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Preventative Care in First Responder Mental Health: Focusing on Access and Utilization via Stepped Telehealth Care

First responders are at high risk for disorders that arise from repeat exposure to stress and trauma (Post Traumatic Stress Disorder, depression, and problematic alcohol use). Although mental health treatments are available, first responders often do not access them, anchored by barriers that includ...

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Autores principales: Wright, Hannah M., Fuessel-Hermann, Dianna, Pazdera, Myah, Lee, Somi, Ridge, Brook, Kim, Joseph U., Konopacki, Kelly, Hilton, Layne, Greensides, Michael, Langenecker, Scott A., Smith, Andrew J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10012773/
https://www.ncbi.nlm.nih.gov/pubmed/36925868
http://dx.doi.org/10.3389/frhs.2022.848138
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author Wright, Hannah M.
Fuessel-Hermann, Dianna
Pazdera, Myah
Lee, Somi
Ridge, Brook
Kim, Joseph U.
Konopacki, Kelly
Hilton, Layne
Greensides, Michael
Langenecker, Scott A.
Smith, Andrew J.
author_facet Wright, Hannah M.
Fuessel-Hermann, Dianna
Pazdera, Myah
Lee, Somi
Ridge, Brook
Kim, Joseph U.
Konopacki, Kelly
Hilton, Layne
Greensides, Michael
Langenecker, Scott A.
Smith, Andrew J.
author_sort Wright, Hannah M.
collection PubMed
description First responders are at high risk for disorders that arise from repeat exposure to stress and trauma (Post Traumatic Stress Disorder, depression, and problematic alcohol use). Although mental health treatments are available, first responders often do not access them, anchored by barriers that include: lack of knowledge, stigma, negative experience with mental health providers, and time-based burdens. In this study, we designed an intervention to address these barriers, extending a Planned-Action framework. Step 1 involved self-report screening for four mental health risks (PTSD, depression, anxiety, and alcohol use risk), delivered to all personnel electronically, who were free to either consent and participate or opt-out. The detection of risk(s) in Step 1 led to scheduling a Step 2 telehealth appointment with a trained clinician. We report descriptive statistics for participation/attrition/utilization in Steps 1 and 2, rates of risk on four mental health variables, and rate of adherence to follow-up treatment recommendations. Step 1: In total, 53.3% of personnel [229 of 429 full-time employees (221 males; eight females; 95% White; 48% paramedic or Emergency Medical Technician; 25% captain; 19% engineer; 7% other)] initially opted-in by consenting and completing the brief remote screening survey. Among those who opted-in and completed (n = 229), 43% screened positive for one or more of the following mental health risks: PTSD (7.9%); depression (9.6%); anxiety (13.5%); alcohol use (36.7%). Step 2: A maximum of three attempts were made to schedule “at risk” individuals into Step 2 (n = 99). Among the 99 who demonstrated a need for mental health treatment (by screening positive for one or more risk), 56 (56.6%) engaged in the telehealth appointment. Of the 56 who participated in Step 2 clinical appointments, 38 were recommended for further intervention (16.6% of full-time personnel who participated). Among the 38 firefighters who were recommended to seek further mental health services, 29 were adherent/followed through (76.3% of those who received recommendations for further services). Taken together, evidence-based, culturally conscious, stepped care models delivered via the virtual/telehealth medium can promote access, utilization, and cost-effective mental health services for first responders. Implications are for informing larger, more rigorous dissemination and implementation efforts.
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spelling pubmed-100127732023-03-15 Preventative Care in First Responder Mental Health: Focusing on Access and Utilization via Stepped Telehealth Care Wright, Hannah M. Fuessel-Hermann, Dianna Pazdera, Myah Lee, Somi Ridge, Brook Kim, Joseph U. Konopacki, Kelly Hilton, Layne Greensides, Michael Langenecker, Scott A. Smith, Andrew J. Front Health Serv Health Services First responders are at high risk for disorders that arise from repeat exposure to stress and trauma (Post Traumatic Stress Disorder, depression, and problematic alcohol use). Although mental health treatments are available, first responders often do not access them, anchored by barriers that include: lack of knowledge, stigma, negative experience with mental health providers, and time-based burdens. In this study, we designed an intervention to address these barriers, extending a Planned-Action framework. Step 1 involved self-report screening for four mental health risks (PTSD, depression, anxiety, and alcohol use risk), delivered to all personnel electronically, who were free to either consent and participate or opt-out. The detection of risk(s) in Step 1 led to scheduling a Step 2 telehealth appointment with a trained clinician. We report descriptive statistics for participation/attrition/utilization in Steps 1 and 2, rates of risk on four mental health variables, and rate of adherence to follow-up treatment recommendations. Step 1: In total, 53.3% of personnel [229 of 429 full-time employees (221 males; eight females; 95% White; 48% paramedic or Emergency Medical Technician; 25% captain; 19% engineer; 7% other)] initially opted-in by consenting and completing the brief remote screening survey. Among those who opted-in and completed (n = 229), 43% screened positive for one or more of the following mental health risks: PTSD (7.9%); depression (9.6%); anxiety (13.5%); alcohol use (36.7%). Step 2: A maximum of three attempts were made to schedule “at risk” individuals into Step 2 (n = 99). Among the 99 who demonstrated a need for mental health treatment (by screening positive for one or more risk), 56 (56.6%) engaged in the telehealth appointment. Of the 56 who participated in Step 2 clinical appointments, 38 were recommended for further intervention (16.6% of full-time personnel who participated). Among the 38 firefighters who were recommended to seek further mental health services, 29 were adherent/followed through (76.3% of those who received recommendations for further services). Taken together, evidence-based, culturally conscious, stepped care models delivered via the virtual/telehealth medium can promote access, utilization, and cost-effective mental health services for first responders. Implications are for informing larger, more rigorous dissemination and implementation efforts. Frontiers Media S.A. 2022-06-09 /pmc/articles/PMC10012773/ /pubmed/36925868 http://dx.doi.org/10.3389/frhs.2022.848138 Text en Copyright © 2022 Wright, Fuessel-Hermann, Pazdera, Lee, Ridge, Kim, Konopacki, Hilton, Greensides, Langenecker and Smith. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Health Services
Wright, Hannah M.
Fuessel-Hermann, Dianna
Pazdera, Myah
Lee, Somi
Ridge, Brook
Kim, Joseph U.
Konopacki, Kelly
Hilton, Layne
Greensides, Michael
Langenecker, Scott A.
Smith, Andrew J.
Preventative Care in First Responder Mental Health: Focusing on Access and Utilization via Stepped Telehealth Care
title Preventative Care in First Responder Mental Health: Focusing on Access and Utilization via Stepped Telehealth Care
title_full Preventative Care in First Responder Mental Health: Focusing on Access and Utilization via Stepped Telehealth Care
title_fullStr Preventative Care in First Responder Mental Health: Focusing on Access and Utilization via Stepped Telehealth Care
title_full_unstemmed Preventative Care in First Responder Mental Health: Focusing on Access and Utilization via Stepped Telehealth Care
title_short Preventative Care in First Responder Mental Health: Focusing on Access and Utilization via Stepped Telehealth Care
title_sort preventative care in first responder mental health: focusing on access and utilization via stepped telehealth care
topic Health Services
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10012773/
https://www.ncbi.nlm.nih.gov/pubmed/36925868
http://dx.doi.org/10.3389/frhs.2022.848138
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