Lisa A. Jaegers

Background: During the COVID-19 pandemic in the United States, healthcare workers were devastated by the insufficient preparedness to respond to their patients’ and personal health needs. A gap exists in resources to prevent or reduce acute and long-term healthcare worker mental illnesses resulting from COVID-19 frontline response. Methods: We performed an exploratory, mixed methods, longitudinal study of healthcare workers at a regional rural-urban hospital system in the Midwest United States during the COVID-19 response (4 timepoints, 2020). Using the Total Worker Health^® (TWH) participatory needs assessment approach, self-identified frontline COVID-19 workers participated in a survey including Health-Related Quality of Life, Impact of Event Scale, and a modified version of the American Nursing Association COVID-19 survey; and a hospital timeline tracked system-level activities. Findings: Response rate at Timepoint (T)1 was 21.7% ( N = 39) and of those, 14 (36%) completed all four surveys. From T1 to T4, the rate of COVID-19 patients steadily increased, staff exceeded the threshold for post-traumatic stress disorder at T1 and T4; staff reported not enough rest or sleep 50% of the month, T1-T4. Helpfulness of family support increased but community support decreased, T1-T4. Concerns with performing new tasks increased; the challenges related to lack of protective equipment and negative media decreased. Workers wanted to be involved in decision-making, desired timely communication, and needed adequate physical, environmental, and psychological supports. Conclusions/Applications for Practice: Utilization of a TWH^® strategy for describing health needs, hospital response, and multi-level staff suggestions to workplace health solutions during the COVID-19 pandemic identified evidence-based health promotion interventions in a hospital system.

Background: Public safety workers (PSWs), including correctional officers (COs), law enforcement, firefighters, emergency medical service, and military personnel, are at risk of organizational stress and burnout. Exposure to traumatic events, job hazards, injuries, fatalities, and work-related stressors such as work overload, irregular shift assignments, and lack of administrative support can negatively impact PSWs’ mental health. Peer support programs (PSPs) have been cited as an intervention to address the mental health of PSWs. Purpose: The purpose of this review is to explore the use, including facilitators and barriers, of PSPs to reduce organizational stress and trauma for PSWs. Implications for COs will be discussed. Method: A scoping review was conducted using the Arksey and O’Malley methodology. A search was conducted for articles published between 1996 and 2021 using six databases. Selected articles described, implemented, or evaluated peer support as an intervention to reduce PSW organizational stress and trauma. Findings: Thirteen articles met eligibility criteria. Organizational support, including policies, practices, and peer leadership training, contributed to the sustainability of PSPs. Confidentiality, trust, and shared lived experience were also essential to PSP. Stigma was identified as the primary barrier to participation. Public safety workers found PSP helpful in normalizing experiences, increasing hope, and decreasing stigma. Peer support programs also serve to bridge the gap in mental health services use. Conclusions: Peer support programs are a potential mental health intervention to reduce organizational stress and trauma for COs. Awareness of the facilitators and barriers to PSPs is the first step in developing such programs.

Date Presented 04/21/2023 We will present the results from a long-term process evaluation of the Occupational Therapy Transition and Integration Services (OTTIS) reentry program. Lessons learned will be explored with examples of how the program has evolved over the past 4.5 years, working with people who are incarcerated. Primary Author and Speaker: Lisa Jaegers Additional Authors and Speakers: Christine Picker, Mackenzie Murphy Contributing Authors: Karen Barney

Improving safety and health for correctional workers and people who are incarcerated are widespread yet separate initiatives. Correctional workers and people who are incarcerated experience similar challenges involved with poor workplaces and living conditions, including mental health crises, violence, stress, and chronic health issues, and the available resources lack integration with respect to safety and health promotion. This scoping review sought to contribute to an integrated approach for correctional system safety and health resources and identify studies of correctional resources that address health promotion among correctional workers and people who are incarcerated. Guided by PRISMA, a search of gray literature, also termed peer-reviewed literature, published between 2013–2023 (n = 2545) was completed, and 16 articles were identified. Resources primarily targeted individual and interpersonal levels. At every level of intervention, resources improved the environment for both workers and those incarcerated, with trends of less conflict, more positive behaviors, and improved relations, access to care, and feelings of safety. The corrections environment is impacted by changes from both workers and people who are incarcerated and should be examined using a holistic approach. Future health and safety resources should target the larger correctional environment by utilizing practices, policies, and procedures to improve safety and health for incarcerated people and workers.

Background: Correctional workers are at high risk for exposure to trauma, both as direct violence and as threats to their safety and well‐being. The distress associated with these critical incidents (CIs) affects mental and physical health. Current tools are limited for detecting CIs in this workforce and are therefore insufficient for addressing correctional worker trauma.Methods: Community prison employees (N = 105) self‐reported CIs using the adapted Correctional Worker Critical Incident Survey (CWCIS). We examined: (1) prevalence of CIs and occurrences, (2) differences in exposures to CIs by custody and noncustody staff, and (3) differences in job satisfaction, posttraumatic stress (PTSD), lower back disease, and health behaviors, such as missed work and sleep.Results: CIs occurred among most staff (59%) and more often for custody staff as compared to noncustody staff. CIs most often experienced were coworker injury, exposure to disease, and badly beaten adults (frequency 10−50). For the 1−9 frequency category, the most described events were: seeing someone dying, life threatened, and coworker injury. PTSD was identified in 44% of staff, and those who experienced CIs reported lower job satisfaction, greater feelings of PTSD, and more work absences than those not experiencing CIs (p < 0.05).Conclusions: CIs and PTSD are prevalent among custody and noncustody correctional workers; and job dissatisfaction, PTSD, and work absence are significantly worse for those who experienced CIs. The CWCIS detected CIs; future study is needed to inform trauma prevention, reduction, and rehabilitation interventions specific to correctional work.

Objective: Correctional officers are exposed to violence more often than many other public service workers, yet little is known about the traumatic nature of these risks. We examine violence exposure and post-traumatic stress disorder (PTSD) among a large, multi-facility sample of jail officers. Method: One thousand three hundred and sixty five officers working in 20 jails were surveyed regarding background characteristics, exposure to violence at work, and post-traumatic stress symptoms measured by the PTSD Checklist for DSM-5 (PCL-5). Results: About one-third of the sample met the criteria for a “provisional PTSD Diagnosis” or “probable PTSD”.’ Victimization and exposure to violence, both in and outside of work, significantly contributed to PTSD symptoms. Conclusions: Findings highlight the severity of, and link between, exposure to violence and PTSD among jail officers. Implications for diagnosing, treating, and preventing PTSD among jail officers are discussed.

Annals of International Occupational Therapy | Background:In 2018, the Justice-Based Occupational Therapy (JBOT) initiative was formed to convene a network of key stakeholders in criminal justice reform. The goals of JBOT are to (1) explore the role of occupational therapy in justice-based practice, teaching, and research, identifying which information is critical for sharing with a wider audience; and (2) disseminate resources to articulate

Importance: Jail officers are an underserved population of public safety workers at high risk for developing chronic mental health conditions. Objective: In response to national calls for the examination of stressors related to the unique work contexts of correctional facilities, we implemented a pilot study informed by the Total Worker Health® (TWH) strategy at two urban and two rural jails. Design: Participatory teams guided areas of interest for a mixed-data needs assessment, including surveys with 320 jail officers to inform focus groups (N = 40). Setting: Urban and rural jails in the midwestern United States. Participants: Jail correctional officers and sheriff’s deputies employed at participating jails. Measures: We measured mental health characteristics using the Patient-Reported Outcomes Measurement Information System Global Mental Health scale, the Center for Epidemiologic Studies Depression scale, and the two-item Posttraumatic Stress Disorder Checklist. Constructs to identify workplace characteristics included emotional support, work–family conflict, dangerousness, health climate, organizational operations, effectiveness of training, quality of supervision, and organizational fairness. Results: On the basis of general population estimates, we found that jail officers were at higher risk for mental health disorders, including depression and posttraumatic stress disorder. Jail officers identified workplace health interventions to address individual-, interpersonal-, institutional-, and community-level needs. Conclusion: Implementation of a TWH needs assessment in urban and rural jails to identify evidence-informed, multilevel interventions was found to be feasible. Using this assessment, we identified specific workplace health protection and promotion solutions. What This Article Adds: Results from this study support the profession’s vision to influence policies, environments, and systems through collaborative work. This TWH study has implications for practice and research by addressing mental health needs among jail officers and by providing practical applications to create evidence-informed, tailored interventions to promote workplace health in rural and urban jails.

Importance: Transition and integration reentry services continue to grow in carceral settings; however, related provision of occupational therapy is limited. Objective: To examine the implementation fidelity of an occupational therapy–administered interprofessional reentry program initiated in an urban jail. Design: Retrospective, mixed quantitative and qualitative design. Setting: Community-based reentry services provided prerelease in a Midwestern urban jail and postrelease in the local St. Louis community. Participants: Occupational therapy practitioners tracking process measures for identifying reentry project feasibility. Intervention: Provision of recruitment, assessment, and skilled occupational therapy services with people held in a short-term jail facility and follow-up during community reentry. Outcome and Measures: Detailed logs were analyzed to describe attendance at and duration of sessions. We coded barriers to and facilitators of implementation from weekly team meeting notes and logs using social–ecological categories. Results: Findings indicate that it was feasible to implement prerelease jail-based services (N = 63) because of jail operations and community partnerships (facilitators) and to overcome institutional policies and environmental limitations (barriers). Full 8-wk prerelease programming was completed by 38% (n = 24) of participants, and 52% (n = 33) participated less than 8 wk. All who completed the full prerelease program and transitioned to the community (n = 15) initiated postrelease occupational therapy services. Conclusions and Relevance: The iterative feedback provided by process evaluation supported the feasibility of implementing the jail-based Occupational Therapy Transition and Integration Services program. What This Article Adds: This process evaluation provides evidence that implementation of an occupational therapy–based transition program in an urban jail is feasible.