Accepted for/Published in: JMIR Formative Research
Date Submitted: Mar 2, 2021
Date Accepted: Jul 6, 2021
Date Submitted to PubMed: Aug 13, 2021
The experience of key stakeholders during the implementation and use of trauma therapy via digital health for military, veteran, and public safety personnel: A qualitative thematic analysis
ABSTRACT
Background:
Exposure to occupational stressors and potentially psychologically traumatic events experienced by Public Safety Personnel (PSP; e.g., paramedics, police, fire, correctional officers etc.), military members (MMs), and veterans can lead to the development of Post-Traumatic Stress Injuries (PTSIs) and other mental health (MH) disorders. Providing emergency services during COVID-19 has intensified challenges. Due to COVID-restrictions, MH service providers (MHSPs) offering support to these populations have had to rapidly pivot to using digital versus in-person methods of service delivery.
Objective:
To explore the experience of MHSPs regarding digital health (DH) service delivery, including: (1) the current state of digital MH service delivery, (2) barriers and facilitators to the use of DH for MH service delivery experienced during the pandemic, and; (3) recommendations for implementing and integrating DH into regular MH service delivery.
Methods:
This embedded mixed-methods study included questionnaires and focus groups with key stakeholders (n=31) with knowledge and experience providing MH services. Data analysis included descriptive quantitative analysis and qualitative thematic analysis.
Results:
Three themes emerged: (1) being forced into change, (2) daring to deliver MH services using DH, and (3) and future possibilities offered by DH. In each theme, participants’ responses reflected their perceptions of service providers (SPs), organizations and clients. Participants reported using DH for MH service delivery amidst COVID-19 and suggested that DH could be adopted as a standard delivery mode for trauma therapy with benefits from the widespread adoption of DH including: more equitable access to MH services especially in geographically remote locations, reduction in MH barriers and stigma, and the ability to develop novel and creative MH solutions. Participants also identified that attention needs to be given to certain issues prior to widespread adoption of DH including: update policies and procedures concerning privacy and security; infrastructure, hardware, software, and connectivity at the organizational, clinical, and client levels; and workflow, appointments, electronic medical records, needing to be adapt to DH trauma-therapy.
Conclusions:
Results suggest that DH is a viable component of a model of care for MMs, veterans, and PSP that is inclusive of in-person and virtual modes of trauma-focused service delivery. Findings offer considerations for whom and at what point in treatment DH is appropriate, clarification of the training, support, resources and guidelines necessary for SPs to be successful in the digital delivery of trauma therapy, and a better understanding of the factors influencing SP perceptions and acceptance of DH. As the COVID-19 pandemic continues, remote service delivery methods for trauma therapy will be increasingly needed to support the mental health and well-being of MMs, veterans, and PSP who continue to serve and respond to the needs of communities.
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.