Occupational Therapy and Public Safety Personnel: Return to Work Practices and Experiences

Background. Public safety personnel (PSP) are frequently exposed to psychological trauma through their work. Evidence shows that worker's compensation claims for work-related psychological injuries are on the rise for PSP. Occupational therapists increasingly provide return to work (RTW) services for this population. Purpose. To explore the therapeutic practices and personal experiences of occupational therapists working with PSP who have work-related psychological injuries. Method. This mixed methods descriptive study included a chart review of available occupational therapy client records from 2016 to 2020 for PSP with work-related psychological injuries from two Ontario companies. Additionally, a web-based self-report survey for Ontario occupational therapists providing RTW services to this same population was available from November 1, 2021 to June 1, 2022. Findings. The chart review included 31 client records and the online survey was completed by 49 Ontario occupational therapists. Therapists commonly provided services in clients' homes, workplaces, and communities, and focused on functional activities. The evidence base drawn on by therapists was not always occupation-based. Barriers to RTW included challenges with interprofessional collaboration, stigma, and the COVID-19 pandemic. Implications. Occupational therapists are commonly working with PSP with work-related psychological injuries and have the opportunity to contribute to the evidence base for occupational approaches to RTW.

Return to Work Experiences of Ontario Public Safety Personnel with Work-Related Psychological Injuries

PURPOSE

Public safety personnel (PSP) perform work that puts them at greater risk of psychological injury than the general public. PSP who subsequently develop posttraumatic stress disorder (PTSD) or other mental health conditions may need to take time off of work and use the workers compensation system. Very little is known about the experiences of PSP making this type of claim in Ontario to the Workplace Safety and Insurance Board (WSIB), or which healthcare professionals (HCP) PSP access as part of the treatment and return to work (RTW) process. This study captures the experiences of Ontario PSP in their RTW journeys, including with employers, WSIB, and HCPs.

METHODS

A survey-based study was conducted, using email and social media platforms to distribute the survey to PSP across Ontario. Quantitative data were summarized using means and frequencies, and open text results were analyzed using qualitative framework analysis.

RESULTS

145 survey respondents met the inclusion criteria for the study. On a scale out of 5, PSP rated their experience with WSIB and employer support as poor on their first RTW attempt with an average rating of 2.93 and 2.46 respectively. The top three HCPs accessed by PSP were psychologists (61%), occupational therapists (OT; 60%) and general practitioners (GP; 44%). Respondents identified the cultural competence of HCPs in understanding their work demands and work culture as very important.

CONCLUSIONS

To improve RTW experiences for PSP who make a workers compensation claim for a psychological injury, an increase in HCP cultural competence related to PSP work is indicated, as well as improved RTW processes and workplace support.

Mental health of public safety personnel: Developing a model of operational, organizational, and personal factors in public safety organizations

The work of public safety personnel (PSP) such as police officers, firefighters, correctional officers, and paramedics, as well as other PSP, makes them vulnerable to psychological injuries, which can have profound impacts on their families and the communities they serve. A multitude of complex operational, organizational, and personal factors contribute to the mental health of PSP; however, to date the approach of the research community has been largely to explore the impacts of these factors separately or within single PSP professions. To date, PSP employers have predominantly focused on addressing the personal aspects of PSP mental health through resiliency and stress management interventions. However, the increasing number of psychological injuries among PSPs and the compounding stressors of the COVID-19 pandemic demonstrate a need for a new approach to the study of PSP mental health. The following paper discusses the importance of adopting a broader conceptual approach to the study of PSP mental health and proposes a novel model that highlights the need to consider the combined impacts of operational, organizational, and personal factors on PSP mental health. The TRi-Operational-Organizational-Personal Factor Model (TROOP) depicts these key factors as three large pieces of a larger puzzle that is PSP mental health. The TROOP gives working language for public safety organizations, leaders, and researchers to broadly consider the mental health impacts of public safety work.

Therapy services for children and youth living in rural areas of high-income countries: a scoping review

PURPOSE

To identify and describe therapeutic services provided to children and youth with disabilities living in rural areas of mid- and high-income countries and to summarize the benefits, positive outcomes, and challenges related to these services.

METHODS

This scoping review involved a systematic search of four academic electronic databases: MEDLINE, EMBASE, CINAHL, and Psych INFO, using a combination of subject headings and keywords related to (1) child disabilities; (2) rehabilitation: occupational therapists, speech-language pathologists, physiotherapists, audiologists, and recreation therapists; (3) multidisciplinary care team; (4) rural areas. Charting involved an iterative process whereby the full text articles meeting the inclusion criteria were abstracted using the charting form by two independent reviewers.

RESULTS

Thirty-seven articles from seven high-income countries were included in the analysis. Twenty-seven articles reported on in-person services, and 19 on telepractice (nine evaluated in-person and telepractice). In person services included outreach programs and specialized on-site programs. Positive outcomes and challenges of in person and telepractice services in rural areas are described.

CONCLUSIONS

Findings of this review highlight the need for further research on service delivery models offered in rural areas of upper middle and high-income countries, especially those focusing specifically on the rural communities, with a clear description of services. IMPLICATIONS FOR REHABILITATIONThis scoping review helps to advance the understanding of how therapy services are offered in rural areas of high-income countries.Telepractice was found to enhance ease of access to services for families living in rural areas.The findings of this review suggest that telepractice may be an effective means of providing therapy services to children and youth with disabilities living in rural areas of high-income countries, pending families' access to technology.