Browsing by Author "Cramm, Heidi"

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Open Access
Assessing the impact of the Royal Canadian Mounted Police (RCMP) protocol and Emotional Resilience Skills Training (ERST) among diverse public safety personnel
(BMC, 2022-12-09) Carleton, R. Nicholas; McCarron, Michelle; Krätzig, Gregory P.; Sauer-Zavala, Shannon; Neary, J. Patrick; Lix, Lisa M.; Fletcher, Amber J.; Camp, Ronald D.; Shields, Robyn, E.; Jamshidi, Laleh; Nisbet, Jolan; Maguire, Kirby Q.; MacPhee, Renée, S.; Afifi, Tracie O.; Jones, Nicholas A.; Martin, Ronald, R.; Sareen, Jitender; Brunet, Alain; Beshai, Shadi; Anderson, Gregory S.; Cramm, Heidi; MacDermid, Joy C.; Ricciardelli, Rosemary; Rabbani, Rasheda; Teckchandani, Taylor A.; Asmundson, Gordon J.G.
Public safety personnel (PSP; e.g., border services personnel, correctional workers, firefighters, paramedics, police, public safety communicators) are frequently exposed to potentially psychologically traumatic events. Such events contribute to substantial and growing challenges from posttraumatic stress injuries (PTSIs), including but not limited to posttraumatic stress disorder.
Open Access
Assessing the Relative Impact of Diverse Stressors Among Public Safety Personnel
(Multidisciplinary Digital Publishing Institute, 2020-02-14) Carleton, R. Nicholas; Afifi, Tracie O.; Taillieu, Tamara L.; Turner, Sarah; Mason, Julia, E.; Ricciardelli, Rosemary; McCreary, Donald, R.; Vaughan, Adam D.; Anderson, Gregory S.; McCreary, Rachel; Donnelly, Elizabeth, A.; Camp, Ronald D.; Groll, Dianne; Cramm, Heidi; MacPhee, Renée, S.; Griffiths, Curt T.
Public Safety Personnel (PSP; e.g., correctional workers and officers, firefighters, paramedics, police officers, and public safety communications officials (e.g., call center operators/dispatchers)) are regularly exposed to potentially psychologically traumatic events (PPTEs). PSP also experience other occupational stressors, including organizational (e.g., staff shortages, inconsistent leadership styles) and operational elements (e.g., shift work, public scrutiny). The current research quantified occupational stressors across PSP categories and assessed for relationships with PPTEs and mental health disorders (e.g., anxiety, depression). The participants were 4820 PSP (31.7% women) responding to established self-report measures for PPTEs, occupational stressors, and mental disorder symptoms. PPTEs and occupational stressors were associated with mental health disorder symptoms (ps < 0.001). PSP reported substantial difficulties with occupational stressors associated with mental health disorder symptoms, even after accounting for diverse PPTE exposures. PPTEs may be inevitable for PSP and are related to mental health; however, leadership style, organizational engagement, stigma, sleep, and social environment are modifiable variables that appear significantly related to mental health.
Open Access
CCWORK Protocol: The longitudinal study of Canadian Correctional Workers’ Wellbeing, Organizations, Roles and Knowledge
(BMJ Publishing Group, 2021-10-26) Ricciardelli, Rosemary; Andres, Elizabeth; Mitchell, Meghan; Quirion, Bastien; Groll, Dianne; Adorjan, Michael; Cassiano, Marcella Siqueira; Shewmake, James; Herzog-Evans, Martine; Moran, Dominique; Spencer, Dale, C.; Genest, Christine; Czarnuch, Stephen; Gacek, James; Cramm, Heidi; Maier, Katharina; Phoenix, Jo; Weinrath, Michael; MacDermid, Joy C.; McKinnon, Margaret; Haynes, Stacy; Arnold, Helen; Turner, Jennifer; Eriksson, Anna; Heber, Alexandra; Anderson, Gregory S.; MacPhee, Renée, S.; Carleton, R. Nicholas
Introduction Knowledge about the factors that contribute to the correctional officer’s (CO) mental health and well-being, or best practices for improving the mental health and well-being of COs, have been hampered by the dearth of rigorous longitudinal studies. In the current protocol, we share the approach used in the Canadian Correctional Workers’ Well-being, Organizations, Roles and Knowledge study (CCWORK), designed to investigate several determinants of health and well-being among COs working in Canada’s federal prison system.
Open Access
Health of Canadian Firefighters: The Impact of Sleep and Work
(Multidisciplinary Digital Publishing Institute,, 2021-12-16) Cramm, Heidi; Richmond, Rachel; Jamshidi, Laleh; Edgelow, Megan; Groll, Dianne; Ricciardelli, Rosemary; MacDermid, Joy C.; Keiley, Michael; Carleton, R. Nicholas
Volunteer and career firefighters are at risk of major depressive disorders, posttraumatic stress disorder (PTSD), alcohol use disorder, and other mental health disorders due to the demanding and unpredictable nature of their employment. The mental health risks are exacerbated by the need to work extended hours, night shifts, and/or rotating schedules, or the competing demands of other employment, especially in volunteer firefighters. The mental health disorders and risk factors interact with altered sleeping patterns. In the current study, we examined volunteer and career firefighters regarding the association between mental health and sleep, drawing from a national Canadian mental health survey of 1217 firefighters. Most (69%) of the firefighters reported less than ideal sleep quality and 21% screened positive for clinical insomnia, with no significant difference between volunteer and career subgroups. Firefighters with insomnia had higher odds ratios (OR) and frequencies for PTSD (OR = 4.98), generalized anxiety disorder (OR = 7.15), panic disorder (OR = 6.88), social phobia (OR = 4.98), and major depressive disorder (OR = 7.91), than firefighters without insomnia. The burden of sleep disorders and their association with mental health disorders suggests that sleep should be considered in health monitoring and self-management, environmental design, fire service work-organization policies, and health programming.
Open Access
Mental Disorder Symptoms among Public Safety Personnel in Canada
(SAGE Publications, 2017-08-28) Carleton, R. Nicholas; Afifi, Tracie O.; Turner, Sarah; Taillieu, Tamara L.; Duranceau, Sophie; LeBouthillier, Daniel, M.; Sareen, Jitender; Ricciardelli, Rosemary; MacPhee, Renée, S.; Groll, Dianne; Hozempa, Kadie; Brunet, Alain; Weekes, John R.; Griffiths, Curt T.; Abrams, Kelly J.; Jones, Nicholas A.; Beshai, Shadi; Cramm, Heidi; Dobson, Keith S.; Hatcher, Simon; Keane, Terence M.; Stewart, Sherry H.; Asmundson, Gordon J.G.
Canadian public safety personnel (PSP; e.g., correctional workers, dispatchers, firefighters, paramedics, police officers) are exposed to potentially traumatic events as a function of their work. Such exposures contribute to the risk of developing clinically significant symptoms related to mental disorders. The current study was designed to provide estimates of mental disorder symptom frequencies and severities for Canadian PSP.
Open Access
Mental health disorder symptom changes among public safety personnel after emotional resilience skills training.
(Elsevier Inc., 2025-02-05) Carleton, R. Nicholas; Sauer-Zavala, Shannon; Teckchandani, Taylor A.; Maguire, Kirby Q.; Jamshidi, Laleh; Shields, Robyn, E.; Afifi, Tracie O.; Nisbet, Jolan; Andrews, Katie L.; Stewart, Sherry H.; Fletcher, Amber J.; Martin, R; MacPhee, Renée, S.; MacDermid, J.C.; Keane, Terence M.; Brunet, Alain; McCarron, Michelle C. E.; Lix, Lisa M.; Jones, N.A.; Krätzig, Gregory P.; Neary, J. Patrick; Anderson, Gregory S.; Ricciardelli, Rosemary; Cramm, Heidi; Sareen, Jitender; Asmundson, Gordon J.G.
Public safety personnel (PSP) are frequently exposed to psychologically traumatic events. The exposures potentiate posttraumatic stress injuries (PTSIs), including posttraumatic stress disorder (PTSD). The Royal Canadian Mounted Police (RCMP) Protocol was designed to mitigate PTSIs using ongoing monitoring and PSP-delivered Emotional Resilience Skills Training (ERST) based on the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders. The current study pilot-tested ERST effectiveness among diverse PSP.
Open Access
Mental Health Risk Factors Related to COVID-19 among Canadian Public Safety Professionals
(Multidisciplinary Digital Publishing Institute, 2022-12-26) Wagner, Shannon; Di Nota, Paula; Groll, Dianne; Lentz, Liana; Shields, Robyn, E.; Carleton, R. Nicholas; Cramm, Heidi; Wei Lin, Becky; Anderson, Gregory S.
Public safety personnel (PSP) are known to experience difficult and demanding occupational environments, an environment that has been complicated by the COVID-19 pandemic. Firefighters, paramedics, and public safety communicators were among the front-line workers that continued to serve the public throughout the course of the pandemic. The present study considered the potential impacts of the COVID-19 pandemic on self-reported symptoms of mental health challenges in Canadian firefighters, paramedics, and public safety communicators. Participants were firefighters (n = 123), paramedics (n = 246), and public safety communicators (n = 48), who completed an online survey, including demographics, questions related to COVID-19 exposure and worry, the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7, the Social Interaction Phobia Scale, and the Posttraumatic Stress Disorder Checklist-5. Results revealed that risk factors for increased mental health symptom reporting were paramedic occupation, self-identified female, younger in age, COVID-19 personal contact, requirement to self-isolate, and self-perception of COVID-19 contraction (without confirmation through testing). The COVID-19 pandemic should be considered a risk factor for increased mental health symptom reporting in PSP.
Open Access
Mental Health Training, Attitudes Towards Support, and Screening Positive for Mental Disorders
(Taylor and Francis Group, 2019-02-22) Carleton, R. Nicholas; Afifi, Tracie O.; Turner, Sarah; Taillieu, Tamara L.; Vaughan, Adam V.; Anderson, Gregory S.; Ricciardelli, Rosemary; MacPhee, Renée, S.; Cramm, Heidi; Czarnuch, Stephen; Hozempa, Kadie; Camp, Ronald D.
Public Safety Personnel (PSP; e.g. correctional workers, dispatchers, firefighters, paramedics, police) are frequently exposed to potentially traumatic events (PTEs). Several mental health training program categories (e.g. critical incident stress management (CISM), debriefing, peer support, psychoeducation, mental health first aid, Road to Mental Readiness [R2MR]) exist as efforts to minimize the impact of exposures, often using cognitive behavioral therapy model content, but with limited effectiveness research. The current study assessed PSP perceptions of access to professional (i.e. physicians, psychologists, psychiatrists, employee assistance programs, chaplains) and non-professional (i.e. spouse, friends, colleagues, leadership) support, and associations between training and mental health. Participants included 4,020 currently serving PSP participants. Data were analyzed using cross-tabulations and logistic regressions. Most PSP reported access to professional and non-professional support; nevertheless, most would first access a spouse (74%) and many would never, or only as a last resort, access professional support (43–60%) or PSP leaders (67%). Participation in any mental health training category was associated with lower (p < .01) rates for some, but not all, mental disorders, with no robust differences across categories. Revisions to training programs may improve willingness to access professional support; in the interim, training and support for PSP spouses and leaders may also be beneficial.
Open Access
Paraprofessional delivery of online narrative exposure therapy for firefighters
(Wiley, 2023-06-08) Olthuis, Janine V.; Kaltenbach, Elisa; Giberson, Emma; Saryeddine, Tina; Asmundson, Gordon J.G.; Carleton, R. Nicholas; Cramm, Heidi; Crombach, Anselm; Devlin, Julie; Mack, Jeff; Lingley-Pottie, Patricia; Rao, Sanjay; Sullivan, Michael; Wozney, Lori; McGrath, Patrick J.
Firefighters are at increased risk for developing posttraumatic stress disorder (PTSD) and face numerous barriers to accessing mental health care. Innovative ways to increase access to evidence-based interventions are needed. This study was a case series testing the acceptability, feasibility, and preliminary effectiveness of a paraprofessional-delivered, virtual narrative exposure therapy (eNET) intervention for PTSD. Participants were 21 firefighters who met the criteria for clinical or subclinical probable PTSD and completed 10–12 sessions of eNET via videoconference. Participants completed self-report measures pre- and postintervention and at 2- and 6-month follow-ups as well as a postintervention qualitative interview. Paired samples t tests evidenced statistically significant decreases in PTSD, anxiety, and depressive symptom severity and functional impairment from pre- to postintervention, ds = 1.08–1.33, and in PTSD and anxiety symptom severity and functional impairment from preintervention to 6-month follow-up, ds = 0.69–1.10. The average PTSD symptom severity score fell from above to below the clinical cutoff for probable PTSD at postintervention and follow-ups. Qualitative interviews indicated that paraprofessionals were considered central to participants’ success and experience with the intervention. No adverse events or safety concerns were raised. This study is an important step in demonstrating that appropriately trained and supervised paraprofessionals can effectively deliver eNET to firefighters with PTSD.
Open Access
Peer Support for Public Safety Personnel in Canada: Toward a Collective Typology
(Multidisciplinary Digital Publishing Institute, 2022-04-20) Price, Jill A.B.; Ogunade, Adeyemi; Fletcher, Amber J.; Ricciardelli, Rosemary; Anderson, Gregory S.; Cramm, Heidi; Carleton, R. Nicholas
Public safety personnel (PSP) are frequently exposed to potentially psychologically traumatic events (PPTEs) which can impact mental health. To help mitigate the negative effects of PPTEs, PSP commonly rely on peer support. Peer support generally refers to a wide variety of mental health resources that offer social or emotional assistance to a peer, and in some cases professional assistance. Despite the use of and demand for peer support, there is relatively little empirical evidence regarding effectiveness. The evidence gaps regarding peer support effectiveness may be due, in part, to inadequate guidelines and standards of practice that are publicly supported by a consensus among peer support providers. The current study was designed to explore the current conceptualization and implementation of peer support among Canadian PSP using a document analysis. The results indicate that peer support can be conceptualized via three models (i.e., peer-enabled, peer-led, peer-partnership) and implemented via two delivery methods (i.e., program, service). The research team proposed a novel diagram towards a typology of peer support to highlight the diversity in peer support conceptualization and implementation and provide a foundation for the development of mutually agreed-upon language and a shared framework. Overall, the current study can help inform peer support resources within and beyond PSP communities.
Open Access
Sleep quality and mental disorder symptoms among correctional workers in Ontario, Canada
(Springer Science and Business Media LLC, 2024-06-28) Ricciardelli, Rosemary; Taillieu, Tamara L.; McElheran, Megan; Cramm, Heidi; Ajith, Harsha; Johnston, Matthew S.; Carleton, R. Nicholas
Correctional workers (CWs) report high levels of work stressors, frequent exposures to potentially psychologically traumatic events (PPTEs), and substantial mental health challenges. There is evidence of associations between sleep disturbances and diverse mental health challenges, including preliminary evidence from public safety personnel; however, replications and extensions would better inform interventions to support mental health. The current study was designed to examine associations between quality of sleep, work stress, and mental health disorders in a sample of diverse CWs employed in a provincial correctional service in Ontario, Canada. Data were analyzed from 943 CWs who participated in the cross-sectional, web-based Ontario Provincial Correctional Worker Mental Health and Well-Being Study conducted from December 2017 to June 2018. Sleep quality indicators included symptoms of insomnia, total hours of sleep per night on work nights and off-shift nights, number of days feeling rested per week, and overall sleep quality. Descriptive statistics, analyses of variance, correlational analyses, and logistic regression were used to examine relationships among sleep quality, stress of shift work, and mental health disorder symptoms. CWs slept an average of 6.0 h per night when working and 7.2 h during off-shift nights. CWs reported waking up feeling rested an average of 2.6 days per week and rated their overall quality of sleep in the fair to poor range. Many CWs (64.9%) screened positive for clinically significant symptoms of insomnia. There were also differences across occupational groups such that CWs working as correctional officers reported the most sleep problems. There were statistically significant relationships between insomnia and mental health disorder symptoms. Higher levels of stress from shift work were associated with worse sleep quality. CWs, especially those working as correctional officers in a provincial prison, reported many indicators consistent with poorer quality of sleep. Poor quality of sleep was also associated with work stress and mental health disorders.