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Mental health check: A game changer for public safety personnel

I recently completed my 20^th year in policing and had time to reflect on the changes I’ve seen over the last two decades, specifically, around mental health and wellness.

Being curious about mental health started early for me, as my father spent the last 15 years of his policing career as a technical traffic collision investigator. It wasn’t until I became a police officer myself that I realized the devastating aftermath of fatal motor collisions; more specifically, the connection the officer makes with the family as the case could go on for many years. If the case is concluded with an unfavorable decision, the officer may be affected by moral injury. When I made this realization, I initiated a conversation with my father about his job and how it affected him. I learned, he came from a “suck it up” mentality and any signs or symptoms that were related to a mental health issue were ignored and passed off as normal aspects of being a police officer. There was no mental health education, awareness or prevention and most officers turned to unhealthy coping strategies.

Fast forward to 2010, I completed research with the Internet Child Exploitation (ICE) Investigators in my organization and discussed how the work affected them. I started this research because there were people leaving ICE because of PTSD, and at the time it was difficult for people in leadership positions to understand why. The ICE Unit was created in 2000 and I interviewed everyone who worked in the unit from 2000 to 2010, and I came to the same conclusions regarding self-awareness. The ICE officers explained their symptoms strictly from a physical perspective and made no connection to a mental health issue.

I also learned through my research the impact of moral injury. A term originally created for the military, “moral injury is the suffering people experience when in high stakes situations, things go wrong, and harm results that challenges one’s deepest moral codes and ability to trust in others or ourselves” (Shay, 2014). Without knowing it, the ICE officers talked about many instances of moral injury in their job and denied their signs and symptoms were related. My experience as a police officer, peer supporter and researcher consistently drew me to the same conclusions – that most police officers do not always know where they fall on the mental health continuum. Unlike going to your family doctor and having your blood pressure taken, which shows whether you have high blood pressure or not, mental health is more complex.

Public safety personnel (PSP) across Canada became introduced to the mental health continuum in 2015 with the introduction of the Road to Mental Readiness (R2MR) program. Originally designed for the military, R2MR was designed to inform officers of the importance of early help seeking, stigma and most importantly the signs and symptoms of the early stages of a mental health issue. The infamous colours became common language and, most PSP felt more comfortable talking about being in the green or heading to the orange opposed to saying they are suffering with a mental health issue. The importance of this program educated officers on how to realize that their signs and symptoms were not normal aspects of the job and, early help seeking in the yellow or orange can alleviate the need to go off work in the long term.

Unlike going to your family doctor and having your blood pressure taken, which shows whether you have high blood pressure or not, mental health is more complex.

It has been a few years since R2MR was taught and the COVID-19 pandemic further exacerbated issues for PSP, with increased rates of mental disorders and sick leave being reported (Li, Scherer, Felix & Kuper, 2021). Additionally, staffing shortages because of the COVID-19 pandemic, increasing retirements, and low recruitment and retention are likely to continue, worsening the workload and demands on PSP. Seeking care for mental health disorders continues to be a significant challenge for PSP because of stigma, issues of confidentiality and accessibility of care.

One such program being implemented across police services in Ontario is the Mental Health Check (MHC-PSP). The MHC-PSP was created by Life Support Mental Health Inc. and is designed to assist with the early detection and prevention of mental illness by allowing PSPs to conduct a mental health check at any time in their career in the privacy of their own home. The assessment brings together a unique battery of psychological tools to screen for common mental health challenges that are often observed in PSP. This includes things like anxiety, depression, operational and organizational stress, burnout, trauma, and substance-misuse to name a few. The measures included in the Mental Health Check assessment have been either specifically endorsed by the American Psychiatric Association, supported by external research evidence, a clinical advisory team and subject matter experts.

Once the MHC is completed, the PSP will receive a follow-up virtually or over the phone with a registered mental health professional to go over their results and will mirror the mental health continuum. In other words, the results will let PSP know what colour they are in each area. If the findings indicate a need for ongoing support, a list of qualified mental health professionals that meet the PSP’s specific and unique needs will be generated and shared to the member for referral. This smooth, streamlined process allows for the communication of results and subsequent referral, should it be necessary. The process is designed to be quick and efficient to assist in early detection of mental health issues and/or alleviating the stigma associated to reaching out for help.

The main difference of the MHC and other online assessments is quick access to a mental health professional, self-awareness and a detailed explanation of where you fall on the continuum in a confidential manner. Furthermore, because a mental health professional reviews your assessment and meets with you to go over your results, it is covered by your insurance provider. The overall goal of the MHC is to create a mental health baseline for PSP and to assist with the early detection and prevention of mental health issues.

The MHC has just been approved to be studied through the University of Ottawa Research Institute as a Quality Improvement Project. Following a phone call or virtual meet with the mental health professional, an email will be sent to the PSP member to answer five questions related to the MHC. The goal is to have evidence to support that the MHC is a viable option for the early detection and prevention of mental health issues, alleviating stigma and to support early help-seeking to ensure all PSP are healthy throughout their career. Any PSP can visit the site and conduct the MHC, which is covered by the members’ psychological benefits. The police services who have currently adopted and have endorsed the MHC are London, York, Durham and Waterloo as of April 2023.

References

1. Li, Y., Scherer, N., Felix, L. & Kuper, H. (2021). Prevalence of depression, anxiety and post traumatic stress disorder in health care workers during the COVID-19 pandemic: A systematic review and meta-analysis. PLoS One
2. Shay (2014). What is Moral Injury? Retrieved from https://www.voa.org/moral-injurywar-inside.

Editor’s note: For more information on the Mental Health Check for PSP please visit https://www.lifesupport247.com/public-safety-personnel/.

Staff Sergeant Beth Milliard currently works for York Regional Police and oversees a platoon. She is also a post-doctoral fellow with University of Regina, CIPSRT.