The police paradox: A qualitative study of post-overdose outreach program implementation through public health-public safety partnerships in Massachusetts

Carroll, Jennifer J.; Cummins, Emily R.; Formica, Scott W.; Green, Traci C.; Bagley, Sarah M.; Beletsky, Leo; Rosenbloom, David; Xuan, Ziming; Walley, Alexander Y.

doi:10.1016/j.drugpo.2023.104160

Cited by 11 publications

(4 citation statements)

References 67 publications

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“…Compassion fatigue is characterized by a physical, emotional, and spiritual depletion in the capacity to care among those on the frontlines of caregiving for traumatized groups [ 19 , 24 , 50 – 52 ]. Compassion fatigue can affect job satisfaction, reduce productivity, and negatively impact the delivery of healthcare services [ 9 , 53 ]. Many post-overdose outreach team members interviewed for this study reported working in post-overdose outreach for multiple years, with consistent exposure to stressful events, in support of Ludick and Figley’s repeated exposure construct of the compassion fatigue resilience model [ 41 ]. There are layered concerns about compassion fatigue for post-overdose outreach workers that warrant attention.…”

Section: Discussionmentioning

confidence: 92%

“…This post-hoc study analyzed interview data collected as part of the qualitative component of a cross-sectional, mixed method explanatory sequential examination [ 9 ] of post-overdose outreach programs in Massachusetts (United States) conducted between September 2018 and March 2022. In summary, the larger study identified 157 post-overdose outreach programs that were operating in Massachusetts prior to July 2019.…”

Section: Methodsmentioning

confidence: 99%

“…A detailed survey completed by 138 of these programs was used to characterize their components (e.g., team composition, outreach approach, services provided) [ 4 ] and to explore associations between the presence of these programs and subsequent reductions in opioid overdose deaths [ 6 ]. The qualitative aim of the larger study involved conducting semi-structured interviews with 38 post-overdose outreach team members at 11 of these programs to further explore patterns observed in the quantitative data related to the implementation of these programs [ 8 , 9 ]. Primary data for the present study were drawn from questions related to potentially stressful exposures during outreach and to how teams and team members process and cope with these exposures.…”

Section: Methodsmentioning

confidence: 99%

“…On the upstream side, they view an individual’s empathic ability, the “capability and proclivity to recognize suffering in others” [ 41 , p.117] as essential for building rapport and providing effective front-line services; however, this ability also produces vulnerability to STS and compassion fatigue – particularly in the absence of effective coping strategies and meaningful professional or psychological support [ 41 ]. Previous qualitative research suggests that the presence of such supports vary across post-overdose outreach programs, with some offering no professional or psychological supports to outreach team members at all [ 9 ]. Previous data from our research group indicated that just over half (53%) of post-overdose outreach programs surveyed in Massachusetts reported establishing protocols for supporting post-overdose outreach team members affected by grief [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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“Wanna cry this out real quick?”: an examination of secondary traumatic stress risk and resilience among post-overdose outreach staff in Massachusetts

Schoenberger,

Cummins,

Carroll

et al. 2024

Harm Reduct J

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Background Post-overdose outreach programs engage overdose survivors and their families soon after an overdose event. Staff implementing these programs are routinely exposed to others’ trauma, which makes them vulnerable to secondary traumatic stress (STS) and compassion fatigue. The purpose of this study was to explore experiences of STS and associated upstream and downstream risk and protective factors among program staff. Methods We conducted a post-hoc analysis of semi-structured interviews with post-overdose outreach program staff in Massachusetts. Transcripts were analyzed using a multi-step hybrid inductive-deductive approach to explore approaches and responses to outreach work, factors that might give rise to STS, and compassion fatigue resilience. Findings were organized according to the three main constructs within Ludick and Figley’s compassion fatigue resilience model (empathy, secondary traumatic stress, and compassion fatigue resilience). Results Thirty-eight interviews were conducted with staff from 11 post-overdose outreach programs in Massachusetts. Within the empathy construct, concern for others’ well-being emerged as a motivator to engage in post-overdose outreach work – with staff trying to understand others’ perspectives and using this connection to deliver respectful and compassionate services. Within the secondary traumatic stress construct, interviewees described regular and repeated exposure to others’ trauma – made more difficult when exposures overlapped with staff members’ personal social spheres. Within the compassion fatigue resilience construct, interviewees described the presence and absence of self-care practices and routines, social supports, and workplace supports. Job satisfaction and emotional detachment from work experiences also arose as potential protective factors. Interviewees reported inconsistent presence and utilization of formal support for STS and compassion fatigue within their post-overdose outreach teams. Conclusion Post-overdose outreach program staff may experience secondary traumatic stress and may develop compassion fatigue, particularly in the absence of resilience and coping strategies and support. Compassion fatigue resilience approaches for post-overdose outreach staff warrant further development and study.

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