Police-mental health partnerships and persons with severe mental illness: An exploratory study of perceived risk and use of force.

There is a need to maximize understanding of conditions under which officers are most likely to use lethal force when interacting with persons with severe mental illness (SMI) and whether utilization of a mental health professional (MHP) serves to reduce use of force (UoF) severity. Using a mixed methods concurrent triangulation design framework, this exploratory study examined UoF with individuals exhibiting signs of psychosis and whether police-MHP partnerships decrease UoF severity. Findings indicate officers use more severe forms of force with armed individuals displaying signs of psychosis and that MHP presence did not reduce force severity in such cases. Qualitative themes provide context for these findings and include (1) concerns for MHP safety, (2) planned collaborations support safety, and (3) MHPs support de-escalation. Discussion highlights a need for increased officer education on SMI, appropriate de-escalation strategies, co-created engagement/disengagement protocols for MHPs, and defined standards of practice for police-mental health collaborations.

A Mixed Methods Investigation on the Relationship Between Perceived Self-Regard, Self-Efficacy, and Commitment to Serve Among Military Medical Students.

INTRODUCTION: Routinely faced with potentially traumatizing situations, resilience is critical for military physicians. However, related studies are limited in scope. The current study distinctively combines hyper-realistic immersion training for military medical students with emotional intelligence and hardiness measures. With self-reflection shown to improve performance, qualitative inquiry was concurrently conducted in a mixed methodology approach to provide a uniquely comprehensive perspective on the resilience training needs of this population. MATERIALS AND METHODS: Thirty-four osteopathic military medical students participated in a week-long training simulating real-life combat and mass casualty events. The Emotional Quotient-Inventory 2.0 (EQ-i 2.0) and Hardiness Resilience Gauge were administered as pre- and post-test measures. Paired t-tests were used to determine statistically significant gains, and a multiple case study analysis of a six-student focus group allowed for the synchronization of quantitative and qualitative data. Institutional Review Board approval for the study was obtained through Rocky Vista University with a reciprocal agreement with Touro University California's Institutional Review Board. All students participating in the study received written informed consent. RESULTS: Qualitative findings for this study aligned with this current year's findings of statistically significant results in the improvement of the Overall EQ-i and Overall Hardiness. Qualitative responses thematically analyzed demonstrated environmental realism, adaptation, increased awareness, and positive interpersonal and clinical outlook. Notable increases occurred in all EQ-i domains except Decision-Making and Stress Tolerance. The Self-Perception domain saw significant increases in Self-Regard and Emotional Self-Awareness while Well-Being and Optimism simultaneously improved. CONCLUSION: This unique pilot study showed that quantitative and qualitative results aligned, supporting the finding that a safe trauma-related training environment can improve the confidence and resilience in military medical students. The goal of this training was to promote resilience and mitigate trauma. Results demonstrate improved self-efficacy and enhanced commitment. Increases in self-awareness and confidence made participants more inclined to see their worth and strengthened their sense of duty as described in their qualitative responses. Pervasive gains suggest that the training aligned well with its purpose, and the methods employed enhanced participant experience. Long-term follow-up studies are needed to assess outcome sustainability.

Social connectedness, mindfulness, and coping as protective factors during the COVID-19 pandemic.

The COVID-19 pandemic has had an unprecedented psychological impact, revealing immense emotional disturbances among the general population. This study examined the extent to which social connectedness, dispositional mindfulness, and coping moderate symptoms of anxiety and depression in 1242 adults under the same government-issued COVID-19 stay-at-home mandate. Participants completed measures of anxiety, depression, dispositional mindfulness, social connectedness, and coping, and regression analyses were used to examine associations and interaction effects. Results indicated that social connectedness and dispositional mindfulness were associated with reduced symptoms. For individuals living with a partner, decreased mindfulness and avoidant coping were associated with anxious symptoms. In households with children, overutilization of approach coping served to increase symptoms of depression. Results indicate the importance of considering social connectedness, mindfulness, and coping in counseling to enhance factors serving to protect clients during a public health crisis. Implications for professional counselors and areas of future research are discussed.

Psychological impact of coronavirus disease 2019 (COVID-19) social distancing mandates on trauma survivors.

Objective: Despite recognition that coronavirus disease 2019 (COVID-19) pandemic created an unprecedented impact on global mental health, information on the psychological health among trauma survivors during the COVID-19 pandemic is rare. We sought to examine psychological outcomes among individuals with preexisting traumatic experiences during COVID-19. Methods: We sampled 1 242 adults in the mid-Atlantic region of the United States under a state-issued Phase 1 stay-at-home mandate to examine associations between pre-pandemic trauma exposure as measured by the Brief Trauma Questionnaire (BTQ) and anxiety and depression, as measured by the Patient Reported Outcome Scale Anxiety and Depression (PROMIS-A and PROMIS-D). Results: Pre-pandemic trauma exposure among the sample was reported, with 281 (22.6%) participants identifying as experiencing one trauma, 209 (16.8%) reporting two, and 468 (37.7%) reporting three or more. As reported experiences of trauma increased, so did participant anxiety and depressive symptomatology. One-way Analysis of Variance indicated that reported trauma was significantly positively correlated with anxiety (P < 0.01) and depressive symptomatology (P < 0.01). Conclusion: Findings highlight the immense psychological toll of the COVID-19 pandemic, specifically with individuals who were previously exposed to trauma. Public health officials can encourage physicians, employers, and universities to screen patients, employees, and students to assess previous trauma, psychological functioning, and risk factors. Collaboration between physicians and mental health providers including psychiatrists, psychologists, counselors, and social workers to provide evidence informed rapid coordination of care can better meet the global mental health crisis that is arising as a result of this unprecedented global trauma.

Shelter-in-place and mental health: an analogue study of well-being and distress.

UNLABELLED: Based on the disaster mental health literature and research on quarantine, confinement, social distancing, and isolation, considerable evidence exists which supports the idea that individuals who shelterin-place (SIP) may experience adverse emotional and/or mental-health responses. OBJECTIVE: This study investigated the impact of a long-term (48-hour) SIP simulation on mental health during a "dirty bomb" detonation. DESIGN/PARTICIPANTS: Participants (n = 73) completed the Mental Health Inventory (MHI; Veit and Ware, 1983) and a self-report questionnaire on current functioning. RESULTS: Sheltering-in-place did not have adverse effects on mental health although supplemental analysis indicated that groups that are cohesive have an easier time. Qualitative observations also provided a significant amount of information regarding group dynamics, attrition, and cognitive functioning. CONCLUSIONS: The results of this study provide evidence to emergency management professionals that SIP is viable disaster response strategy that does not adversely impact mental health provided group cohesion is high. The findings also have implications regarding public messaging and outreach initiatives regarding the emotional and physical safety of SIP.