Emotional Burden and Selfcare Strategies Among Opioid Overdose Prevention and Response Personnel in Milwaukee and Waukesha Counties, Wisconsin, USA: A Qualitative Study

INTRODUCTION: Opioid prevention personnel who interface with overdose events are at a risk of emotional challenges, though little research has explored their emotional experiences and self-care strategies. We explored the emotional experiences and self-care strategies to manage mental and emotional challenges among individuals who work in overdose prevention and response. METHODS: This was a qualitative study. Using a phenomenological approach, we conducted in-depth key informant interviews (KIIs) with forty-six purposively selected opioid overdose prevention and response personnel from August 2022 to March 2023 in two counties in Wisconsin using an interview guide. Data were coded and analyzed using MAXQDA. The coding was both deductive and inductive based on the domains and constructs of the Consolidated Framework for Implementation Research (CFIR). RESULTS: Three themes were discovered from the data under the individual, intervention and inner setting domains of the CFIR framework: the burden of the intervention and its emotional effects; self-care strategies; and organizational mental health related support to overdose prevention and response personnel. Most opioid overdose prevention personnel experienced emotional strain, with feelings of guilt, self-doubt, and mental exhaustion intensified by personal loss and lived experiences. The key self-care strategies to manage emotional strain included professional practices like trauma-responsive methods, creation of personal boundaries, and social support from peer networks. Individual techniques like journaling, music, therapy, were also reported. Different institutions supported responders by providing resources such as mental health days, therapy access, and employee assistance programs. CONCLUSION: Most overdose prevention and respose personnel experience emotional strain and mental exhaustion. A strong emphasis on self-awareness, compassion, and teamwork is crucial for fostering resilience and sustaining mental health among the personnel. Organizational initiatives to promote mental health and proactive wellness play a critical role in self-care among individuals who work in overdose prevention and response. This study contributes to the limited evidence on the mental health challenges of overdose prevention and response personnel and the need to prioritize their mental wellness.