Stakeholder Perspectives on Internet-Delivered Cognitive Behavioural Therapy for Public Safety Personnel: A Qualitative Analysis

Public safety personnel (PSP)-including border security agents, correctional workers, dispatchers, firefighters, paramedics, and police- have elevated rates of depression, anxiety, and posttraumatic stress. In its Action Plan on Posttraumatic Stress Injuries, the Government of Canada reported that many PSP are unable to access treatment for mental health problems. The Action Plan identified internet-delivered cognitive behavioural therapy (ICBT) as a treatment that can improve access to care for PSP. Nevertheless, little is known about how PSP perceive ICBT and what tailoring PSP deem important to address their needs. We conducted interviews with 126 PSP stakeholders in the Canadian provinces of Saskatchewan and Quebec to explore their perspectives on ICBT. The results confirmed that PSP face many barriers to treatment. Stigma was the most frequently cited barrier. The results also indicated that PSP have positive perceptions of ICBT; most stakeholders reported believing there is a need for ICBT tailored for PSP and that PSP would be likely to use it. Stakeholders provided valuable recommendations regarding how researchers and clinicians should design and deliver ICBT for PSP. Specifically, PSP recommended that tailored ICBT should treat a range of symptoms, address other concerns that are important to PSP, and be delivered in a flexible manner. The results indicate that PSP perceive ICBT as an appropriate treatment option to help address the high prevalence of mental health problems among Canadian PSP. These findings have helped us tailor an existing ICBT program for PSP and may help researchers tailoring interventions to PSP in other contexts.