Post-traumatic stress disorder (PTSD) and other operational stress injuries (OSI) are both ubiquitous and harmful within the public safety community. Although recent focus has given rise to increased awareness to mental health issues, barriers to the development of evidence-informed prevention and treatment regimens continue to exist.
Undesirable stigma associated with mental health issues has been a very difficult hurdle for the public safety community. Much progress has been made toward reduction of stigma; however, efforts need to continue in order for mental health to be truly improved for public safety personnel.
Another fundamental barrier to providing meaningful response to the mental health needs of public safety personnel is a true understanding of the detailed nature and scope of the problem. Numbers matter! Until recently, there existed a paucity of reliable data on OSI symptom prevalence and, potentially of equal importance, what differences or similarities exist within the specific public safety communities (e.g., police, EMS, fire, etc.).
Realizing the critical importance of this data, the Canadian Institute for Public Safety and Treatment (CIPSRT) developed a study designed to provide estimates of the prevalence of several mental disorder symptoms and provide explicit comparisons across diverse public safety categories. The results are intended to support a recommended National Action Plan that includes ongoing increasingly robust research.
Background: Partnering with first responder and public safety leadership and associations, CIPSRT is a coast-to-coast multi-university team of top Canadian researchers working with key stakeholders on long-term initiatives to identify the resources required to support the recognition, prevention, intervention and treatment of mental health concerns facing Canadian first responders and public safety personnel.
Method: In this national study, CIPSRT engaged nearly 6,000 participants in an anonymous survey designed to provide critically needed information about OSI symptom prevalence (e.g., symptoms of PTSD, depression, panic) for Canadian public safety personnel. The survey was made available from September 2016 to January 2017, after which estimates of symptom prevalence were derived using well-validated screening measures.
Data were collected using a web-based self-report survey that included measures for screening mental disorder symptom levels that may warrant further clinical attention.
In order to establish a representative sample, participants were grouped into demographic categories (e.g., public safety category, sex, age, marital status, provincial region, ethnicity, education, years of service and urban/rural work location) for comparison, and subsequently compared to the general population using information provided by Statistics Canada.
Results: Substantial portions of the survey participants self-reported symptoms consistent with one or more mental disorders.
In fact, results indicate that 44.5% screened positive for clinically significant symptom clusters consistent with one or more mental disorders. This proportion appears significantly higher than previous research and comparison to diagnostic rates for the general population, in which estimates range near 10.5%.
The study also revealed some significant differences between public safety categories in frequencies of positive screens that warrant further investigation. For example, when comparing the data between paramedics and firefighters, the study found higher rates of PTSD (24.5%), depression (29.6%) and panic disorder (10.3%) among paramedics.
The results also indicated that rates for these same mental health measures were lower for paramedics when compared to corrections officers where PTSD (29.1%), depression (31.1%) and panic disorder (12.2%) were all higher.
Discussion: The study results are an invaluable asset to public safety leadership. The volume of willing participants responding to the survey indicates success in reducing the stigma associated with OSIs-a significant barrier to engaging strategies and allocating resources to support mental health for all public safety personnel.
The study results provide a more comprehensive understanding than previously available of how common symptoms are within the broader public safety realm. Further, identifiable differences and trends among each of the public safety categories have been identified.
This is critically important and novel information for researchers. It will help them develop coordinated plans to improve methods of prevention and treatment of OSIs.