JMIR Publications

ABSTRACT

Background:

Canadian public safety personnel (PSP) report high rates of mental health concerns and barriers to treatment. PSPNET is a clinical research unit that offers internet-delivered cognitive behavioral therapy (ICBT) that is free, confidential, and developed with and for PSP. Treatment outcomes are promising with clinically significant symptom improvement (eg, anxiety, depression, posttraumatic stress) and favorable treatment satisfaction. While these results are promising, research has yet to explore ways to optimize therapist-guided ICBT for leaders within public safety. Optimizing ICBT for leaders is particularly important given their widespread organizational impact that can affect other PSP.

Objective:

This study included 10 clients who self-identified as being in a supervisory or leadership position within their public safety organization and completed either the therapist-guided PSP Wellbeing Course or PSP PTSD Course. We used descriptive statistics to analyze demographics, mental health symptoms, treatment engagement, and treatment satisfaction. We used a reflexive thematic analysis of semi-structured interview transcripts to assess leaders’ course perceptions and feedback.

Methods:

Qualitative data was collected via 10 semi-structured interviews with clients who self-identified as being in a supervisory or leadership position within their public safety organization and completed either the therapist-guided PSP Wellbeing Course or PSP PTSD Course. These interviews assessed leaders’ mental health stressors and course perceptions.

Results:

Canadian leaders within public safety reported occupational and non-occupational stressors and enrolled in ICBT to support their own or colleagues’ mental health. Most clients enrolled in the PSP Wellbeing Course, accessed 4 of 5 lessons (n=7;70%), engaged with therapist support (n=7;70%), and identified as employed (n=8;80%), White (n=8;80%), and men (n=7;70%) with an average age of 45 years. At pre-treatment, 80% of clients endorsed clinically significant symptoms of one or more disorder; most often depression (n=7;70%) and/or anger (n=6;60%). Clients reported favorable attitudes toward the ICBT courses with most reporting that they were satisfied with the course (n=9;90%). Feedback to further optimize ICBT content for leaders included development of a leader case story (n=6;60%) and new resources to help leaders apply skills learned in ICBT within the context of their leadership roles (n=4;40%). Leaders also recommended optimizing ICBT delivery by improving the platform technology and incorporating more multimedia.

Conclusions:

Canadian leaders within public safety perceived therapist-guided ICBT developed with and for PSP as a suitable treatment option for their needs and identified ways to further optimize its content and delivery. Future research should investigate the impacts of these efforts and explore optimizing ICBT for other groups of clients. Clinical Trial: Clinicaltrials.gov NCT04127032; https://www.clinicaltrials.gov/ct2/show/NCT04127032; Clinicaltrials.gov NCT04335487; https://clinicaltrials.gov/study/NCT04335487