Psychological stress injuries in public safety personnel: a quality improvement initiative

Abstract

Public safety personnel experience disproportionately high rates of anxiety, depression, and suicide, with U.S. law enforcement officers facing a suicide rate 54% higher than that of the general population (Violanti & Steege, 2021). In Montana, where limited resources and stigma impede mental health care, the suicide rate ranks among the nation's highest at 29.3 per 100,000--nearly double the national average (National Center for Injury Prevention and Control (U.S.)Division of Violence Prevention, 2018). In response to these challenges, a quality improvement (QI) initiative was launched in a moderately sized police department located in a city with a population of approximately 75,000 in the Northwestern United States to enhance the agency's existing wellness program. The QI initiative includes a pilot program that offers interventions for early detection, education, and a structure for ongoing organizational support - areas known to improve mental health outcomes for public safety personnel (PSP). For early detection, the pilot introduced a self-awareness screening tool, the Professional Quality of Life (ProQOL) questionnaire. Education was provided through a four-hour psychological stress awareness training, covering topics such as the pilot program's background, stress physiology, decision-making strategies, and the Stress First Aid (SFA) curriculum. Quality improvement was assessed through participation rates and survey results. The short-term goals of the pilot project were met, with intervention participation rates and role diversity exceeding expectations. These results indicated promising feasibility for expanding the pilot program agency-wide while operating within the agency's constraints, goals, and available resources. Furthermore, ongoing agency support can leverage the Replicating Effective Programs (REP) QI framework and the self-assessment tool to develop strategies for tracking long-term mental health and well-being goals.