Search

BACKGROUND: We conducted a cluster randomized trial of a workplace mental health intervention in an Australian police department. The intervention was co-designed and co-implemented with the police department. Intervention elements included tailored mental health literacy training for all members of participating police stations, and a leadership development and coaching program for station leaders. This study presents the results of a mixed-methods implementation evaluation of the trial. METHODS: Descriptive quantitative analyses characterized the extent of participation in intervention activities, complemented by a qualitative descriptive analysis of transcripts of 60 semistructured interviews with 53 persons and research team field notes. RESULTS: Participation rates in the multicomponent leadership development activities were highly variable, ranging from <10% to approximately 60% across stations. Approximately 50% of leaders and <50% of troops completed the mental health literacy training component of the intervention. Barriers to implementation included rostering challenges, high staff turnover and changes, competing work commitments, staff shortages, limited internal personnel resources to deliver the mental health literacy training, organizational cynicism, confidentiality concerns, and limited communication about the intervention by station command or station champions. Facilitators of participation were also identified, including perceived need for and benefits of the intervention, engagement at various levels, the research team's ability to create buy-in and manage stakeholder relationships, and the use of external, credible leadership development coaches. CONCLUSIONS: Implementation fell far short of expectations. The identified barriers and facilitators should be considered in the design and implementation of similar workplace mental health interventions.

OBJECTIVES: To report age-standardised rates and methods of suicide by health professionals, and to compare these with suicide rates for other occupations. STUDY DESIGN: Retrospective mortality study. SETTING, PARTICIPANTS: All intentional self-harm cases recorded by the National Coronial Information System during the period 2001-2012 were initially included. Cases were excluded if the person was unemployed at the time of death, if their employment status was unknown or occupational information was missing, or if they were under 20 years of age at the time of death. Suicide rates were calculated using Australian Bureau of Statistics population-level data from the 2006 census. MAIN OUTCOME MEASURES: Suicide rates and method of suicide by occupational group. RESULTS: Suicide rates for female health professionals were higher than for women in other occupations (medical practitioners: incidence rate ratio [IRR], 2.52; 95% CI, 1.55-4.09; P < 0.001; nurses and midwives: IRR, 2.65; 95% CI, 2.22-3.15; P < 0.001). Suicide rates for male medical practitioners were not significantly higher than for other occupations, but the suicide rate for male nurses and midwives was significantly higher than for men working outside the health professions (IRR, 1.50; 95% CI 1.12-2.01; P = 0.006). The suicide rate for health professionals with ready access to prescription medications was higher than for those in health professions without such access or in non-health professional occupations. The most frequent method of suicide used by health professionals was self-poisoning. CONCLUSION: Our results indicate the need for targeted prevention of suicide by health professionals.