Department of Sociology, Memorial University of Newfoundland, St. John's, Newfoundland A1C 5S7, Canada.
Department of Electrical and Computer Engineering and Discipline of Emergency Medicine, Memorial University of Newfoundland, St. John's, Newfoundland A1C 5S7, Canada.
Occup Med (Lond). 2020 May 27;70(3):155-161. doi: 10.1093/occmed/kqaa007.
Many public safety personnel (PSP) experience trauma directly or indirectly in their occupational role, yet there remain barriers to accessing care or seeking help.
To understand how PSP interpret different potentially traumatic events and how perceived eligibility for being traumatized is determined among PSP.
We analysed open-ended comments provided by over 800 PSP in a survey designed to assess the prevalence of post-traumatic stress injuries and other mental disorders.
We found evidence that a trauma hierarchy may exist among PSP. Certain experiences may be interpreted as more traumatic, based on both the event and the PSP role in the actual event. For example, involvement in a shooting may be interpreted as more traumatic than arriving on the scene later. Similarly, a single event may be deemed more traumatic than an accumulation of events. The role of the individual and social context in shaping experiences and interpretations of trauma may be largely ignored in line with confirmation biases.
The role that individuals and social contexts play in shaping experiences and interpretations of trauma appear suppressed by perceptions of a trauma hierarchy, facilitating systematic discrediting or valuation of some experiences, therein evidencing that trauma is subjective and reinforcing barriers to care seeking. A trauma hierarchy may also propagate stigma and legitimize discrimination regarding mental health. We argue that recognizing, engaging with, and dismantling the perception of a trauma hierarchy may help create a respectful and open occupational culture supportive of mental health needs.
许多公共安全人员(PSP)在职业角色中直接或间接地经历创伤,但仍存在获得护理或寻求帮助的障碍。
了解 PSP 如何解释不同的潜在创伤事件,以及 PSP 如何确定自己是否有资格受到创伤。
我们分析了一项旨在评估创伤后应激障碍和其他精神障碍患病率的调查中超过 800 名 PSP 提供的开放式评论。
我们发现 PSP 中可能存在创伤层次结构的证据。某些经历可能被解释为更具创伤性,这取决于事件本身以及 PSP 在实际事件中的角色。例如,参与枪击事件可能被解释为比后来到达现场更具创伤性。同样,单一事件可能被视为比事件积累更具创伤性。个人和社会环境在塑造创伤经历和解释方面的作用可能在很大程度上被忽视,这符合确认偏差。
个人和社会环境在塑造创伤经历和解释方面的作用似乎受到创伤层次结构的感知所抑制,这有助于系统地贬低或评估某些经历,从而证明创伤是主观的,并加剧了寻求护理的障碍。创伤层次结构也可能传播耻辱感,并使心理健康方面的歧视合法化。我们认为,认识、参与和消除对创伤层次结构的感知,可能有助于创造一个尊重和开放的职业文化,支持心理健康需求。