Engaging Law Enforcement Employees in Mental Health Help-Seeking: Examining the Utilization of Interactive Screening Program and Motivational Interviewing Techniques.

AIM: The Interactive Screening Program (ISP) is an anonymous screening and dialogue platform used in workplaces to encourage mental health help-seeking. This study examined utilization of ISP among law enforcement workplaces and assessed how motivational interviewing techniques were associated with various help-seeking outcomes. METHOD: This retrospective study used secondary ISP screening and dialogue data collected from 2013 to 2019 at four law enforcement workplaces or unions (N = 691). Independent variables include counselors' use of motivational interviewing techniques in their dialogue such as asking questions and showing empathy in their response. Help-seeking outcomes include requesting a referral, making a commitment to counseling services, decreased ambivalence about mental health services, and increased willingness to seek future services. RESULTS: Two-thirds of participants screened within the high distress level of ISP. Among them, 53% responded to the counselor's initial email and 50% of those who responded requested a referral for future services. Binary logistic regression models showed that counselors' use of confrontation in the dialogue was associated with improved willingness to seek services among ISP users (OR = 2.88, 95% CI = 1.24, 6.64). Further, ISP users who accessed ISP through their workplace peer support program, as compared to their employee assistance program (EAP), are more likely to show decreased ambivalence about seeking future services over time (OR = 0.28, 95% CI = 0.09, 0.80). CONCLUSION: This study demonstrates that the anonymous ISP program can successfully engage employees with high distress levels, including employees with suicidal ideation. Results highlight the importance of customizing ISP counselors' responses to be responsive for law enforcement employees.

Effectiveness of man therapy to reduce suicidal ideation and depression among working-age men: A randomized controlled trial.

OBJECTIVE: This randomized controlled trial of the online intervention, man therapy (MT), evaluated efficacy to reduce suicidal ideation (SI) and depression among working-aged men. METHOD: Five-hundred and fifty-four men enrolled and 421 completed all surveys. Control Condition men explored the Healthy Men Michigan (HMM) website and Intervention Condition men explored HMM and MT. Hypotheses included men who used MT would report decreased SI and depression over time compared to Control Condition men. RESULTS: Latent growth curve modeling revealed improvements in SI (slope = -0.23, p < 0.001, 95% CI: -0.29, -0.16) and depression (slope = -0.21, p < 0.001, 95% CI: -0.23, -0.18) over time for men in both groups; however, there was no difference in slope based on group assignment. Depression, lifetime suicide attempts, and interpersonal needs were associated with SI. Interpersonal needs and poor mental health were associated with depression. No group differences in change in risk and protective factors over time were observed. MT sub-group analyses revealed significant improvements in risk and protective factors. CONCLUSION: While a direct effect of MT versus HMM on SI or depression was not observed, men in both groups improved. Results suggest online screening might play a role in reducing SI and depression among men and there are potential benefits to MT related to mental health, social support, and treatment motivation.

Help-seeking and Man Therapy: The impact of an online suicide intervention.

INTRODUCTION: Suicide is a leading cause of death for men in the United States. Men traditionally have been hesitant to seek help, based on masculine norms of stoicism and self-reliance, among other factors. Man Therapy (MT) is an online suicide prevention and mental health initiative that provides promise for facilitating male help-seeking. METHODS: This study draws on data from a randomized controlled trial which examined effects of MT on a sample of men residing in Michigan aged 25-64. The current study utilized logistic regression to test MT's effect on nonprofessional and professional help-seeking, controlling for marital status, education, and sexual orientation. RESULTS: A statistically significant positive association was found between MT and professional help-seeking (OR = 1.55, p = 0.049). A significant inverse association was also found with marital status, with partnered men less likely to seek professional help (OR = 0.53, p = 0.007). There was no significant association between MT and nonprofessional help-seeking. CONCLUSION: Man Therapy demonstrates the promise of web-based suicide prevention efforts to reach men who typically do not engage in help-seeking, providing a gateway to vital professional support. As technology continues to emerge, further suicide research is needed on use of this modality with working-age men from diverse backgrounds.

Suicide intervention training with law enforcement officers.

Law Enforcement Officers' (LEO) interactions with people facing mental health crises have risen exponentially since the era of deinstitutionalization. On average, about 10% of the individuals law enforcement interacts with daily have mental health challenges. Several factors influence the outcome of these interactions, not least of which is an officer's role as a gatekeeper as well as their training related to people with mental health challenges. We hypothesized that participating in the online QPR Training for Law Enforcement Officers would be associated with improved knowledge about suicide, attitudes to suicide and suicide intervention, and self-efficacy. Additionally, we hypothesized that these outcomes would be associated with greater use of intervention skills when encountering individuals at risk for suicide in the community. Results of our longitudinal analysis find that most of the participating officers reported some prior training and yet demonstrated statistically significant improvements in knowledge and attitudes after controlling for previous training. No significant changes were observed in LEO's use of intervention skills following training. We conclude by suggesting that there is substantial need for increased training; and offering possible conceptual and empirical explanations for the observed results.

Predicting the impact of chronic health conditions on workplace productivity and accidents: results from two US Department of Energy national laboratories.

OBJECTIVE: Examine associations of chronic health conditions on workplace productivity and accidents among US Department of Energy employees. METHODS: The Health and Work Performance Questionnaire-Select was administered to a random sample of two Department of Energy national laboratory employees (46% response rate; N = 1854). RESULTS: The majority (87.4%) reported having one or more chronic health conditions, with 43.4% reporting four or more conditions. A population-attributable risk proportions analysis suggests improvements of 4.5% in absenteeism, 5.1% in presenteeism, 8.9% in productivity, and 77% of accidents by reducing the number of conditions by one level. Depression was the only health condition associated with all four outcomes. CONCLUSIONS: Results suggest that chronic conditions in this workforce are prevalent and costly. Efforts to prevent or reduce condition comorbidity among employees with multiple conditions can significantly reduce costs and workplace accident rates.

Advancing training to identify, intervene, and follow up with individuals at risk for suicide through research.

Research and training on suicide is critical given the fact that the majority of suicide deaths are preventable with accurate identification of risk and intervention by trained individuals. However, implementing and evaluating training is difficult because of the multiple factors involved, including, but not limited to, the heterogeneity of trainees, their diverse roles in suicide prevention, absence of clear guidelines for training content across settings, and limited methods for assessing outcomes. Here, three groups of trainees are discussed: community and professional gatekeepers and behavioral health providers. The roles each group plays in managing suicide risk and the training content it needs to be effective are addressed. A staged training approach is proposed, building on the core components of currently used suicide training: knowledge, attitudes, and skills/behaviors. Limitations of current assessment methods are identified and recommendations for alternative methods are provided. The article concludes with a discussion of next steps in moving the field forward, including overcoming challenges and identifying and engaging opportunities.