Improving Mental Health Knowledge and Reducing Mental Health Stigma Among Public Safety Personnel: Comparison of Live vs. Online Psychoeducation Training Programs

This study evaluates the effectiveness of a brief psychoeducation training program in reducing mental health stigma, both toward others and oneself, among public safety personnel, while also comparing the relative effectiveness of in-person and online training modalities. In total, 1686 public safety personnel in Florida received psychoeducation on the mental health impacts of public safety work. Participants completed pre- and post-training questionnaires assessing demographics, mental health knowledge, and mental health stigma toward others and themselves. Among the participants, 871 completed the training online, and 44 completed the training in-person. A paired samples t-test assessed changes in knowledge from pre- to post-test, and 2 × 2 repeated measures ANOVAs analyzed stigma-related data. Mental health knowledge increased and mental health stigma toward others decreased post-training, with no differences between training modalities. No changes in mental health self-stigma were found. Police officers reported significantly greater self-stigma than firefighters. Firefighters and dispatchers reported significantly less stigma toward others than police officers. This study found that both in-person and online psychoeducation can similarly improve mental health knowledge and reduce stigma toward others, which may help reduce barriers to seeking care.

The Effectiveness and Implementation of Psychological First Aid as a Therapeutic Intervention After Trauma: An Integrative Review

Psychological First Aid (PFA) is known to be an initial early intervention following traumatic exposure, yet little is known about its optimal implementation and effectiveness. This review aims to examine the evidence for the effectiveness of PFA interventions and how PFA interventions have been designed, implemented, and experienced. MEDLINE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, PsychINFO, Embase, Web of Science, PILOTS, and China National Knowledge Infrastructure (in Chinese) databases were searched. Twenty studies from 4,735 records were included and quality rated, followed by an integrative synthesis of quantitative and qualitative evidence. PFA intervention following trauma exposure shows a positive effect for reducing anxiety and facilitating adaptive functioning in the immediate and intermediate term, yet the evidence for reducing Post-traumatic stress disorder/depressive symptoms is less compelling. Furthermore, commonalities in the components and techniques across different PFA approaches identified tend to align with four of Hobfoll's five essential elements: safety, calm, efficacy, and connectedness (as reflected among 7/11 PFA protocols), whereas the "hope" element was less developed. These commonalities include active listening, relaxation/stabilization, problem-solving/practical assistance, and social connection/referral. Intensive techniques such as cognitive reconstruction have also been incorporated, intensifying PFA delivery. The substantial variation observed in PFA format, timing, and duration, coupled with inadequate documentation of fidelity of implementation and adaptation, further constrains the ability to inform best practices for PFA. This is concerning for lay frontline providers, vital in early trauma response, who report implementation challenges despite valuing PFA as a time-sensitive, supportive, and practical approach.

Exploring the needs of healthcare workers receiving psychological first aid during the COVID19 pandemic

BACKGROUND

Healthcare workers (HCW; e.g., nurses, social workers) work in stressful conditions, a situation that has been further exacerbated by the COVID-19 pandemic. A review of the supportive role of Psychological first aid (PFA) suggested that it can protect HCW from psychological distress. Despite the growing interest of PFA among public health organizations, there is a dearth of literature on its potential impact for the psychological well-being of HCW and its implementation within organizations.

OBJECTIVE

This study aimed to evaluate whether PFA met the psychological needs of HCW in Montreal, Quebec.

METHODS

A sample of 15 HCW who received PFA by a peer within their organization were recruited to participate in semi-structured interviews. Qualitative research using thematic analysis was conducted.

RESULTS

Five themes were identified: 1) PFA satisfied participants' psychosocial needs; 2) PFA provided by peers allowed participants to feel understood and supported; 3) High availability and multiple modalities facilitated PFA access; 4) Occupational and organizational cultures hindered PFA access; and 5) Recommendations to promote the use of the PFA service.

CONCLUSION

Results describe four psychosocial needs met by the PFA intervention: to have resources/strategies, to be validated, to obtain a better understanding of the psychological reactions they were experiencing, and to be guided and supported in their difficulties at work. Overall, these findings illustrate how PFA goes beyond the reduction of distress symptoms in the aftermath of a potentially traumatic event. The relevance to further the assessment of PFA's positive effects on psychological adaptation and/or recovery is also highlighted.

Barriers and facilitators to implementing workplace interventions to promote mental health: qualitative evidence synthesis

BACKGROUND

Despite growing interest in workplace mental health interventions, evidence of their effectiveness is mixed. Implementation science offers a valuable lens to investigate the factors influencing successful implementation. However, evidence synthesis is lacking, especially for small-to-medium-sized enterprises (SMEs) and for specific work sectors. The objectives of this review are to establish the scope of research with explicit analysis of implementation aspects of workplace mental health interventions and to identify barriers and facilitators to implementation in general and within SMEs and selected sectors.

METHODS

A systematic scoping review and meta-synthesis of mixed methods process evaluation research from 11 databases, with the evaluation of methodological quality (MMAT) and confidence in findings (CERQual), was conducted. We selected information-rich studies and synthesised them using domains within the Nielsen and Randall implementation framework: context, intervention activities, implementation; and mental models.

RESULTS

We included 43 studies published between 2009 and 2022, of which 22 were rated as information-rich to be analysed for barriers and facilitators. Most studies were conducted in healthcare. Facilitators reflecting 'high confidence' included: relevant and tailored content, continuous and pro-active leadership buy-in and support, internal or external change agents/champions, assistance from managers and peers, resources, and senior-level experience and awareness of mental health issues. Healthcare sector-specific facilitators included: easy accessibility with time provided, fostering relationships, clear communication, and perceptions of the intervention. Stigma and confidentiality issues were reported as barriers overall. Due to the small number of studies within SMEs reported findings did not reach 'high confidence'. A lack of studies in construction and Information and Communication Technology meant separate analyses were not possible.

CONCLUSIONS

There is dependable evidence of key factors for the implementation of workplace mental health interventions which should be used to improve implementation. However, there is a lack of studies in SMEs and in a larger variety of sectors.

SYSTEMATIC REVIEW REGISTRATION

Research Registry ( reviewregistry897 ).

Feasibility and acceptability of a culturally adapted psychological first aid training intervention (Preparing Me) to support the mental health and well-being of front-line healthcare workers in China: a feasibility randomized controlled trial

Background: Psychological first aid (PFA) training helps to prepare healthcare workers (HCWs) to manage trauma and stress during healthcare emergencies, yet evidence regarding its effectiveness and implementation is lacking.Method: A two-arm feasibility randomized controlled trial design was conducted in a Chinese tertiary hospital. Participants were randomly allocated to receive either a culturally adapted PFA training (the intervention arm) or psychoeducation (the control arm). Feasibility indicators and selected outcomes were collected.Results: In total, 215 workers who expressed an interest in participating in the trial were screened for eligibility, resulting in 96 eligible participants being randomly allocated to the intervention arm (n = 48) and control arm (n = 48). There was a higher retention rate for the face-to-face PFA training session than for the four online group PFA sessions. Participants rated the PFA training as very helpful (86%), with a satisfaction rate of 74.25%, and 47% reported being able to apply their PFA skills in responding to public health emergencies or providing front-line clinical care. Positive outcome changes were observed in PFA knowledge, skills, attitudes, resilience, self-efficacy, compassion satisfaction, and post-traumatic growth. Their scores on depression, anxiety, stress, and burnout measures all declined. Most of these changes were sustained over 3 months (p < .05). Repeated measures analysis of variance found statistically significant interaction effects on depression (F2,232 = 2.874, p = .046, η p 2  = .031) and burnout (F2,211 = 3.729, p = .018, η p 2  = .037), indicating a greater reduction in symptoms of depression and burnout with PFA compared to psychoeducation training.Conclusion: This culturally adapted PFA training intervention was highly acceptable among Chinese HCWs and was feasible in a front-line care setting. Preliminary findings indicated positive changes for the PFA training intervention on knowledge, skills, attitudes, resilience, self-efficacy, compassion satisfaction, and post-traumatic growth, especially a reduction of depression and burnout. Further modifications are recommended and a fully powered evaluation of PFA training is warranted.

Implementing a complex mental health intervention in occupational settings: process evaluation of the MENTUPP pilot study

BACKGROUND

According to the Medical Research Council (MRC) framework, the theorisation of how multilevel, multicomponent interventions work and the understanding of their interaction with their implementation context are necessary to be able to evaluate them beyond their complexity. More research is needed to provide good examples following this approach in order to produce evidence-based information on implementation practices.

OBJECTIVES

This article reports on the results of the process evaluation of a complex mental health intervention in small and medium enterprises (SMEs) tested through a pilot study. The overarching aim is to contribute to the evidence base related to the recruitment, engagement and implementation strategies of applied mental health interventions in the workplace.

METHOD

The Mental Health Promotion and Intervention in Occupational Settings (MENTUPP) intervention was pilot tested in 25 SMEs in three work sectors and nine countries. The evaluation strategy of the pilot test relied on a mixed-methods approach combining qualitative and quantitative research methods. The process evaluation was inspired by the RE-AIM framework and the taxonomy of implementation outcomes suggested by Proctor and colleagues and focused on seven dimensions: reach, adoption, implementation, acceptability, appropriateness, feasibility and maintenance.

RESULTS

Factors facilitating implementation included the variety of the provided materials, the support provided by the research officers (ROs) and the existence of a structured plan for implementation, among others. Main barriers to implementation were the difficulty of talking about mental health, familiarisation with technology, difficulty in fitting the intervention into the daily routine and restrictions caused by COVID-19.

CONCLUSIONS

The results will be used to optimise the MENTUPP intervention and the theoretical framework that we developed to evaluate the causal mechanisms underlying MENTUPP. Conducting this systematic and comprehensive process evaluation contributes to the enhancement of the evidence base related to mental health interventions in the workplace and it can be used as a guide to overcome their contextual complexity.

TRIAL REGISTRATION NUMBER

ISRCTN14582090.

Post-incident psychosocial interventions after a traumatic incident in the workplace: a systematic review of current research evidence and clinical guidance

Background: After a traumatic incident in the workplace organisations want to provide support for their employees to prevent PTSD. However, what is safe and effective to offer has not yet been established, despite many organisations offering some form of intervention after a traumatic event.Objective: To systematically review the evidence for post-incident psychosocial interventions offered within one month of a workplace trauma, and to compare the content, effectiveness and acceptability of these interventions. Given the lack of a yet clearly established evidence-base in this field, we sought to examine both published empirical research as well as guidelines published by expert groups working with staff in high-risk roles.Methods: We conducted systematic searches for empirical research across bibliographic databases and searched online for clinical practice guidelines to April 2023. We were also referred to potentially relevant literature by experts in workplace trauma. Both empirical research and clinical guidelines were appraised for their quality.Results: A total of 80 research studies and 11 clinical practice guidelines were included in the review. Interventions included Critical Incident Stress Debriefing (CISD), Critical Incident Stress Management (CISM), unspecified Debriefing, Trauma Risk Management (TRiM), Psychological First Aid (PFA), EMDR, CBT and group counselling. Most research and guidance were of poor quality. The findings of this review do not demonstrate any harm caused by CISD, CISM, PFA, TRiM, EMDR, group counselling or CBT interventions when delivered in a workplace setting. However, they do not conclusively demonstrate benefits of these interventions nor do they establish superiority of any specific intervention. Generic debriefing was associated with some negative outcomes. Current clinical guidelines were inconsistent with the current research evidence base. Nevertheless, interventions were generally valued by workers.Conclusions: Better quality research and guidance is urgently needed, including more detailed exploration of the specific aspects of delivery of post-incident interventions.

Protocols and strategies to use emergency psychology in the face of an emergency: A systematic review

BACKGROUND

Trauma survivors are at a high risk of developing mental health problems. Hence, mental help in the form of emergency psychology has to be availed in the aftermath of a traumatizing event. When studied in-depth, emergency psychology comprises protocols, strategies, and techniques that establish it as an interventional activity.

OBJECTIVE

The main of this review is to analyze how emergency psychology services are provided to people, to verify to what extent these interventions are homogeneous in the delivery methods and consequently, facilitate the creation of relevant measures. Consequently, the general view of emergency psychology is reviewed and analyzed to identify the protocols, guidelines, and strategies used.

METHODS

A search was done on the ScienceDirect, APA PsycINFO, Emerald, and Scopus databases for articles published from 1st January 2017 to 1st April 2022. The reference lists of the identified studies were also screened.

RESULTS

After the non-duplicate articles were removed and after filtering the articles according to inclusion criteria, 20 articles were included for the thematic analysis: nine research articles, 10 case study reports, and one randomized controlled trial (RCT). During the analysis, different aspects of emergency psychology were categorized: Responders, Crisis Management and Structure, and types of psychological interventions. This categorization led to the identification of protocols, guidelines, and strategies that can be placed in a sequence to give a general direction of how an emergency psychology intervention is supposed to be carried out.

CONCLUSIONS

The adopted protocols, guidelines and strategies may vary from one disaster management to another but the main goal will always remain the same.