Preventing and treating mental health injuries of all kinds in the first responders and other personnel who keep our society safe is the focus of Carleton’s innovative research

When Dr. Nicholas Carleton talks about mental health in what he terms “public safety personnel,” he goes beyond the common preconceptions of post-traumatic stress disorder (PTSD) in first responders — in many ways.

His ground-breaking research in this area has garnered the 6th annual Royal-Mach-Gaensslen Prize for Mental Health Research, awarded by the Mach-Gaensslen Foundation and the Royal’s Institute for Mental Health Research.

“Dr. Nicholas Carleton is an excellent choice for the 2020 Royal-Mach-Gaensslen award,” said Dr. Christopher Carruthers, chair of the Mach-Gaensslen Foundation. “His work goes from the academy to the front lines to give public safety personnel the tools to face the challenges of their work.”

Our picture of first responders — usually police officers, firefighters, and paramedics — misses many people working in public safety who may face potentially traumatic situations in their jobs. These include border services, Indigenous emergency managers, correctional officers, search-and-rescue personnel, and many other services. To broaden the picture, Dr. Carleton, a professor of psychology at the University of Regina, prefers to talk about “public safety personnel” or PSP, he said during the award ceremony, held virtually via Zoom on December 3, 2020, and attended by about 250 people from across Canada. Because of the virtual nature of the event, interim president of the University of Regina, Dr. Tom Chase, presented Dr. Carleton with his prize in Regina.

“All PSP work hard to keep us safe,” explained Dr. Carleton, “but in doing so they can be exposed to a tremendous number of potentially psychologically traumatic events.”

While there is growing awareness of PTSD among these critical frontline workers, there is less understanding that these personnel are at higher risk of other mental illnesses, such as major depressive disorder, generalized anxiety disorder, and panic disorder. Carleton’s research has shown that up to 44% of Canadian PSP have clinical signs of one of these illnesses. When these mental illnesses are linked to on-the-job stress, they are now considered “operational stress injuries.”

During the event, Dr. Carleton was joined by Dr. Patrick Smith, president of the Centre of Excellence on PTSD and Related Mental Health Conditions at the Royal, and Lorraine Downey, a paramedic who coordinates the Ottawa Paramedical Peer Support Group, to talk about mental health in PSP. The discussion was moderated by the event’s host, CBC Radio news anchor Laurence Wall.

PSP need support from their peer group, from their employers and from governments, said panellists. And that support also needs to extend to the family members of PSP. During the pandemic, support is critical, as PSP are helping others cope with the pandemic, while dealing with the additional stress on themselves.

The peer support offered to Ottawa paramedics, as an example, helps normalize talking about stresses of the job, said Ms. Downey. Paramedics have a dedicated “peer support room” where there’s always plenty of coffee and tissues, she said. She emphasized “reaching in” to help colleagues who may be suffering stress, as PSP may be reluctant to “reach out” for help.

Dr. Carleton, one of the founders and scientific director of the Canadian Institute for Public Safety Research and Treatment (CIPSRT), has been involved in establishing “PSP Net.” It is an online therapeutic program that all public safety personnel can access at any time, supplemented by secure email and phone support from therapists. The program is currently available in Saskatchewan and Quebec, with plans to extend it to other parts of Canada.

Support must also come from employers, said Dr. Smith. He said organizations — from grocery stores to armed forces — should see mental health support as a “health in the workplace” issue. Dr. Smith described the approach used by an organization called Phoenix Australia that sets standards to minimize trauma in the workplace in that country. Phoenix Australia works with the employers to manage trauma and provide treatment.

Governments can provide leadership and funding, said Dr. Carleton. CIPSRT receives funding from Public Safety Canada, a federal government department that is promoting mental health for PSP. Governments at all levels have expressed commitment to this area, said Dr. Carleton.

Families of PSP are often affected by the uncertainty and stress in PSP work, said the panellists. Family members are aware of the dangers PSP face and worry about their family member coming home safely after a shift, said Dr. Carleton. In fact, his research has shown that the uncertainty that is a big part of PSP work is a major stressor.

The pandemic has added to the stress on PSP, the panellists said. Visits to the Ottawa paramedics’ peer support program are up 50% this year over last, said Ms. Downey. Dr. Carleton said that PSPs have to worry about infection and protective equipment on top of the emergencies they are attending. Like everyone else, PSP may have the stresses of caring for seniors or home-schooling children on top of their workload during the pandemic, Ms. Downey pointed out.

Dr. Carleton thanked the award’s sponsors and expressed his appreciation for this honour.

Meet Dr. Nicholas Carleton, 2020 recipient of the Royal-Mach-Gaensslen Prize for Mental Health Research – YouTube

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