Background: Exposure to potentially traumatic events in emergency service workers is an issue of public interest, given the associated risk for PTSD, burnout, and work incapacity. Understanding the prevalence of PTSD in this cohort can help to guide prevention and treatment initiatives. The current meta-analysis of existing research builds upon past reviews by comprehensively comparing all emergency services within the context of both large-scale disasters and routine exposures, while additionally assessing trends over recent years and differences between economic contexts.
Methods: Searches were conducted across five databases in July 2023. Publication date was limited to post-2008, given meta-analyses addressing similar questions captured literature until this point. Included studies were observational and peer-reviewed, with currently employed or volunteering samples. Random effects meta-analyses and meta-regressions were run, exploring the impacts of exposure category, occupation, sex, economic context, volunteer status, PTSD measurement, and trends over time.
Results: A total of 117 studies (147 independent samples) were included in analyses (pooled sample size = 86,898). Samples exposed to large-scale disasters possessed lower prevalence (7.6%) than general samples with routine exposures (13.3%). Within each exposure category, there were no differences in prevalence between sex and occupational subgroups. Low-middle-income countries and non-volunteers possessed greater PTSD prevalence than high-income countries and volunteers. PTSD outcome measurement significantly impacted findings. There was some evidence of a small increase in prevalence over time only within high-income countries and non-volunteers with routine exposures.
Conclusion: In contrast to previous meta-analyses, all emergency service occupations appear equally prone to PTSD, and thus equally in need of intervention. Workers in low-middle-income countries are particularly vulnerable to PTSD, potentially due to more limited resourcing. Important questions remain regarding why PTSD prevalence has not decreased over time in relation to increasing efforts to support the mental health of this cohort.

At 17 years of age Kevin* (like many others) joined the WA Police Force hoping to "make a difference". He was young and optimistic and was dedicated to serving his community.
In the three decades that followed, as the trauma accumulated day in and day out, he began to succumb to the monster that is PTSD.
Not only did he personally suffer, but so did the people around him, trying to manage the beast that he was burdened with. In 2019 faced with the wicked problem of what his day-to-day life had become, he made the ultimate decision.
Not only mental ill health, but attrition, and recruiting problems mean our police force is slowly being eaten away.
So, what can we possibly do?
Three things - create supportive communities, remind officers of their worth through purposeful activity, and help officers regain their strength.

Food and food-related behaviours are essential pillars of mental, emotional, physical and social health. For veterans and families of veterans, there are unique factors that may impact food related behaviours, such as medication, physical pain, mental trauma and health conditions that challenge the every-day ability to get food to the table

In 2022, 3.7 million households experienced food insecurity in Australia (Foodbank Hunger Report 2023). In US and UK, emerging data estimates nearly 1 in 10 veterans are living in food insecure households, but there is limited data to confirm for the Australian Defence community.

Eating behaviours and social connections are based around food, eating habits and meals with loved ones, which in turn, are a social pathway that links positive emotions to positive mental health.

This study explored the views and experiences of food insecurity, food-related behaviours, social connection and well-being among Australian veterans and their families. A cross-sectional survey was conducted with more than 50 Australian veterans and families of veterans.

The results highlight the important role of food and meal times in well-being and the unique needs and views of veterans and families of veterans across food-related behaviour.

The findings have practical implications for services, policies and programs aimed to improve health and for effective health promotion interventions to address well-being and promote longer term recovery of physical and mental health.

This presentation examines the psychological and emotional health of adult and adolescent surf life savers, who often act as "first responders" in critical, high-stress situations. Drawing on data collected from 2021 and 2023, this research investigates the prevalence and impact of potentially traumatic events (PTEs) on these individuals, with a focus on the unique challenges faced by adolescent life savers.
An online, anonymous survey of 471 adults aged 18+ years and 118 adolescent aged 13-17 years Surf Life Saving (SLS) members were recruited via internal communications and social media groups. The analyses explore how protective influences and mediating factors—such as social support, self -efficacy and the attitudes towards mental health—serve as buffers against the adverse effects of potentially traumatic events (PTEs) in adolescents and adults.
PTE’s in and outside of SLSA service were considered and as expected, the longer in service in SLS, the greater number of PTE’s experienced. Similarly, adolescents aged 13-17 years old were exposed to a range of PTE’s that were associated with increased levels of post-traumatic stress. Importantly, the results in adult and adolescent surf life savers show that social support and self-efficacy and attitudes towards mental health are important contributors to lower PTSS severity.
The findings contribute to the development of comprehensive, informed and relevant knowledge to build strategies that seek to prevent, mitigate and support the health and well-being of surf lifesavers as they address difficult and often potentially traumatic events throughout adolescent and adult service.

Frontline workers put their well-being on the line to protect and help others. When frontline workers sustain injuries, the journey to recovery can be fraught with challenges. Traditional treatments can inadvertently contribute to a sense of disempowerment, leaving frontline workers feeling defined by their injuries rather than their strengths, values, and meaning-making frameworks.

In contrast, embracing the concept of the “healing self” offers a transformative pathway to resilience and recovery. By focusing on identity, purpose, meaning, and embodied well-being, we can empower frontline workers to reclaim their sense of self and harness their inner resilience.

In 2023, recognizing the urgent need to address the impact of moral injury and exposure to occupational violence and aggression, we developed two innovative strategies based on emerging research: integrating ‘self’ into wellbeing (identity, purpose, and meaning) and ‘feeling safe in self’ (embodied wellbeing). Our approach is based on evidence suggesting narrative therapy supports healing from moral injury and occupational violence. We create space for clients to reframe their experiences and make sense of them in a way that preserves their internal frameworks and morals.

We utilise the following approaches in post-incident support and professional supervision:
• Externalising: Separating identity from challenges.
• Re-authoring: Highlighting strengths and achievements.
• Stories of Origin and Preferred Stories: Connecting with roots and envisioning preferred futures.
• Double Listening: Valuing both spoken and unspoken narratives.
• Insider Knowledge and Outsider Witness: Leveraging community wisdom and external validation.

Additionally, our framework includes polyvagal mapping, wellbeing plans, and internally delivered telehealth services for psychological first aid, which regulate the nervous system’s response to stress, empowering staff to maintain embodied safety and good mental health.

This presentation will review our preliminary data to demonstrate how these interventions have significantly enhanced staff resilience and fostered a stronger sense of community and support.

This didactic and experiential workshop focuses on using
principles of Post-Traumatic Growth Somatic Therapy to support resilience and prevent burnout. Frontline workers often have inherent resilience that is often unrecognized. Using the lens of the nervous system, It will include information on practical skills that can be easily applied to support front-line workers. Utilizing the lens of the nervous system brings an understanding of the humanness of stress and burnout responses.

Critical reflection on current best practice models of frontline organisations is central to developing strategies that promote a healthy workplace. These models provide frameworks that promote mental wellbeing, minimise risks to mental and physical health through stress and psychological pain, support people experiencing mental health concerns and reduce stigma associated with mental health. A holistic, integrated approach to mental health combines initiatives for protection, promotion, and intervention.
Volunteer surf lifesavers are a predominantly unpaid workforce of first responders that provide education, preventative, and rescue services to the Australian community. Surf lifesavers can be exposed to high-risk, demanding and potentially traumatic experiences, which may negatively impact mental health and wellbeing. Given the complex range of factors that can influence the mental health and wellbeing of first responders, organisations must take the time to understand the context of their specific risk profile and management strategy.
This presentation discusses the results of several resources used to guide the implementation of mental health wellbeing in other emergency service organisations (e.g. “Positive mental health in young adult emergency service personnel”, and the “Good practice framework for mental health and wellbeing in first responder organisations”). This presentation will highlight current organisational actions that have been taken within SLS to promote mental wellbeing to protect, support and empower members to identify and respond to signs of poor mental health and the SLS movement.

In SuperFriend’s latest ITW 24 seasonal data findings, Associate Professor Ross Iles and Dr Natalie Flatt will present a comprehensive analysis of psychosocial hazard risk profiles and clinical outcomes across public and private hospitals. Hospitals, being integral to the healthcare system, are deeply affected by broader industry trends and their mental health implications. This data-driven approach underscores the need for proactive strategies to support staff and improve overall wellbeing in this vital sector. Data will highlight critical issues such as burnout, loneliness and menopause, and the coping mechanisms staff are employing to manage these challenges. The data will also describe how needs change throughout the year and discuss proactive data driven recommendations.

Key Findings:
- Psychosocial Hazard Risk Profiles: Both public and private hospitals face significant psychosocial risks. Understanding these risks is crucial for developing targeted, well-timed interventions.
- Clinical Outcomes: Loneliness and menopause are prominent issues affecting staff wellbeing. Our data reveals how these factors impact mental health and job performance.
- Coping Mechanisms: We identify various coping strategies that staff are using, providing insights into their effectiveness and areas needing improvement. This presentation will address:

Actionable Insights:
- How to Support Mental Health and Psychological Safety: Implementing targeted actions to address psychosocial hazards, including tailored mental health support and enhanced psychological safety measures.
- Spotlight Good Practices: How to Identify and promote effective mental health practices, particularly during times of heightened stress, to foster a supportive work environment year-round.
Strategic Timing:
- Seasonal Focus: Highlighting the importance of mental health practices during peak stress periods, ensuring ongoing support and awareness throughout the year.

Let’s Talk TACTICS is a universal framework focusing on the ‘how to’ of communication. It’s offer very clear and easy steps on how to communicate while building on confidence and personal strengths. Its primary focus is to educate individuals, family members, friends, and colleagues on how to effectively initiate conversations and then what to do afterwards, such as are 'are you ok?', ‘I’m not ok’, and ‘let’s make a plan’. TACTICS builds communication and confidence skills to offer a sustainable solution to address the mental health needs of local communities.

The core principle of TACTICS is that communication is a shared responsibility among individuals, their family, friends, and colleagues. TACTICS provides the skills to share concerns, ask questions and manage responses. For example, knowing how to tell someone you are not doing okay, to knowing what to say when someone tells you this. TACTICS views addressing mental health as a collective effort, not the sole responsibility of one person.

TACTICS is a preventative initiative aimed at alleviating the weight of mental health issues in communities. It promotes help-seeking behaviours and works to reduce the stigma associated with seeking help.

TACTICS ensures long-term benefits without exhausting time, funds and resources. It emphasises the prevention of mental health issues through education, awareness, and resilience promotion. TACTICS can build and improve community capacity by educating and upskilling members to deal with a range of circumstances, such as critical incidents and natural disasters. TACTICS focuses on the goal of preventing issues from escalating.

Designed for scalability, TACTICS can reach larger populations without losing effectiveness and can be adapted to different contexts and evolving needs, including workplaces. It aims to create systems and practices that are resilient, inclusive, and capable of providing ongoing support and care. Ultimately, TACTICS contributes to healthier individuals and communities.

Defence in partnership with SafeSide Prevention are leading major reforms in suicide prevention, embedding a system-wide approach focusing on a culture of prevention and safety.

Participants will gain an understanding of how:
• Defence has communicated key changes in practices and policies (moving from risk prediction and stratification to member-centred safety planning)
• SafeSide’s training has been customised to ‘look, feel and sound like us’ using Defence scenarios, military risk and protective factors, and member lived experience stories.
• SafeSide’s CARE model (Connect, Assess, Respond, Extend) supports members at risk.
• Defence will monitor, evaluate and update training.

Initial program feedback and evaluation data will be shared for:

1. CARE Model: Risk Formulation for Members at Risk of Suicide, Self-Harm, and Harm to Others: Designed for mental health professionals, medical officers and nurse practitioners to embed a new approach for assessing, managing and communicating about these risks and guide compassionate care, focusing on the member’s needs.

2. CARE Model: Supporting Members at Risk of Suicide, Self-Harm, and Harm to Others: Targets other health clinicians, chaplaincy and wellbeing support personnel. It provides an overview of the approach, and highlights the collaboration between them, mental health and command in connecting and extending support.

3. CARE Model: Leaders and Managers Supporting Members at Risk of Suicide, Self-Harm, and Harm to Others eCourse for commanders, leaders, and managers that provides updates on language and policy changes, examples for modelling and reinforcing protective behaviours.

4. Defence Suicide Awareness eCourse for all personnel providing key information on strengthening protective factors, recognising change, connecting with someone they're worried about and how the SafeSide CARE model will apply if they need support.

We are equipping Defence personnel to build a workplace culture where everyone feels safe, supported, and empowered to seek and provide help for suicide concerns.

Since 1909, Surf Life Saving Queensland (SLSQ) has been a vital frontline service, protecting Queensland's beaches and waterways with its iconic 'red and yellow' lifesavers and lifeguards. Aiming for zero preventable deaths, SLSQ’s 34,474 volunteers operate across 57 clubs, patrol 8,000 km of coastline, and contribute over 295,000 hours annually to patrols. They are highly trained in aquatic rescue and cardiopulmonary resuscitation (CPR), a skill proven to save lives.

The demanding nature of their work exposes them to significant physical and psychological challenges, particularly during traumatic events. The complexity is further heightened by the prevalence of substances like alcohol and drugs, as well as cases of intentional suicide among drowning victims.

While CPR is governed by best practice guidelines, it also carries a substantial psychological impact. A total of 20 semi-structured interviews (10 lifeguards and 10 lifesavers) conducted as part of a PhD research project explored SLSQ members' experiences, perceptions, and perspectives on performing resuscitations. Initial findings, still under thematic analysis, reveal how members respond to their exposure to vicarious trauma and life-threatening situations, highlighting the development of significant resilience. This resilience emerges through exposure to high-stress scenarios, supported by quality training, strong team camaraderie, structured debriefing processes, and managing public and media scrutiny.

The forthcoming findings will be presented to enhance understanding of how SLSQ members address mental health challenges. Insights from these interviews will shed light on their resilience and coping strategies, guiding improvements in support systems to better manage the psychological demands of their critical roles. The findings from this research aim to support all frontline service personnel in maintaining their mental health while continuing to provide essential lifesaving services.

PEER SUPPORT IN AN ED CLINICAL SETTING

Author:
DANNY JEFFERY₁

₁ Emergency Department Prince of Wales Hospital, Sydney, Australia

Background/Purpose:

Encouraging patients to actively participate in their treatment and recovery thereby reducing stigma and creating an environment of trust between patients and clinical professionals.

Intervention:

The ED has introduced a Peer Navigator role to enhance its Mental Health service. The role is targeted to a person with lived experience, and is additional to existing clinical (nursing and medical) roles.

The Peer Navigator uses recovery orientated approaches, encouraging hope, engagement and choice. The Peer Navigator acts as a neutral support and understanding presence, helping people navigate the ED process, advocating for their rights where required, and modelling recovery and future planning.

Outcomes/Impact:

Enhanced orientation to the ED and supports as well as contributing to minimising the risk of early departures and re-presentation.

Safe, co-ordinated, and streamlined transition for patients from ED to inpatient admission or community care.
.
Better understanding of the effectiveness of the peer workforce in a clinical ED.

Contributing to a reduction in chemical restraint.

Innovation and Significance:

Lived experience provides an empathetic bridge that allows connection with patients on a profound level offering a different dimension to discussions. This fosters a sense of trust and openness, which can be challenging to establish within a pure ED clinical environment.

Offer inspiration and hope facilitating discussions around treatment options, coping strategies, and lifestyle adjustments from a real-world perspective.

Enrich the multidisciplinary discourse by adding lived experience to clinical decisions, helping other team members better grasp the intricacies of a patient’s daily life, challenges, and aspirations.

Ensures the ED is not only evidence-based but also compassionate, person-centred, and genuinely attuned to the diverse needs of not only patients but family members maximising recovery and resilience.

Disclosure of Interest Statement:

None.

Mindarma is an evidence-based preventative mental health program (Joyce et al., 2019) adopted by many of Australia’s largest emergency services and frontline agencies including NSW Ambulance (Wooldridge & Joyce 2023), Ambulance Victoria (Barrett & Joyce, 2022), Australian Federal Police (Arena & Joyce, 2024), DFES WA, the Department of Communities and Justice NSW, NSW Health and DFFH Victoria. Mindarma teaches psychological skills and strategies that bolster adaptive resilience, enhance self-compassion and wellbeing, and increase early help-seeking behaviour (Couson et al., 2019; Joyce et al., 2018). Along with cognitive strategies and mindfulness training, two core practises taught are Mindful Self-Compassion (MSC) and proactive Self-Care. MSC has been found to play an important role in protecting the mental health (Neff, 2023; Gilbert 2014). Importantly, Self-Compassion practises help us to recognise, process and safely integrate challenging emotions and experiences. Emerging neuroscientific research also highlight the important role MSC can play in protecting against and reversing the impact of Empathic Distress Fatigue (EDF) (previously termed compassion fatigue) (Hoffmeyer et al. 2020; Singer et al., 2014; Klimecki et al., 2013; Weng et al., 2013). EDF refers to a sense of emotional exhaustion, burnout and psychological distress that can emerge for those who work in traumatic situations or frequently witness or support those in distress (Hofmeyer et al., 2020; Cocker & Joss 2016). It involves personal suffering resulting from the intense sharing of another's challenging emotions/experiences. Mindarma holds psychologist-led webinar training to help learners recognise EDF and to develop and integrate self-compassion and self-care skills. These series are highly popular with 6,248 frontline workers attending in 2023 and 2024.

Within an Australian setting, student nurses complete comprehensive university training, which covers mental health education and, in some instances, a subsequent mental health clinical placement. However, student nurses are reporting high levels of anxiety and fear during mental health clinical placement, impacting their educational opportunities, ultimately influencing their future registered nursing practice (Han et al., 2015; McKenzie et al., 2020). From these exisiting concerns, the Australian Government’s Productivity Commission into Mental Health (2020) recommended that health students complete their clinical placements within alternative environments, increasing their learning opportunities.

Utilising a Heideggerian phenomenological approach, our research sought to bring to light new understandings regarding the experiences of student nurses undertaking a mental health clinical placement within an alternative environment. For the purpose of our study, a therapeutic recreation environment was chosen. During this clinical placement, student nurses had direct contact with individuals with a lived experience of mental illness while undertaking therapeutic recreation activities such as the flying fox, archery, campfires and bush dances on a five-day, four-night long cabin based camp.

Throughout the individual semi-structured interviews and following data analysis, it was uncovered that positive, student focused mental health clinical placements within alternative environments have numerous professional and personal impacts on student nurses’ learning. Student nurses disclosed that through the process of learning direct from those with a lived experiences regarding mental health, they were able to develop their own personal understanding of how to manage their mental health when nursing. Through the outdoor camp environment and therapeutic recreation program, student nurses were also able to develop their own personal mental health related coping strategies and practice how they would implement them when practicing post registration. From our research, it is evident that alternative mental health clinical increase a student nurses mental health knowledge both professional and personally.

Background - The Wholebeing health project was established in June 2022 as an early intervention support mechanism for emergency service personnel (ESP) who have been diagnosed with a primary psychological injury (PSI). Guardian Exercise Rehabilitation and Verde Nutrition Co collaborated to provide integrated care to support emergency service personnel.
Aim – Promote a durable and sustainable return to health for ESP experiencing a PSI.
Approach – From June 2022 to January 2024, we offered the dual-service project to ESP. The average duration of each exercise physiology and dietitian interventions was 12 sessions over 18 weeks and 6 sessions over 12 weeks, respectively. Tools used to measure program effectiveness included the Depression, Anxiety and Stress Scale – 21 items (DASS-21), Mediterranean Diet Score (MDS) Questionnaire, and Patient Reported Outcomes Measurement Information System (PROMIS-10).
Outcome: DASS-21, MDS and PROMIS-10 results all showed improvements for ESP at completion of the project. Workers who engaged in the dual treatment increased their work hours at completion of the program, with some workers completing the program with a final medical certificate of capacity.
Implications for practice: A dual early exercise and nutrition intervention is an effective strategy to promote a durable and sustainable return to health for ESP experiencing a PSI. Providing dietitian services and some exercise physiology services via telehealth is an innovative way to allow quality service to be provided regardless of remote location.

BeWell is the psychological wellbeing service for Monash Health Staff, which was initially developed/implemented in response to COVID-19. The program delivers evidenced based interventions by Monash Health psychologists in a tailored way to support the bespoke needs of the diverse healthcare network. It provides four key deliverables: team sessions, pro-active check-ins for individuals, psychological first aid and coaching for our leaders on supporting our workers and team wellbeing.
Our presentation will share our learnings from the service data and qualitative feedback from a 12 month period (2022). We will discuss the systemic challenges within an organisation the scope and size of Monash Health (approx. 28,000 staff), as well as the benefits of BeWell as reported by staff including dedicated time and space, practical tools and strategies and the role of the facilitator. In addition, we will talk to the various ways the program can provide a responsive intervention that is both promoting, preventative and responsive to the diverse needs of the staff at Monash Health.

Defence in partnership with SafeSide Prevention are leading major reforms in suicide prevention, embedding a system-wide approach focusing on a culture of prevention and safety.

Participants will gain an understanding of how:
• Defence has communicated key changes in practices and policies (moving from risk prediction and stratification to member-centred safety planning)
• SafeSide’s training has been customised to ‘look, feel and sound like us’ using Defence scenarios, military risk and protective factors, and member lived experience stories.
• SafeSide’s CARE model (Connect, Assess, Respond, Extend) supports members at risk.
• Defence will monitor, evaluate and update training.

Initial program feedback and evaluation data will be shared for:

1. CARE Model: Risk Formulation for Members at Risk of Suicide, Self-Harm, and Harm to Others: Designed for mental health professionals, medical officers and nurse practitioners to embed a new approach for assessing, managing and communicating about these risks and guide compassionate care, focusing on the member’s needs.

2. CARE Model: Supporting Members at Risk of Suicide, Self-Harm, and Harm to Others: Targets other health clinicians, chaplaincy and wellbeing support personnel. It provides an overview of the approach, and highlights the collaboration between them, mental health and command in connecting and extending support.

3. CARE Model: Leaders and Managers Supporting Members at Risk of Suicide, Self-Harm, and Harm to Others eCourse for commanders, leaders, and managers that provides updates on language and policy changes, examples for modelling and reinforcing protective behaviours.

4. Defence Suicide Awareness eCourse for all personnel providing key information on strengthening protective factors, recognising change, connecting with someone they're worried about and how the SafeSide CARE model will apply if they need support.

We are equipping Defence personnel to build a workplace culture where everyone feels safe, supported, and empowered to seek and provide help for suicide concerns.

Background: First responders are frequently exposed to traumatic events, and have an elevated risk of mental health related injuries. Unfortunately, this group faces many barriers to accessing timely, individualized, evidence informed services, exacerbated by a culture that valorizes strength and stamina over reaching out for support. This project explored implementation of a mobile health app designed to promote early intervention and support for First responders.
Methods: A prospective case study approach, informed by implementation science was used to study implementation of PeerOnCall in six participating organizations (2 police, 2 fire, 2 paramedic organizations) over a 6 month period. Data included app utilization patterns (e.g., # of downloads, features accessed), baseline and follow-up interviews with eleven organizational champions, and focus groups with peer supporters in each organization. Analysis was informed by the Consolidated Framework for Implementation Research to identify facilitators and barriers to uptake of the mobile health platform.
Results: Rates of downloading the application ranged from 5% to 55% of employees in participating organizations. Facilitators to uptake included a recognized need for mental health supports, supportive leadership, and a need to revitalize their peer support service. The app was reported to be relevant, easy to use, and they appreciated the anonymous, private access to peer support. Barriers to use included ongoing stigma related to reaching out, skepticism regarding new technology, competing priorities, and limited peer support infrastructure.
Conclusion: Optimizing implementation requires strategies that are customized the unique culture and infrastructure of each organization.

Unprecedented workload pressures and high rates of mental health issues among healthcare workers has led to an urgent need for high quality, accessible mental health supports. Mobile health technology has the potential to reduce barriers to seeking help by providing accessible, private, on-demand information and support, however, little is known about what affects adoption of mental health apps among employees in healthcare organizations.
Methods: This presentation will highlight findings from a mixed methods implementation study exploring uptake of Beyond Silence, a novel mental health information and peer support app customized for Canadian healthcare workers. A six month trial of Beyond Silence was conducted in eight diverse healthcare organizations. Patterns of app utilization were examined, including download rates and access to various features, including outreach to peer support. Baseline and follow-up interviews with 15 organizational champions, and focus groups with over 25 peer support providers were conducted in order to explore facilitators and barriers to implementation.
Results: Download rates varied from 3% to 56% of employees across the eight organizations. Less than 10% of all app users reached out to peer support. Interview and focus group data highlighted strong alignment of the app with the mission of the organization to support frontline workers, and the perceived value of the app to enable outreach to peer support. Challenges to uptake, however, included mental heath literacy and stigma associated with reaching out, lack of time to download and use the app, and generational differences in comfort with technology and mental health outreach. Conclusion: App-based peer support can be a valuable strategy to promote early intervention and support, but optimizing implementation requires proactive, sustained outreach sufficient time to facilitate awareness and behavior change.

Human Performance Optimisation (HPO) describes a framework of performance development which has emerged in the military context over the last 15 years. HPO explores creating greater capacity within soldiers within all areas of performance: physical, cognitive, emotional, etc. The aim of HPO is to provide military personnel with increased capabilities for achieve mission objectives and provide a greater range of function to address situations which personnel face. HPO additionally is designed to increase resilience.

The aim of this poster is to examine if there is applicability for HPO in paramedicine. This considers if HPO, or elements of HPO can be utilised in paramedicine to increase paramedic performance, improve patient outcomes or increase paramedic resilience.

A literature review was conducted using Arksey and O’Malley’s framework for scoping reviews. This explored if any literature existed concerning paramedicine and HPO. There was also general examination of HPO literature to consider the elements which underpin HPO in practice,

No literature exists specifically addressing paramedicine and HPO. In general, there is limited literature discussing individual paramedic performance at all. Examination of HPO suggests capability in military performance operates in different frameworks than paramedic performance.

There are elements of HPO applicable to paramedicine. However, paramedicine likely relies on a wider range of practitioner characteristics which are harder to measure. Likewise, paramedicine is less defined in its mission objectives than military practice due to paramedicine’s focus on the quality of patient experience which is more subjective. There is value in exploring performance and capability optimisation as a strengths-based approach to improving individual practitioner capability and maximising their capacity in a range of key skills and traits. In this way practitioner capability is enhanced which in turn supports patient experience and outcomes as well as underpinning individual practitioner self-esteem, resilience and leadership.

Dementia is a progressive condition and an umbrella term used to describe a set of symptoms that affects many older adults. Older adults living with dementia often experience social stigma, which can impact their quality of life. Most people with dementia need the assistance of a caregiver in order to enhance their health. The present study seeks to explore the perspective of nurses as the primary caregivers of people living with dementia in Saudi Arabia, focusing on the challenges faced by nurses and their reactions to these challenges. A descriptive qualitative approach using semi-structured interviews with 10 nurses with experience caring for people living with dementia from 2 hospitals in Jeddah, Saudi Arabia. Using thematic analysis, 4 main themes were identified: (1) types of support, (2) challenges when caring for people living with dementia, (3) society’s views on people living with dementia, and (4) nurses’ perceptions of dementia. The nurses stated that people living with dementia do not receive sufficient support from their families. Most participants believed that public awareness about dementia is insufficient. Increased efforts to raise public awareness about dementia could include harnessing social norms around family structure and respect for elders to improve care provided to people living with dementia.

The aim of this project is to explore the feasibility and effectiveness of VR Art Therapy using the Tilt Brush application to reduce anxiety and improve mental health and wellbeing of Veterans. There is limited research into the use of Virtual Reality in Art Therapy for Veterans and Emergency Services personnel or family members.

Recruiting from people already in Art Therapy, participants were invited to attend an introductory session to familiarize themselves with the use of the VR hardware and the Tilt Brush app. While the project was running, they were able to access VR up to five times during their therapy sessions if as appropriate within their ongoing therapy.

To date, seven participants have been recruited. Initial feedback from the Art Therapist running the sessions suggests that the use of VR is engaging and has potential to be integrated into practice. The participants reported feeling immersed and connected to their emotion/experience, giving them stronger responses than with their usual art creations. Recruitment is ongoing and final results will be completed by September 2024.

Future work in this area will focus on the development of guidelines and processes to embed VR as an option for use in Art Therapy.

Rosie, a medically retired NSW Police Officer and founder of Tactical Yoga Australia, brings a unique blend of frontline experience and holistic wellness practices to the mental health conversation. With over 12 years of service in high-stress law enforcement roles—including operational safety training, undercover operations, and specialist youth policing—Rosie has first hand insight into the profound impact of trauma on first responders. Her extensive experience also includes working in rural and remote settings, where access to mental health resources can be limited. This background fuels her passion for ensuring that wellness resources are available in these challenging environments.

Rosie’s personal journey through PTSD, anxiety, and depression led her to discover the transformative power of yoga, breathwork and mindfulness. This journey inspired her to develop "The First Responder Mental Wellness Method," a comprehensive program designed to address the unique needs of frontline workers. In this presentation, Rosie will explore how yoga and mindfulness can be powerful tools for trauma recovery, particularly when integrated with traditional mental health treatments. She will demonstrate how these practices help regulate the nervous system, reduce stress, and foster emotional resilience, with a focus on adapting these strategies for rural and remote settings.

As the host of the podcast "Triumph Beyond Trauma," Rosie has created a platform for frontline workers to share their healing journeys and connect through shared experiences. She will discuss the crucial role of peer support in mental health recovery, emphasising how a strong support network can build community resilience and healing.

Attendees will leave with practical strategies for enhancing mental wellness in high-pressure environments, including actionable steps for integrating yoga, mindfulness, and peer support into their lives or of those they support,.

BeWell is the psychological wellbeing service for Monash Health Staff, which was initially developed/implemented in response to COVID-19. The program delivers evidenced based interventions by Monash Health psychologists in a tailored way to support the bespoke needs of the diverse healthcare network. It provides four key deliverables: team sessions, pro-active check-ins for individuals, psychological first aid and coaching for our leaders on supporting our workers and team wellbeing.
Our presentation will share our learnings from the service data and qualitative feedback from a 12 month period (2022). We will discuss the systemic challenges within an organisation the scope and size of Monash Health (approx. 28,000 staff), as well as the benefits of BeWell as reported by staff including dedicated time and space, practical tools and strategies and the role of the facilitator. In addition, we will talk to the various ways the program can provide a responsive intervention that is both promoting, preventative and responsive to the diverse needs of the staff at Monash Health.

The Tasmanian Emergency Services Critical Incident Stress Management Team was established in 1988 by Tasmania Police, Tasmania Fire Service, State Emergency Service and Ambulance Tasmania to provide services to first responders throughout the State. Initially based firmly in the Mitchell Model (Mitchell and Everly) it has been peer-led from the start. Nonetheless there has been psychology input for the duration including the early establishment of a position of Clinical Consultant. A cohort of 6 psychologists from the three regions of the state joined the Team during the initial stages of development. Reflective practice has been fundamental to Team operation and, as other evidence-based perspectives emerged and the Mitchell model drew critiques, a process of continuous improvement evolved within the Team. The 2006 Australian Guidelines for the Prevention and Treatment of Acute Stress Disorder, Posttraumatic Stress Disorder and Complex PTSD and the recently published Expert Guidelines: Diagnosis and treatment of post-traumatic stress disorder in emergency service workers have been instrumental in developing best practice. Owing to increased resourcing, in 2022 an additional cohort of 12 psychologists joined the Team, inevitably resulting in a review of Team functioning and practice.
This presentation examines, from the perspective of the providers of psychological input, the evolution in services offered by the Team and its psychologists, and how this has changed over time. To ground the discussion, the differences and similarities in the response by the Team and Team psychologists to the Port Arthur incident in 1996, at a time when the Mitchell model was still considered best practice, and the Team’s approach to the Hillcrest tragedy in late 2022 will be explored. For a fresh perspective, the experience of a long term peer, now Team Co-Manager, regarding the way in which the role of “the psychs” has changed will be offered.