Sustaining and Expanding Internet-Delivered Cognitive Behavioral Therapy (ICBT) for Public Safety Personnel across Canada: A Survey of Stakeholder Perspectives
Abstract
:1. Introduction
- To what extent do PSP perceive a need for ICBT, and does this differ between stakeholders with prior knowledge of PSPNET and those without, as well as between leaders and non-leaders?
- What advantages and concerns do PSP identify about ICBT, and do perceptions differ between stakeholders with prior knowledge of PSPNET and those without, as well as between leaders and non-leaders?
- What are PSP leaders’ perspectives on how PSPNET should be implemented? Specifically, how do PSP leaders believe that their organization can support PSPNET, how do they believe PSPNET should be funded, and what factors do they perceive as facilitators or impediments to funding PSPNET?
2. Materials and Methods
2.1. Sample and Setting
2.2. Materials and Data Collection
2.3. Data Analysis
3. Results
3.1. Summary of Quantitative Data
3.1.1. Perceptions of Need for Mental Health and ICBT Services
3.1.2. Perceptions of Advantages of ICBT
3.1.3. Negative Perceptions or Concerns about ICBT
3.1.4. Leaders’ Perceptions and Support of ICBT Services
3.2. Summary of Qualitative Data
3.2.1. Funding Recommendations
3.2.2. Perceptions of Factors That Will Facilitate Funding of PSPNET
3.2.3. Perceptions of Barriers for Obtaining New Funding for Sustaining PSPNET
4. Discussion
4.1. Perceptions of Characteristics
4.2. Support for ICBT in the Organizational Setting
4.3. Facilitators and Barriers to Funding PSPNET
4.4. Implications
4.5. Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | Total Sample (n = 524) |
---|---|
Gender, n (%) | |
Women | 239 (45.6) |
Men | 273 (52.1) |
Non-binary | 2 (0.4) |
Missing data | 10 (1.9) |
Province, n (%) | |
Ontario | 104 (19.8) |
British Columbia | 104 (19.8) |
Quebec | 103 (19.7) |
Saskatchewan | 77 (14.7) |
Alberta | 69 (13.2) |
Atlantic Canada a | 45 (8.5) |
Manitoba | 23 (4.2) |
PSP Sector, n (%) | |
Police | 131 (25.0) |
Correctional worker | 121 (23.1) |
Paramedic | 92 (17.6) |
Fire | 66 (12.6) |
Public safety communicator | 50 (9.5) |
Not listed (e.g., support staff) | 64 (12.2) |
Ethnicity, n (%) | |
White | 448 (85.5) |
Indigenous (i.e., First Nations, Inuit, Metis) | 21 (4.0) |
Ethnic minority b | 35 (6.7) |
Prefer not to answer | 10 (1.9) |
Missing data | 8 (1.5) |
Leadership status, n (%) | |
Manager | 144 (27.5) |
Union or association representative | 50 (9.5) |
Not leadership | 262 (50.0) |
Other | 68 (13.0) |
Missing data | 10 (1.8) |
Knowledge of PSPNET, n (%) | |
Never heard of PSPNET | 377 (71.9) |
Heard of PSPNET | 147 (28.9) |
Received services from PSPNET | 16 (3.1) |
Age, n (%) | |
19–29 | 51 (9.9) |
30–39 | 146 (28.2) |
40–49 | 162 (31.3) |
50+ | 158 (30.6) |
Missing data | 7 (1.3) |
Heard of PSPNET | Self-Identified Leader | |||
---|---|---|---|---|
Yes (n = 147) | No (n = 376) | Yes (n = 262) | No (n = 262) | |
Attitudes, M (SD) | ||||
| 4.48 (0.67) | 4.53 (0.71) | 4.3 (0.65) | 4.51 (0.71) |
| 4.16 (0.95) | 4.22 (0.89) | 4.18 (0.87) | 4.23 (0.93) |
| 4.37 (0.72) | 4.17 (0.72) ** | 4.27 (0.72) | 4.19 (0.73) |
| 4.68 (0.61) | 4.56 (0.59) * | 4.61 (0.58) | 4.58 (0.62) |
| 4.08 (1.15) | 4.20 (1.02) | 4.16 (1.08) | 4.18 (1.04) |
| 4.07 (0.99) | 4.08 (0.85) | 4.03 (0.89) | 4.12 (0.89) |
| 3.25 (1.21) | 3.55 (1.17) ** | 3.44 (1.18) | 3.48 (1.19) |
| 2.54 (1.04) | 2.86 (0.92) *** | 2.69 (0.98) | 2.84 (0.94) |
Advantages | Heard of PSPNET | Self-Identified Leader | ||
---|---|---|---|---|
Yes (n = 147) | No (n = 377) | Yes (n = 262) | No (n = 262) | |
Accessible, M (SD) | ||||
Accessible at any time and location | 3.81 (0.53) | 3.71 (0.60) | 3.77 (0.52) | 3.70 (0.64) |
Minimal wait time | 3.80 (0.52) | 3.74 (0.54) | 3.80 (0.47) | 3.72 (0.59) |
Website easy to use | 3.50 (0.73) | 3.45 (0.71) | 3.54 (0.69) | 3.39 (0.74) * |
No referral needed | 3.68 (0.72) | 3.65 (0.65) | 3.67 (0.66) | 3.65 (0.68) |
Free service | 3.79 (0.61) | 3.74 (0.64) | 3.73 (0.65) | 3.78 (0.61) |
Therapist-Guided, M (SD) | ||||
Initial online and telephone assessment | 3.48 (0.77) | 3.33 (0.82) * | 3.42 (0.76) | 3.33 (0.86) |
Referral to other services if needed | 3.61 (0.68) | 3.46 (0.74) * | 3.53 (0.67) | 3.47 (0.78) |
Therapist guidance for 16 weeks | 3.76 (0.59) | 3.59 (0.68) ** | 3.68 (0.59) | 3.60 (0.72) |
Flexibility of therapist contact (email/phone) | 3.71 (0.64) | 3.59 (0.66) | 3.65 (0.62) | 3.60 (0.70) |
Customized for PSP, M (SD) | ||||
Stories and examples from PSP | 3.34 (0.85) | 3.14 (0.82) * | 3.25 (0.82) | 3.15 (0.83) |
Developed with input from PSP | 3.50 (0.74) | 3.36 (0.76) | 3.44 (0.74) | 3.37 (0.77) |
Tailored for PSP | 3.64 (0.66) | 3.48 (0.72) * | 3.54 (0.69) | 3.50 (0.73) |
Effective Format and Resources, M (SD) | ||||
Additional resources | 3.58 (0.68) | 3.48 (0.70) | 3.51 (0.69) | 3.50 (0.69) |
Effectiveness through peer-review | 3.51 (0.74) | 3.42 (0.73) | 3.45 (0.74) | 3.44 (0.73) |
Exercises to help build skills | 3.53 (0.71) | 3.45 (0.71) | 3.51 (0.68) | 3.44 (0.73) |
Online delivery | 3.58 (0.70) | 3.40 (0.77) ** | 3.53 (0.71) | 3.37 (0.79) ** |
Material can be downloaded | 3.66 (0.69) | 3.52 (0.71) | 3.58 (0.67) | 3.55 (0.75) |
Other, M (SD) | ||||
Greater privacy than other treatments | 3.54 (0.77) | 3.36 (0.86) * | 3.45 (0.80) | 3.36 (0.88) |
Extensively Researched | 3.60 (0.72) | 3.49 (0.76) | 3.55 (0.74) | 3.49 (0.75) |
Complements existing services | 3.54 (0.72) | 3.36 (0.74) ** | 3.43 (0.70) | 3.38 (0.78) |
Heard of PSPNET | Self-Identified Leader | |||
---|---|---|---|---|
Yes (n = 147) | No (n = 376) | Yes (n = 262) | No (n = 262) | |
Concerns, M (SD) | ||||
| 2.58 (0.88) | 2.66 (0.92) | 2.67 (0.87) | 2.60 (0.95) |
| 1.99 (0.96) | 1.96 (0.93) | 1.98 (0.94) | 1.96 (0.93) |
| 2.10 (1.11) | 2.34 (1.04) * | 2.24 (1.10) | 2.30 (1.03) |
| 2.26 (0.93) | 2.32 (0.90) | 2.35 (0.90) | 2.25 (0.92) |
| 2.05 (0.90) | 1.98 (0.86) | 2.06 (0.91) | 1.94 (0.84) |
| 2.31 (0.85) | 2.42 (0.85) | 2.36 (0.82) | 2.42 (0.87) |
| 2.18 (0.89) | 2.18 (0.94) | 2.20 (0.91) | 2.17 (0.91) |
| 2.40 (0.90) | 2.45 (0.94) | 2.43 (0.92) | 2.44 (0.94) |
Heard of PSPNET | ||
---|---|---|
Yes (n = 96) | No (n = 159) | |
Attitudes, M (SD) | ||
| 3.76 (1.16) | 3.69 (1.16) |
| 3.47 (1.06) | 3.55 (1.06) |
| 3.59 (1.08) | 3.64 (1.01) |
| 4.38 (0.74) | 4.09 (0.85) ** |
| 4.34 (0.78) | 4.08 (0.84) * |
| 4.23 (0.75) | 3.99 (0.87) * |
| 4.05 (0.80) | 3.88 (0.85) |
| 4.03 (0.81) | 3.99 (0.81) |
| 3.96 (1.01) | 3.91 (0.88) |
| 3.11 (1.18) | 3.10 (0.90) |
| 4.36 (0.84) | 3.93 (0.91) *** |
Categories | Description | References, n (%) |
---|---|---|
Government funding | PSPNET should be funded through government funding, be it provincial or federal | 123 (80.3) |
Employer funding | PSPNET should be funded through PSP employers (e.g., Worker’s Compensation Board contributions, employee, and family assistance programs) | 18 (11.8) |
Unsure | Participants reported PSPNET should be funded, but they were not sure where the funds should come from | 6 (3.9) |
Charitable donations | PSPNET should be funded by charitable donations from non-profit organizations | 4 (2.6) |
Payroll deduction | PSNET should be funded by PSP themselves through payroll deduction | 2 (1.3) |
Categories | Description | References, n (%) |
---|---|---|
Evidence of success | PSPNET would be able to facilitate more funding if they present evidence of the success of ICBT services | 38 (37.6) |
Raising awareness of PSP mental health needs | PSPNET would be able to facilitate more funding by advocating for mental health among PSP, raising awareness of PSP mental health needs in public forums, and promoting and advertising PSPNET’s free ICBT services | 23 (22.8) |
Endorsements from trade unions | PSPNET would be able to facilitate funding by obtaining support from trade unions | 12 (11.9) |
Lobbying the government | PSPNET would be able to facilitate funding by lobbying the government | 11 (10.9) |
Other | Participants reported PSPNET should be funded, but they were not sure how this should be achieved | 8 (7.9) |
Endorsements from government health agencies | PSPNET would be able to facilitate funding by obtaining support from government health agencies (e.g., Public Health Agency of Canada) | 6 (5.9) |
Categories | Description | References, n (%) |
---|---|---|
Competing priorities | The government prioritizes other issues ahead of funding PSP mental health | 26 (21.1) |
Lack of political will | There is a lack of understanding of the work PSP do, driving political ambivalence | 22 (17.9) |
Lack of funding | Lack of resources or limited budgets will impede PSPNET funding | 20 (16.3) |
Unsure | Participants indicated they were unsure | 16 (13.0) |
Poor results and low participation | Funding would be impacted if there were poor results or low participation | 16 (13.0) |
Unrecognized need | PSP do not understand the importance of ICBT services or recognize a need for it | 13 (10.6) |
Negative public attitudes | Belief that the general public are not concerned with PSP mental health | 10 (8.1) |
Lack of promotion | PSP are unaware of services | 8 (6.5) |
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Landry, C.A.; Beahm, J.D.; McCall, H.C.; Hadjistavropoulos, H.D. Sustaining and Expanding Internet-Delivered Cognitive Behavioral Therapy (ICBT) for Public Safety Personnel across Canada: A Survey of Stakeholder Perspectives. Int. J. Environ. Res. Public Health 2023, 20, 5592. https://doi.org/10.3390/ijerph20085592
Landry CA, Beahm JD, McCall HC, Hadjistavropoulos HD. Sustaining and Expanding Internet-Delivered Cognitive Behavioral Therapy (ICBT) for Public Safety Personnel across Canada: A Survey of Stakeholder Perspectives. International Journal of Environmental Research and Public Health. 2023; 20(8):5592. https://doi.org/10.3390/ijerph20085592
Chicago/Turabian StyleLandry, Caeleigh A., Janine D. Beahm, Hugh C. McCall, and Heather D. Hadjistavropoulos. 2023. "Sustaining and Expanding Internet-Delivered Cognitive Behavioral Therapy (ICBT) for Public Safety Personnel across Canada: A Survey of Stakeholder Perspectives" International Journal of Environmental Research and Public Health 20, no. 8: 5592. https://doi.org/10.3390/ijerph20085592