MacLean Sarah E, Edgar Nicole E, Ahluwalia Chloe, Testa Valerie, Hatcher Simon
Neurosciences Program, Ottawa Hospital Research Institute, ON, Canada.
School of Journalism and Communication, Carleton University, Ottawa, ON, Canada.
Health Serv Insights. 2025 May 7;18:11786329251333019. doi: 10.1177/11786329251333019. eCollection 2025.
First responders (police, firefighters, and paramedics) are routinely exposed to potentially psychologically traumatic events (PPTE). While the prevalence of mental disorders is difficult to estimate, research has demonstrated that first responders report higher rates of mental health disorders than the general population. They also report significant barriers to accessing mental healthcare, including concerns about the confidentiality of mental health services and stigma by co-workers and organizational leadership. One way to address these barriers to seeking care is through the establishment of a first responder specific mental health clinic. The objective of this qualitative study was to assess how to best implement such a service for first responders in Ottawa, Canada. We conducted 14 in-depth semi-structured qualitative interviews with key interest holders from first responder services, unions/associations, and the Workplace Safety and Insurance Board (WSIB) which explored elements of service delivery and organizational barriers and facilitators to implementing the clinic. Interviews were analyzed and coded using thematic analysis by two independent coders. Four main themes were identified: implementation context (perceived need, workplace culture), design of the clinic (service delivery, confidentiality, cost, and communication about the clinic), the implementation process (barriers and facilitators to implementation), and the broader impact of the implementation of the clinic. Findings show that it is the right time to implement first responder specific clinical services as services begin to prioritize the mental health needs of their members. To increase uptake by first responders, confidentiality and cultural competency of care providers is paramount.
急救人员（警察、消防员和护理人员）经常会接触到潜在的心理创伤事件（PPTE）。虽然精神障碍的患病率难以估计，但研究表明，急救人员报告的心理健康障碍发生率高于普通人群。他们还报告了在获得心理保健方面存在重大障碍，包括对心理健康服务保密性的担忧以及同事和组织领导的污名化。解决这些寻求治疗障碍的一种方法是建立专门针对急救人员的心理健康诊所。这项定性研究的目的是评估如何为加拿大渥太华的急救人员最好地实施这样一项服务。我们对急救服务、工会/协会以及工作场所安全与保险委员会（WSIB）的主要利益相关者进行了14次深入的半结构化定性访谈，探讨了服务提供的要素以及实施该诊所的组织障碍和促进因素。两名独立编码员使用主题分析对访谈进行了分析和编码。确定了四个主要主题：实施背景（感知需求、工作场所文化）、诊所设计（服务提供、保密性、成本以及关于诊所的沟通）、实施过程（实施的障碍和促进因素）以及诊所实施的更广泛影响。研究结果表明，随着各服务部门开始优先考虑其成员的心理健康需求，现在是实施专门针对急救人员的临床服务的合适时机。为了提高急救人员的接受度，护理人员的保密性和文化能力至关重要。
