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可改变的组织因素在减少精神保健障碍中的作用:对加拿大激光行动部署人员的使命感意义、团队关联性和领导信任的纵向研究。

Role of modifiable organisational factors in decreasing barriers to mental healthcare: a longitudinal study of mission meaningfulness, team relatedness and leadership trust among Canadian military personnel deployed on Operation LASER.

机构信息

Director General Military Personnel Research and Analysis, Department of National Defence and the Canadian Armed Forces, Ottawa, Ontario, Canada

Douglas Mental Health University Institute, Montreal, Québec, Canada.

出版信息

BMJ Open. 2024 Feb 8;14(2):e076625. doi: 10.1136/bmjopen-2023-076625.

Abstract

OBJECTIVES

The literature presents complex inter-relationships among individual-factors and organisational-factors and barriers to seeking mental health support after deployment. This study aims to quantify longitudinal associations between such factors and barriers to mental health support.

DESIGN

A longitudinal online survey of Canadian Armed Forces (CAF) personnel collected data at 3 months post-deployment (T1), 6 months post-deployment (T2) and 1 year post-deployment (T3).

SETTING

In 2020, as part of Canada's response to the COVID-19 pandemic, 2595 CAF personnel deployed on Operation LASER to support civilian long-term care facilities in Québec and Ontario.

PARTICIPANTS

All Operation LASER personnel were invited to participate: 1088, 582 and 497 responded at T1, T2 and T3, respectively. Most respondents were young, male, non-commissioned members.

MAIN OUTCOME MEASURES

Barriers to mental health support were measured using 25 self-reported items and grouped into theory-based factors, including eight factors exploring care-seeking capabilities, opportunities and motivations; and two factors exploring moral issues. Logistic regressions estimated the crude and adjusted associations of individual and organisational characteristics (T1) with barriers (T2 and T3).

RESULTS

When adjusting for sex, military rank and mental health status, increased meaningfulness of deployment was associated with lower probability of endorsing barriers related to conflicts with career goals and moral discomfort in accessing support at T2. Higher scores in trust in leadership were associated with lower probability of endorsing four barriers at T2, and five barriers at T3.

CONCLUSIONS

We identified several modifiable organisational-level characteristics that may help reduce perceived barriers to mental health support in military and other high-risk occupational populations. Results suggest that promoting individuals' sense of purpose, instilling trust in leadership and promoting relatedness among team members may improve perceptions of access to mental health supports in the months following a domestic deployment or comparable occupational exposure.

摘要

目的

文献呈现了个体因素和组织因素之间以及部署后寻求心理健康支持的障碍之间复杂的相互关系。本研究旨在量化这些因素和心理健康支持障碍之间的纵向关联。

设计

对加拿大武装部队(CAF)人员进行的一项纵向在线调查,在部署后 3 个月(T1)、6 个月(T2)和 1 年(T3)收集数据。

地点

2020 年,作为加拿大对 COVID-19 大流行反应的一部分,2595 名 CAF 人员部署到行动激光,以支持魁北克和安大略省的民用长期护理设施。

参与者

邀请所有参与行动激光的人员参加:分别有 1088 人、582 人和 497 人在 T1、T2 和 T3 时作出回应。大多数受访者是年轻的、男性的、非委任成员。

主要结果衡量指标

使用 25 项自我报告项目衡量心理健康支持的障碍,并分为基于理论的因素,包括探索寻求护理能力、机会和动机的八个因素;以及探索道德问题的两个因素。逻辑回归估计了个人和组织特征(T1)与障碍(T2 和 T3)的粗关联和调整关联。

结果

当调整性别、军阶和心理健康状况时,部署的意义增加与在 T2 时不太可能认同与职业目标冲突和在获得支持方面感到道德不适有关的障碍相关。领导信任度得分较高与在 T2 时不太可能认同四个障碍以及在 T3 时不太可能认同五个障碍相关。

结论

我们确定了一些可修改的组织层面特征,这些特征可能有助于减少军事人员和其他高风险职业人群对心理健康支持的感知障碍。结果表明,增强个人的使命感、灌输对领导的信任以及促进团队成员之间的联系,可能会改善在国内部署或类似职业暴露后的几个月内对心理健康支持的获取感。

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