The Experience of Key Stakeholders During the Implementation and Use of Trauma Therapy via Digital Health for Military, Veteran, and Public Safety Personnel: Qualitative Thematic Analysis

Abstract

Background Exposure to occupational stressors and potentially psychologically traumatic events experienced by public safety personnel (eg, paramedics, police, fire, and correctional officers), military members, and veterans can lead to the development of posttraumatic stress injuries and other mental health disorders. Providing emergency services during COVID-19 has intensified the challenges. Owing to COVID-19 restrictions, mental health service providers offering support to these populations have had to rapidly pivot to use digital versus in-person methods of service delivery. Objective This paper aims to explore the experience of mental health service providers regarding digital health service delivery, including the current state of digital mental health service delivery, barriers to and facilitators of the use of digital health for mental health service delivery experienced during the pandemic, and recommendations for implementing and integrating digital health into regular mental health service delivery. Methods This embedded mixed-methods study included questionnaires and focus groups with key stakeholders (N=31) with knowledge and experience in providing mental health services. Data analysis included descriptive, quantitative, and qualitative thematic analyses. Results The following three themes emerged: being forced into change, daring to deliver mental health services using digital health, and future possibilities offered by digital health. In each theme, participants’ responses reflected their perceptions of service providers, organizations, and clients. The findings offer considerations regarding for whom and at what point in treatment digital health delivery is appropriate; recommendations for training, support, resources, and guidelines for digitally delivering trauma therapy; and a better understanding of factors influencing mental health service providers’ perceptions and acceptance of digital health for mental health service delivery. Conclusions The results indicate the implementation of digital health for mental health service delivery to military members, public safety personnel, and veterans. As the COVID-19 pandemic continues, remote service delivery methods for trauma therapy are urgently needed to support the well-being of those who have served and continue to serve.

Benefits of Digital Mental Health Care Interventions for Correctional Workers and Other Public Safety Personnel: A Narrative Review

“…This study was included in the review since the program they assessed is available to CWs and other PSP (7). One study (30) recruited PSP but the sample did not include CWs and two studies did not specify the PSP sectors recruited (26,31). These papers were also included for the same reason as the (29) study.…”

“…Indeed, in a study exploring PSP perceptions of e-CBT, many of the questions posed by the participants indicated the need for educational material explaining the logistics of e-CBT and its delivery methods (37). Providing this information can also address low technological competence and familiarity issues that can contribute to attrition (31,32,34,(78)(79)(80) and may increase openness toward e-CBT amongst CWs.…”

Tele-psychotherapy during the COVID-19 pandemic: a mini-review

“…According to a Canadian research, digital health can become a standard delivery mode for trauma therapy ( 44 ). Benefits include equity of access to care and stigma reduction; however, technological and reimbursement issues will need to be addressed if a generalized digital health system becomes the new normal.…”

“…Most of the studies were the first of their kind, given the unprecedented nature of the COVID-19 pandemic and the need for teletherapy to be implemented very rapidly after the start of the pandemic and the related lockdowns. More than ever, studies have insisted that teletherapy is more demanding than face-to-face therapy ( 35 , 44 , 50 ), hence the need for self-care practices for the well-being of therapists ( 17 , 33 ). Teletherapy has a cost for therapists: mental fatigue, physical symptoms, such as eyestrain, blurred vison, and motion sickness, emotional vulnerability, and isolation ( 18 , 21 , 34 , 37 , 42 , 51 ).…”

Sustaining and Expanding Internet-Delivered Cognitive Behavioral Therapy (ICBT) for Public Safety Personnel across Canada: A Survey of Stakeholder Perspectives

“…There remains a need to understand perceptions of ICBT after a longer period of implementation, as it is unknown if perceptions remained the same after implementation. This is particularly important because there is an increasing emphasis on using digital mental health interventions, such as ICBT, within PSP populations [ 27 , 28 , 29 ], but there is still limited evidence on the perceptions of these interventions within PSP populations.…”