None listed
Conditions
Brief summary
First responders, corrective service, and other frontline workers perform some of the most important roles in our society. As a result, first responders are at disparate risk of exposure to traumatic and/or stressful events, demanding workloads, and irregular hours – all known risk factors for mental ill health. Indeed, previous studies report high rates of post-traumatic stress disorder (PTSD), depression, and distress amongst first responders. Widespread reluctance to seek treatment for such mental health issues is especially prevalent in first responders. Mental health screening attempts to detect individuals at risk of, or suffering, a mental health condition to direct them to resources/treatment. Early detection of mental ill health is associated with less intensive treatments and improved recovery. This, in tandem with the fact that mental illness is currently a leading cause of sickness absence and work incapacity in many developed countries, has meant that screening of employee mental health is increasingly applied in workplaces. While increasingly common, workplace mental health screening has received criticisms including the cost and resources required, and employee concerns regarding confidentiality and consequences of disclosure leading to biased reporting. Nonetheless, workplace mental health screening is occurring in real-world first responder workplaces.
Interventions
Description of intervention(s)/exposure: There are two arms to this trial:
Arm 1 (Intervention): Screening followed by feedback tailored to participants’ level of psychological distress as assessed through the K6 and provided at baseline and follow-up. Those reporting minimal psychological distress (K6 score of less than 14) will receive feedback stating it is unlikely they are experiencing a common mental health disorder, but if they feel they would benefit from some more support or a mental h
Description of intervention(s)/exposure: There are two arms to this trial: Arm 1 (Intervention): Screening followed by feedback tailored to participants’ level of psychological distress as assessed through the K6 and provided at baseline and follow-up. Those reporting minimal psychological distress (K6 score of less than 14) will receive feedback stating it is unlikely they are experiencing a common mental health disorder, but if they feel they would benefit from some more support or a mental health care plan, to contact their GP or workplace support team to discuss available options. Those reporting moderate/subsyndromal psychological distress (K6=14-18) will receive feedback that they are currently experiencing symptoms of psychological distress which may be due to (or progress to) a common mental health disorder, and that to address these symptoms they can seek internal supports from their workplace (i.e., wellbeing team, EAP) or external supports (i.e., online mental health tools). Finally, those reporting significant psychological distress (K6 >18) will receive feedback that they are currently experiencing significant symptoms of psychological distress, which may be due to a common mental health disorder, and that to address these symptoms they can seek internal supports from their workplace (i.e., wellbeing team, EAP) or external supports (i.e., seeing their General Practitioner, online mental health tools). Arm 2 (Control): Screening followed by generic feedback, not tailored to level of psychological distress. Tailored feedback provided at follow-up. At baseline, all participants in this study will complete a brief, 2-minute, mental health screening questionnaire, which assesses their level of psychological distress. Psychological distress will be measured using the 6-item Kessler Psychological Distress Scale or ‘K6’ questionnaire (Kessler et al., 2002). The screening questionnaire also assesses help-seeking behaviour (using an adapted version of the Actual Help-Seeking Questionnaire AHSQ; Rickwood, Deane, Wilson, & Ciarrochi, 2005) and a checklist assessing exposure to critical incidents (Harvey et al, 2016). At the completion of the baseline questionnaire, intervention participants will be provided feedback tailored to their level of psychological distress scores. This feedback includes specific information on where they can seek help for their psychological distress, with the aim to promote help-seeking. Specifically, participants receive one of three tailored feedback options depending on the following K6 scores: (i) reporting minimal psychological distress (scoring < 14 on the K6), (ii) reporting subsyndromal psychological distress (scoring 14-18 on the K6), (iii) reporting considerable psychological distress (scoring > 18 on the K6). Three months later, all participants in this study will complete the same 2-minute mental health screening questionnaire again. Help-seeking will be assessed to monitor adherence. This time, both intervention and control participants will be provided feedback tailored to their psychological distress scores identical to that provided to intervention participants at the baseline questionnaire. The intervention will be delivered entirely online, provided individually to participants. Participants can select whether to complete the screening questionnaire either at work during their shift, or at home in their personal time. The duration of the study for any participant will conclude after the 3-month follow-up assessment. References: Kessler, R. C., Andrews, G., Colpe, L. J., Hiripi, E., Mroczek, D. K., Normand, S. L., . . . Zaslavsky, A. M. (2002). Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med, 32(6), 959-976. doi:10.1017/s0033291702006074 Rickwood, D., Deane, F. P., Wilson, C. J., & Ciarrochi, J. (2005). Young people’s help-seeking for mental health problems. Australian e-Journal for the Advancement of Mental Health, 4(3), 218-251. doi:10.5172/jamh.4.3.218 Harvey et al. (2016). The mental health of fire-fighters: An examination of the impact of repeated trauma exposure. ANZJP. 50(7). 649-658
Sponsors
University of New South Wales
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Blinded (masking used) (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Inclusion criteria for participants taking part in this study includes: 1. Age 18 years or older. 2. Currently working as a firefighter or rescue personnel and employed by partnering organisation (Fire & Rescue New South Wales). 3. Currently residing in Australia.
Exclusion criteria
No formal exclusion criteria apply to this study. Only eligible participants will be invited and allowed to participate.
Outcome results
None listed