Associations between Trauma Exposure and Physical Conditions among Public Safety Personnel: Associations entre l’exposition à un traumatisme et les problèmes physiques chez le personnel de la santé publique

Abstract

Background: Trauma exposure is associated with adverse health-related correlates, including physical comorbidities, and is highly prevalent among public safety personnel (PSP). The current study (1) examined the association between context of index trauma exposure (part of job vs. other) and physical conditions and (2) established the prevalence of physical conditions according to PSP category (e.g., police, paramedic) and index trauma type (e.g., serious accident, physical assault) in a large Canadian sample of PSP. Methods: PSP completed an online survey between September 2016 and January 2017. Multivariable logistic regressions examined associations between context of index trauma exposure (i.e., part of job vs. other) and physical condition categories. Cross-tabulations with chi-square analyses examined whether the prevalence of physical conditions significantly differed according to PSP category and index trauma type. Results: There were 5,267 PSP included in the current study. Results from the most stringent model of logistic regressions demonstrated that, compared to PSP who experienced their index trauma in any other context, PSP who experienced it as part of their job had reduced odds of “other” physical conditions (adjusted odds ratio = 0.73, 95% confidence interval, 0.57 to 0.94, P < 0.05). Results also revealed significant differences in the prevalence of physical conditions across all PSP categories and select index trauma types. Conclusion: Results highlight the relevance of trauma exposure outside of an occupational context among PSP and may have implications for the positive impact of stress inoculation and resiliency training programs for PSP.

Correctional Work: Reflections Regarding Suicide

“…CWs described their family physician as a primary contact for help-seeking, which is consistent with previous research results from among other populations, such as PSP and the general public [ 47 ]. Our current preliminary results with CWs are consistent with previous research on PSP [ 48 , 49 ], in that symptoms of psychological distress can present with physical symptoms (e.g., migraines). Future research on PSP who present with physical symptoms may provide important insights into mental health disorders and suicidal behaviours.…”

“…Some of our participating CWs reported feeling less understood or even misunderstood by the mental health professionals who offer help, which is consistent with previous research among police [ 11 , 49 , 50 ] and other PSP [ 47 ]. Participating CWs appeared to understand that their work environment (e.g., prison, community, supporting prisoners/probationers/parolees), organisational culture, and frequent PPTE exposures (e.g., violence, abuse, suicidal behaviours of others) underscore the importance of cultural competence for perceiving psychological services as potentially effective [ 42 ].…”

“…Peer support programs are often premised on peers as helpful for detecting psychological distress and behavioural changes in their colleagues as a function of relational commitment. PSP often turn to peers, friends, and family for help [ 47 ]; therefore, training certain peers to properly detect symptoms of psychological distress and provide appropriate supports and referrals may be a way forward, encouraging prevention and intervention [ 49 ]. Peer support programs may also offer collegial support as a function of shared experiences among CW [ 42 , 51 ].…”

Mental Disorder Symptoms among Paramedics in a Single Canadian Site

“…Addressing a conspicuous absence of similar research in Canada, a recent national survey of Public Safety Personnel (PSP) found that 1 in 4 participating paramedics screened positive for PTSD, 1 in 3 for major depressive disorder, and 1 in 3 for an anxiety disorder, with nearly half screening positive for any one mental disorder [9] and more frequent positive screens observed among women paramedics. Related research has also suggested that exposure to potentially psychologically traumatic events [10][11][12][13][14][15][16]; symptoms consistent with chronic pain, [17] clinical insomnia [18] and alcohol use disorder [9]; suicidal ideation, planning, and attempts [19]; and a history of adverse childhood experiences [20] are prevalent among paramedics, again varying across demographic categories, including gender. The downstream consequences are potentially significant, and can include lost time from work [21], family hardship [22], reduced quality of life [23][24][25][26], and suicidality [7,27], all of which can contribute to burnout [6,28], workplace incivility [29,30], attrition [31] and potentially compromise patient care [32].…”

Adherence to Psychological First Aid after Exposure to a Traumatic Event at Work among EMS Workers: A Qualitative Study

“…A meta-analysis estimated prevalence rates of 11% for PTSD, 15% for depression, 15% for anxiety, and 27% for general psychological distress among EMS workers [ 4 ]. In addition to mental health problems, meta-analyses have highlighted the negative health impacts of PTSD on physical well-being in adults [ 5 ] and among first responders specifically [ 6 , 7 ]. Repercussions are also felt at the organizational level (e.g., increased sick leaves, lowered operational performance; [ 8 , 9 ]).…”