A Qualitative Evaluation of the Before Operational Stress Program: A Pan-Canadian Study of Mental Health Training for Frontline Public Safety Personnel and Healthcare Providers.

Public safety personnel (PSP) and healthcare providers (HCP) are routinely exposed to potentially psychologically traumatic events and are at increased risk of developing mental disorder symptoms and posttraumatic stress injuries (PTSI). The Before Operational Stress program (BOS) is an evidence-informed mental health and resiliency training programme designed to mitigate the effects of PTSI. We conducted 41 in-depth semi-structured interviews with PSP and HCP who had completed the BOS program to investigate whether and how the programme benefits mental health, and how the content can integrate with their personal and professional lives. Data were analysed using team-based template analysis. The four overarching themes that emerged were: (1) health journeys; (2) the ripple effect of helping; (3) the destabilising effect of organizational pressures; and (4) context matters to how the programme was received. Each main theme was developed and supported by multiple subthemes explored herein. The results indicated BOS was well-received and helpful to participants at various career stages while furthering the discourse on mental health in PSP and HCP workplaces; however, difficulties were reported related to persistent stigma around mental health injuries. Organizational policies and systemic strains appear to be key contextual determinants and barriers.