Adapting a holistic program to support the mental health and wellness of front line workers providing care to homeless and street communities

This research aims to address the mental health needs of frontline workers serving homeless communities that have been intensifying during COVID-19. Background: Canada's Chief Public Health Officer has described the sharp increase in drug overdoses and deaths an unintended consequence of COVID-19 and a worrying trend that is disproportionately affecting homeless people. Frontline workers (health providers and peer support workers, many of whom have lived experience of substance use and homelessness) are experiencing acute mental health issues as they respond to the complex trauma being experience by their clients. To maintain healthcare services and lifesaving supports, we must match the mental health needs of front line workers to services that address the secondary trauma they are experiencing so they can continue to provide effective care to the most vulnerable and marginalized members of society. In partnership with Ottawa Inner City Health (OICH), an organization that provides health care services to people who are chronically homeless, we will use a participatory, mixed methods, pre/post design to adapt, implement and evaluate an innovative series of mental health supports, and develop a framework for adapting and scaling delivery to other organizations. The mental health supports involve: 1) holistic wellness retreats, and 2) suite of mental health services (e.g., cognitive and behavioural therapy, workplace huddles, psychotherapy). Methods: We will use focus group interviews to adapt the mental health supports; implement over 3-months; and evaluate impacts on mental health outcomes, feasibility and costs of implementation, utilization and acceptability. We will use validated scales, qualitative interviews, and administrative data. We will develop a framework for adapting and scaling delivery of the mental health supports and a short documentary film highlighting study findings.