Evolving influence of mental health stigma in Ontario public safety organizations: a qualitative study

INTRODUCTION: Mental health stigma has been a long-standing issue in public safety professions and can deter public safety personnel (PSP) from accessing mental health support. This is concerning as PSP experience higher rates of post-traumatic stress injuries (PTSI) than the general population. Public safety employers play an important role in stigma reduction. However, there is little research on Ontario public safety employers' perspectives on mental health stigma in their organization and the accompanying organizational challenges they face in addressing stigma and supporting PSPs' mental health. METHODS: A thematic analysis of 28 semi-structured interviews with 33 public safety employer representatives from fire services, paramedics, police, and provincial corrections within Ontario was conducted. RESULTS: Employer representatives recognized mental health stigma existed historically. They described that stigma is reducing due to sociopolitical changes that restructured PTSI as a common occupational injury. Participants shared ways they are adjusting organizational practices and policies to further reduce stigma and support PSP. They also highlighted accompanying organizational challenges, including ongoing historic stigma, uncertainty in how to support PSP with PTSI, and difficulty finding meaningful accommodations. CONCLUSION: Participants perceived mental health stigma to be decreasing in their public safety organizations. However, ongoing stigma, organizational factors and uncertainty around how to support those experiencing PTSI can pose challenges to return-to-work and accommodation. While in various stages of implementing initiatives to support mental health, organizations need to continue to build PTSI awareness, take accountability for their role in reducing mental health stigma, and build trauma-informed practices and policies