. 2021 Aug 12;5(8):e26369.

doi: 10.2196/26369.

The Experience of Key Stakeholders During the Implementation and Use of Trauma Therapy via Digital Health for Military, Veteran, and Public Safety Personnel: Qualitative Thematic Analysis

Lorraine Smith-MacDonald^{1

2}, Chelsea Jones^{1

3

4}, Phillip Sevigny^{1

5}, Allison White^{1

2}, Alexa Laidlaw^{1

2}, Melissa Voth^{1

2}, Cynthia Mikolas^{1

6}, Alexandra Heber^{7

8}, Andrew J Greenshaw^{1

9}, Suzette Brémault-Phillips^{1

2}

Affiliations

¹ Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.
² Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.
³ 1 Field Ambulance Physical Rehabilitation Department, Canadian Forces Health Services, Department of National Defense, Edmonton, AB, Canada.
⁴ Leiden University Medical Centre, Leiden University, Leiden, Netherlands.
⁵ Department of Educational Psychology, Faculty of Education, University of Alberta, Edmonton, AB, Canada.
⁶ Military Family Resource Centre, Edmonton, AB, Canada.
⁷ Health Professionals Division, Veterans Affairs Canada, Ottawa, ON, Canada.
⁸ Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada.
⁹ Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.

PMID: 34387549
PMCID: PMC8391743
DOI: 10.2196/26369

The Experience of Key Stakeholders During the Implementation and Use of Trauma Therapy via Digital Health for Military, Veteran, and Public Safety Personnel: Qualitative Thematic Analysis

Lorraine Smith-MacDonald et al. JMIR Form Res. 2021.

. 2021 Aug 12;5(8):e26369.

doi: 10.2196/26369.

Authors

Affiliations

¹ Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.
² Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.
³ 1 Field Ambulance Physical Rehabilitation Department, Canadian Forces Health Services, Department of National Defense, Edmonton, AB, Canada.
⁴ Leiden University Medical Centre, Leiden University, Leiden, Netherlands.
⁵ Department of Educational Psychology, Faculty of Education, University of Alberta, Edmonton, AB, Canada.
⁶ Military Family Resource Centre, Edmonton, AB, Canada.
⁷ Health Professionals Division, Veterans Affairs Canada, Ottawa, ON, Canada.
⁸ Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada.
⁹ Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.

PMID: 34387549
PMCID: PMC8391743
DOI: 10.2196/26369

Abstract

Background: Exposure to occupational stressors and potentially psychologically traumatic events experienced by public safety personnel (eg, paramedics, police, fire, and correctional officers), military members, and veterans can lead to the development of posttraumatic stress injuries and other mental health disorders. Providing emergency services during COVID-19 has intensified the challenges. Owing to COVID-19 restrictions, mental health service providers offering support to these populations have had to rapidly pivot to use digital versus in-person methods of service delivery.

Objective: This paper aims to explore the experience of mental health service providers regarding digital health service delivery, including the current state of digital mental health service delivery, barriers to and facilitators of the use of digital health for mental health service delivery experienced during the pandemic, and recommendations for implementing and integrating digital health into regular mental health service delivery.

Methods: This embedded mixed-methods study included questionnaires and focus groups with key stakeholders (N=31) with knowledge and experience in providing mental health services. Data analysis included descriptive, quantitative, and qualitative thematic analyses.

Results: The following three themes emerged: being forced into change, daring to deliver mental health services using digital health, and future possibilities offered by digital health. In each theme, participants' responses reflected their perceptions of service providers, organizations, and clients. The findings offer considerations regarding for whom and at what point in treatment digital health delivery is appropriate; recommendations for training, support, resources, and guidelines for digitally delivering trauma therapy; and a better understanding of factors influencing mental health service providers' perceptions and acceptance of digital health for mental health service delivery.

Conclusions: The results indicate the implementation of digital health for mental health service delivery to military members, public safety personnel, and veterans. As the COVID-19 pandemic continues, remote service delivery methods for trauma therapy are urgently needed to support the well-being of those who have served and continue to serve.

Keywords: digital health; first responder; mental health; military; mobile phone; psychotherapy; public safety personnel; rehabilitation; telemedicine; telepsychiatry; teletherapy; therapy; trauma; veteran.

©Lorraine Smith-MacDonald, Chelsea Jones, Phillip Sevigny, Allison White, Alexa Laidlaw, Melissa Voth, Cynthia Mikolas, Alexandra Heber, Andrew J Greenshaw, Suzette Brémault-Phillips. Originally published in JMIR Formative Research (https://formative.jmir.org), 12.08.2021.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

**Figure 1**
Participants’ perceptions of intention to use digital health, effectiveness, and privacy and security risk (N=24).

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The Experience of Key Stakeholders During the Implementation and Use of Trauma Therapy via Digital Health for Military, Veteran, and Public Safety Personnel: Qualitative Thematic Analysis

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The Experience of Key Stakeholders During the Implementation and Use of Trauma Therapy via Digital Health for Military, Veteran, and Public Safety Personnel: Qualitative Thematic Analysis

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