Effectiveness of Mobile Apps and Text Messaging as an E-mental Health Intervention for the Three Most Common Operational Stress Injuries among Public Safety Personnel: A Review of Meta-Analyses and Systematic Reviews
Context The frequency of probable mental health diagnoses is much higher among public safety personnel (PSP) than in the general population, which can be explained in part by their operational duties. The most common operational stress injuries (OSI) among PSP in Canada are depression, post-traumatic stress disorder and generalized anxiety disorder. Because of their confidential and accessible nature, e-mental health interventions delivered via smartphones (mobile interventions) have great potential among PSP. The Mental Health Commission of Canada has proposed evaluative criteria for a comprehensive review of mobile interventions that goes beyond a scientific examination of the tool’s effectiveness. Objectives The purpose of this framework review is to first identify the modalities and results of systematic reviews and meta-analyses that have examined the effectiveness of mobile interventions in reducing symptoms related to at least one OSI, primarily among PSPs. Second, we will evaluate the mobile interventions that have been studied with PSP using the evaluative criteria proposed by the Mental Health Commission of Canada to determine whether they can be recommended for use with PSPs. Methods Terms related to OSI, mobile technologies, and interventions were used in the Pubmed, PsycInfo, and Embase databases. Articles that measured the effectiveness of mobile interventions in relation to at least one OSI and from which the information for this review could be extracted were selected. Next, a review of the articles included in the selected reviews was conducted to identify studies conducted with a sample of PSP. Results The literature search did not identify any reviews that focused specifically on PSPs, so we had to expand our search to include adults in the general population. Nine articles met the inclusion criteria, which were published between 2016 and 2019. Overall, mobile interventions appear to significantly reduce symptoms of anxiety, depression, and post-traumatic stress. Two mobile interventions studied with PSP were identified, and these met the majority of the evaluative criteria. Conclusion The mobile interventions identified in the literature have great potential for the general population and for PSP. However, meta-analyses and systematic reviews report some important limitations such as heterogeneity between studies and a high drop-out rate. Future research on mobile interventions for PSPs would benefit from further investigation of aspects related to usability, user desirability, and security of personal information. Samples should also include a wider variety of public safety professions.