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Research Questions

  1. What psychological risks do DHS employees face in their day-to-day work or as a result of potentially traumatic incidents?
  2. What is the evidence base for workplace psychological health programs, and how could DHS better address the psychological health needs of its employees?
  3. What programs within DHS address psychological health, peer support, and resilience, and how well do they align with evidence-based practices?

The U.S. Department of Homeland Security (DHS) was created in the aftermath of the September 11, 2001, terrorist attacks from all or part of 22 existing federal departments and agencies to oversee and coordinate a national strategy to protect the country from terrorism and to prevent future attacks. The unique organizational structure of DHS and differences in the number and type of employees in each of its components have resulted in a support system that includes both DHS-wide programs and component-specific programs to promote resilience and prevent psychological health problems that can result from long-term stress and exposure to trauma. However, little is known about the nature and effectiveness of these programs. This report provides an overview of the evidence base for common approaches used in workplace psychological health programs and identifies the extent to which programs across DHS that address psychological health, peer support, and resilience align with evidence-based practices. To ensure employees' psychological well-being, DHS must respond to their specific psychological health needs and concerns, as well as measure the effectiveness of existing programs that address psychological health. The report outlines a path forward for DHS to determine whether its investments in these programs are achieving their desired outcomes for the department, its employees, and their families.

Key Findings

The evidence base for most workplace psychological health interventions is limited

  • Several approaches are commonly used to promote resilience and psychological health in workplaces and may be relevant to DHS efforts: employee assistance programs, short-term counseling, self-care, peer support, critical incident stress management, and psychological, stress, and mental health first aid.
  • There is not a robust pool of evidence for these interventions, and the research varies in terms of the types of effects studied and outcomes measured. Some approaches that have been evaluated are not directly relevant to DHS, so it can be difficult to generalize findings to DHS employees.
  • None of the interventions evaluated met the criteria for high certainty of a net benefit, and few rose to the level of moderate certainty for populations similar to DHS employees.

DHS has a mix of psychological health programs, but there is variation in access, services, and potential effectiveness

  • Some DHS programs had a low certainty of a net benefit, according to the evidence base. Research also indicates that one approach — debriefings conducted in the aftermath of traumatic incidents — carries a risk of harm.
  • Each DHS component has an employee assistance program (moderate certainty of a net benefit). However, interviews with DHS officials indicated that these services are underutilized by the department's employees.
  • All but one DHS component have some kind of peer-support program (low certainty of a net benefit). The nature of these programs and the training that peer supporters receive can differ significantly across components.

Recommendations

  • DHS should ensure that all employees have access to psychological health support and should consider providing each component agency with a licensed mental health care provider trained in the unique stressors and needs of employees.
  • DHS components should develop clear, formal policies for peer-support programs and ensure that peer supporters receive effective training, including refresher training at regular intervals.
  • Components that incorporate debriefings into their critical incident stress management programs in the aftermath of potentially traumatic incidents should consider substituting one of the mental health first-aid approaches that have a higher certainty of a net positive impact.
  • DHS should optimize the management of psychological health programs across the department by conducting a psychological needs assessment prior to developing new programs, developing clear definitions of program types, monitoring programs on an ongoing basis, and establishing collaborative networks between programs and DHS leadership.
  • Evaluation should be built into all DHS psychological health programs. This should involve developing criteria to assess program effectiveness, encouraging consistent data collection across programs, and implementing quality improvement processes. DHS may want to consider having an external organization conduct a formal evaluation of some programs to ensure objectivity in reporting.

Table of Contents

  • Chapter One

    Background

  • Chapter Two

    Overview of Work-Related Stressors and Psychological Health Risks Among DHS Employees

  • Chapter Three

    Workplace Approaches to Increasing Resilience and Reducing Psychological Health Problems Among Employees

  • Chapter Four

    DHS Programs to Address Psychological Health

  • Chapter Five

    Summary and Recommendations

  • Appendix A

    Psychological Health Programs, by Component, in the U.S. Department of Homeland Security

This research was sponsored by the Department of Homeland Security (DHS) Office of Health Affairs and conducted within the Forces and Resources Policy Center of the RAND National Defense Research Institute, a federally funded research and development center sponsored by the Office of the Secretary of Defense, the Joint Staff, the Unified Combatant Commands, the Navy, the Marine Corps, the defense agencies, and the defense Intelligence Community.

This report is part of the RAND Corporation research report series. RAND reports present research findings and objective analysis that address the challenges facing the public and private sectors. All RAND reports undergo rigorous peer review to ensure high standards for research quality and objectivity.

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