Developing Recommendations to Improve Crisis Line Supports for Public Safety Personnel in Canada: Protocol for a Multimethod National Study (Preprint)

BACKGROUND Public Safety Personnel (PSP) in Canada experience disproportionately high rates of mental distress and suicidal thoughts and behaviors. PSP mental health is a critical public health issue with far-reaching implications for both individual well-being and the effectiveness of emergency response systems. Crisis lines are an evidence-based public health intervention; however, knowledge gaps remain regarding PSP crisis line use, barriers to accessing services, and the appropriateness of crisis line service models for meeting PSP mental health needs. OBJECTIVE This study aims to address these knowledge gaps using a participatory approach to better understand the crisis line needs and preferences of PSP communities. We also aim to apply our learnings and co-design actionable recommendations for crisis line service improvements and to support PSP who may wish to contact a crisis line. METHODS This Canada-wide study uses multiple methods across three iterative phases. Phase 1 involves community engagement with PSP to better understand their crisis needs and existing supports. Instrumental to our engagement ethic is the formation of a co-researcher group, composed of PSP with lived experience, who will guide the research process. We will review deidentified crisis line interactions to identify patterns in service use and call outcomes to identify possible points of intervention to enhance service efficacy. We will launch a national web-based anonymous survey to understand the crisis line needs, barriers, and preferences of PSP. Phase 2 focuses on deepening our understanding of PSP experiences with crisis lines through in-depth interviews with those who have accessed or thought about accessing crisis lines and those without crisis line experience who wish to share their views. We will conduct focus groups with crisis sector staff to learn about desired training and resources for improving service delivery to PSP. Phase 3 focuses on developing and conducting co-design workshops to generate evidence-based recommendations with PSP, crisis line responders, researchers, and clinicians. Collaborating across sectors will allow us to codevelop feasible strategies for improving crisis line services to better meet the needs of PSP in crisis who may be inclined to access crisis lines for support. RESULTS As of December 2024, the crisis line dataset has been identified and study recruitment for the national survey was completed. Data collection for all other research activities is expected to conclude by May 2025. We anticipate that study findings will be available by the end of 2025. CONCLUSIONS By identifying barriers to crisis line use and codeveloping solutions, this research will inform policy, service design, and training to enhance services. Ensuring PSP can access crisis line supports that are equitable, evidence-based, and integrated within mental health care systems is crucial to fostering a resilient public safety workforce and emergency response capacities at a societal level. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/75285

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