews with incarcerated persons and staff, to describe the circumstances that led to changes in solitary confinement policies and practices in the North Dakota Department of Corrections and Rehabilitation (ND DOCR) and the perceived impact of these changes on incarcerated persons and prison staff. .

RESULTS

North Dakota's correctional officials and staff members attributed the impetus to change their solitary confinement policies to their participation in a program that directly exposed them to the Norwegian Correctional Service's philosophy, policies, and practices in 2015. The ensuing policy changes made by North Dakota officials were swift and resulted in a 74.28% reduction in the use of solitary confinement between 2016 and 2020. Additionally, placements in any form of restrictive housing decreased markedly for incarcerated persons with serious mental illness. In the two prisons that had solitary confinement units, rule infractions involving violence decreased at one prison overall and it decreased within the units at both prisons that were previously used for solitary confinement. Although fights and assaults between incarcerated people increased in one of the prison's general population units, during the initial months of reforms, these events continued to decline compared to years before reform. Moreover, incarcerated people and staff attributed the rise to a concomitant worsening of conditions in the general population due to overcrowding, idleness, and double bunking. Both incarcerated persons and staff members reported improvements in their health and well-being, enhanced interactions with one another, and less exposure to violence following the reforms.

CONCLUSIONS

Immersing correctional leaders in the Norwegian Correctional Service' public health and human rights principles motivated and guided the ND DOCR to pursue policy changes to decrease the use of solitary confinement in their prisons. Ensuing reductions in solitary confinement were experienced as beneficial to the health and wellness of incarcerated persons and staff alike. This case-study describes these policy changes and the perspectives of staff and incarcerated persons about the reforms that were undertaken. Findings have implications for stakeholders seeking to reduce their use of solitary confinement and limit its harmful consequences and underscore the need for research to describe and assess the impact of solitary confinement reforms.

Assessing Relative Stressors and Mental Disorders among Canadian Provincial Correctional Workers

In the current study, we quantified the mean stress levels of 43 occupational stressors for 868 Correctional Workers (CWs) and analyzed the relationships between occupational stressors, exposure to potentially psychologically traumatic events (PPTEs), and mental health disorders. Our findings emphasize the importance of the occupational environment in relation to CW mental health and indicate that occupational stressors (e.g., staff shortages, inconsistent leadership style, bureaucratic red tape) are more salient contributors to CW mental health than exposure to PPTEs. Finding strategies to ameliorate staff shortages, improve leadership style and communication, and support CWs to maintain physical, mental, and social well-being would be interventions tied to significant organizational and operational stressors within the current study.

Delivering an Online Cognitive Behavioral Therapy Program to Address Mental Health Challenges Faced by Correctional Workers and Other Public Safety Personnel: Protocol for a Mixed Methods Study

BACKGROUND

Public safety personnel have regular and often intense exposure to potentially traumatic events at work, especially workplace violence in the case of correctional workers. Subsequently, correctional workers are at higher risk of developing mental health problems such as posttraumatic stress disorder. Public safety personnel are up to 4 times more likely to experience suicidal ideation, suicidal attempts, and death by suicide compared to the general population. Despite this high prevalence, help-seeking behaviors from public safety personnel are low due to stigma and irregular work hours limiting access to care. Innovative treatments are needed to address these challenges.

OBJECTIVE

This study will investigate the efficacy of an electronically delivered cognitive behavioral therapy (e-CBT) program tailored to correctional workers' mental health problems.

METHODS

This study is composed of 4 phases. In phase 1, we will interview correctional workers individually and in focus groups to identify personal, social, and cultural factors affecting their mental health and barriers to care. Phase 2 will use the information gathered from the interviews to develop gender- and diagnosis-specific e-CBT modules. These will be presented to a new group of participants who will provide further feedback on their usability and accessibility. In phase 3, we will randomly assign participants to either an e-CBT or treatment as usual arm. The program will be evaluated with validated symptomatology questionnaires and interviews. Phase 4 will use this additional information to fine-tune the e-CBT modules for a larger-scale randomized controlled trial design comparing the e-CBT program to in-person CBT. All e-CBT modules will be delivered through a secure online platform.

RESULTS

The study received ethics approval in December 2020, and participant recruitment began in March 2021. Participant recruitment has been conducted through targeted advertisements and physician referrals. To date, there have been 15 participants recruited for Phase 1, and it is expected to conclude in July 2021, with phase 2 beginning in September 2021. Complete data collection and analysis from all phases are expected to conclude by July 2023. Linear and binomial regression (for continuous and categorical outcomes, respectively) will be conducted along with interpretive qualitative methods.

CONCLUSIONS

If proven efficacious and feasible, this e-CBT program can provide a high-quality and clinically validated resource to address the mental health problems of correctional workers. Additionally, findings can contribute to the development of innovative treatments for other public safety professions.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04666974; https://www.clinicaltrials.gov/ct2/show/NCT04666974.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/30845.

Insomnia among Prison Officers and Its Relationship with Occupational Burnout: The Role of Coping with Stress in Polish and Indonesian Samples

Thus far, data on sleep disorders among prison officers (POs) have been scarce. Research allows us to relate this problem to occupational stress, which POs experience every day. The aim of the current study was to analyze the scale, predictors, and impact of select factors on the relationship between insomnia and occupational burnout. This study was carried out on a sample of 376 Indonesian and 288 Polish POs using the Athens Insomnia Scale (AIS), the Coping Orientation to Problems Experienced (COPE) inventory, and the Oldenburg Burnout Inventory (OLBI). Results showed that 43.4% of the Polish sample exhibited early symptoms of insomnia, compared to 26.1% of the Indonesian sample. Sleep disorders had a significant role in developing occupational burnout. In both samples, coping strategies such as help-seeking and engagement were revealed to have a mediating role in the relationship between insomnia and occupational burnout dimensions. For the total sample and for the Polish sample, the coping strategy of help-seeking was the only predictor of insomnia. Discrepancies (concerning the role of age, gender, and multi-shift work) were observed between the current results and earlier studies. The current study's limitations were discussed and new solutions were proposed.

Progress in Corrections Worker Health: The National Corrections Collaborative Utilizing a Total Worker Health® Strategy

OBJECTIVE

To examine National Corrections Collaborative (NCC) activities, as an outreach initiative, to advance corrections workplace health and safety research, practice, and policy through a series of applied Research to Practice (r2p) meetings informed by the Total Worker Health(Total Worker Health is a registered trademark of the U.S. Department of Health and Human Services) (TWH) strategy.

METHODS

We mapped the coalescence of correctional worker health concerns, federal and national professional organization initiatives, and research activities that formed the NCC in 2014.

RESULTS

During the NCC's 5-years of TWH activities, attendance increased, partner composition expanded, and themes of concern evolved. Partners were motivated to participate and work together towards building evidence for health and safety r2p.

CONCLUSIONS

A unified plea to the academic and federal research communities for assistance with better evaluation instruments, data linkages, and for adopting an integrated TWH approach to workforce health and wellbeing continue to drive NCC r2p activities.

Mental Disorders in Firefighters Following Large-Scale Disaster

Firefighting service is known to involve high rates of exposure to potentially traumatic situations, and research on mental health in firefighting populations is of critical importance in understanding the impact of occupational exposure. To date, the literature concerning prevalence of trauma-related mental disorders such as posttraumatic stress disorder (PTSD) has not distinguished between symptomology associated routine duty-related exposure and exposure to large-scale disaster. The present systematic review synthesizes a heterogeneous cross-national literature on large-scale disaster exposure in firefighters and provides support for the hypothesis that the prevalence of PTSD, major depressive disorder, and anxiety disorders are elevated in firefighters compared with rates observed in the general population. In addition, we conducted narrative synthesis concerning several commonly assessed predictive factors for disorder and found that sociodemographic factors appear to bear a weak relationship to mental disorder, while incident-related factors, such as severity and duration of disaster exposure, bear a stronger and more consistent relationship to the development of PTSD and depression in cross-national samples. Future work should expand on these preliminary findings to better understand the impact of disaster exposure in firefighting personnel.

Provincial Correctional Service Workers: The Prevalence of Mental Disorders

Correctional service employees in Ontario, Canada (n = 1487) began an online survey available from 2017 to 2018 designed to assess the prevalence and correlates of mental health challenges. Participants who provided data for the current study (n = 1032) included provincial staff working in institutional wellness (e.g., nurses) (n = 71), training (e.g., program officers) (n = 26), governance (e.g., superintendents) (n = 82), correctional officers (n = 553), administration (e.g., record keeping) (n = 25), and probation officers (n = 144, parole officers). Correctional officers, workers in institutional administration and governance positions, and probation officers reported elevated risk for mental disorders, most notably posttraumatic stress disorder (PTSD) and major depressive disorder. Among institutional correctional staff, 61.0% of governance employees, 59.0% of correctional officers, 43.7% of wellness staff, 50.0% of training staff, and 52.0% of administrative staff screened positive for one or more mental disorders. In addition, 63.2% of probation officers screened positive for one or more mental disorders. Women working as correctional officers were more likely to screen positive than men (p < 0.05). Across all correctional occupational categories positive screens for each disorder were: 30.7% for PTSD, 37.0% for major depressive disorder, 30.5% for generalized anxiety disorder, and 58.2% for one or more mental disorders. Participants between ages 40 and 49 years, working in institutional governance, as an institutional correctional officer, or as a probational officer, separated or divorced, were all factors associated (p < 0.05) with screening positive for one or more mental disorders. The prevalence of mental health challenges for provincial correctional workers appears to be higher than federal correctional workers in Canada and further supports the need for evidence-based mental health solutions.