April 30, 2020

Mental health needs of front-line workers' families often overlooked, until now

CIHR-funded study targets ‘first responders to first responders’

Research reveals that up to 32 per cent of public safety personnel (PSP) experience post-traumatic stress injuries, including post-traumatic stress disorder, as a result of operational stressors encountered while performing their duties.

More commonly known as first responders, paramedics, police officers and firefighters are frequently exposed to traumatic events such as assaults, homicides and suicides, as well as threats to their personal safety. For various reasons, they do not solicit professional aid to manage their mental wellness; rather, their first source of support is often their own family, who largely are not equipped to provide the care needed.

An interdisciplinary team of researchers from the University of Calgary is looking to change this with an intervention that addresses the needs of PSPs as well as their families.

“There are a number of reasons these men and women may not seek out assistance — perceived social stigma, workplace culture, or fear of a reduction in work responsibilities or job loss, among them,” explains principal investigator and Werklund School of Education associate professor Dr. Kelly Schwartz, PhD’02. “We know that PSP members actually prefer to seek out informal support from spouses over more formal avenues of support.”

Community involvement essential for improved physical and relational health

Conversations with national first responder organizations and PSP families early in the development of the study underscored the acute need for a family-based intervention, as existing mental health programs for those working on the front lines typically do not involve relatives. This is a significant oversight as spouses and children often experience vicarious trauma and a loss of personal identity while prioritizing the needs of the PSP.

Our study will address this gap by designing and examining the effectiveness of an intervention program for PSP family members aimed to support and strengthen the mental health of the PSP member.

To do this, Schwartz’s team will enlist PSPs to participate in an eight-week Before Operational Stress (BOS) program. Created specifically for PSPs by WGM Psychological Services’ Dr. Megan McElheran, BOS is a group-based proactive psychological intervention program designed to increase self-awareness and encourage authentic, healthy relationships. The researchers will also pilot a BOS-Families (BOS-F) program. The BOS-F sessions will focus on culture of the PSP family and occupational stress; cognitive, behavioural, and emotional effects of stress on the family; and communication and empathy in PSP families. Participants will also contribute valuable health and wellness biometric data through wearable technology.

“We hypothesize that PSP who participate in BOS will demonstrate improved psychosocial and physiological functioning, as will family members who participate in BOS-F. In six- and 12-month followups, we hope to see evidence of PSP members experiencing greater physical and relational health and less mental health problems.”

To ensure the research has a positive impact on the community, Schwartz says the findings from the BOS and BOS-F programs will be used to train psychologists and other registered mental health providers to deliver these evidence-informed supports to PSP and their families.

Toll of COVID-19 on mental health yet to be fully felt

Though the study was developed before the current COVID-19 outbreak, Schwartz believes it has added relevance as first responders are putting their health at risk in dealing with potentially infected individuals and are undoubtedly experiencing heightened stress as a result.

It is increasingly likely that the second wave of the pandemic may not be physical illness but rather the impact on first responders’ mental health. The operational stress will inevitably be carried by the first responder into the home. Our intervention will hopefully strengthen the resiliency of the first responder through these family members so that they can continue to serve in their important public safety occupation.”

The researchers will be recruiting firefighters, paramedics and police officers and their families in Alberta, Saskatchewan and Ontario for the study. To participate, PSP members must currently be employed full-time (including volunteer firefighters), not currently be on sick or disability leave, been employed for 12 months or more, and have a family member (spouse/partner and youth between 11 and 17 years of age) who resides with them.

Additional details can be found on the Social Development Research Team website. The researchers can also be contacted via email at BOSFamilies@ucalgary.ca or Twitter @BOSFamilies.

The Before Operational Stress: Evaluating Novel Psychosocial Interventions for Public Safety Personnel (PSP) and their Families project is funded through a CIHR Team Grant: Mental Wellness in Public Safety Team Grant. The Canadian Institute for Public Safety Research and Treatment (CIPSRT) is a co-sponsor of the Team Grant with CIHR.

Principal investigators

Dr. Kelly Dean Schwartz, PhD, RPsych (PI) is an associate professor in the Werklund School of Education at the University of Calgary. Schwartz is a member of the Alberta Children's Hospital Research Institute (ACHRI), the Owerko Centre and the Mathison Centre for Mental Health and Education.

Dr. Alan McLuckie, MSW, PhD, RCSW (co-PI) is an associate professor in the Faculty of Social Work at the University of Calgary. McLuckie is a member of the Mathison Centre for Mental Health and Education.

Dr. Carly McMorris, PhD RPsych (co-PI) is an assistant professor in the Werklund School of Education at the University of Calgary. McMorris is a member of the Alberta Children's Hospital Research Institute (ACHRI), the Owerko Centre and the Mathison Centre for Mental Health and Education.

Dr. Megan McElheran, PsyD RPsych (co-PI) is a clinical psychologist with WGM Psychological Services, a community-based psychology practice headquartered in Calgary. 

Dr. Reed Ferber, PhD, (Co-I) is a professor in the Faculty of Kinesiology, Faculty of Nursing, and Cumming School of Medicine at the University of Calgary.

Dr. Linda Duffet-Leger, PhD, RN, (Co-I) is an associate professor in the Faculty of Nursing at the University of Calgary.

Dr. Andrea Stelnicki, PhD, RPsych (Co-I) is a research assistant in the Werklund School of Education and a postdoctoral fellow in the Canadian Institute for Public Safety Research and Treatment at the University of Regina.