PTSD in the Emergency Services

How the profession should come with a health warning…

Let’s get down to it — the nitty gritty of facts and figures and saying the words that people don’t like to say… that being a paramedic should come with a warning — about how it can damage your mental health.

I know the main focus of my personal project is on PTSD in the Emergency Services but, actually, the issues emergency service workers have encompass the full gamut of both mental and physical health problems.

And that’s ok. You know why? Because it means that paramedics are also human beings too. I know, who knew?!

Here are some rather concerning facts and figures for you…

In North America, PTSD affects between 7 and 10% of the general population. Scarily, though, that percentage rockets up to almost 25% in the paramedic community. In an article entitled ‘Post Traumatic Stress Disorder Among Paramedics’ by Cheryl Drewitz-Chesney, it states that, of all the emergency service workers, it is actually health professionals like paramedics who suffer from PTSD most severely. Paramedics are at greater risk than even police officers and firefighters, which is down to the length of time they will likely deal with an event and the intensity of that interaction.

And yet, as professionals who deal with various health-related complaints on a daily basis, including many relating to mental health, it seems our ambulance services are failing us, the paramedics, in both recognising and treating our own mental health issues. Just last year, an article published by The Huffington Post indicated that PTSD amongst ambulance service workers in the UK was on the rise with the number now being at almost 40%.

While it is a subject that is slowly being brought into the public eye, it is clear that there is still not enough being done — not only with recognition and treatment of the mental health conditions that arise as a result of the work paramedics do; but also in talking about these conditions in an effort to remove the stigma and create an environment where first responders recognise and rally around their colleagues, yet also step forward and put their hands up to ask for help, without the fear of being judged, when they need to.

The number of paramedics in the UK alone has increased from 19,000 to around 26,000 over the last decade and this is a number that is set to keep on increasing, given the higher demand for the profession in recent years. It seems pertinent, then, that more time and effort is spent on protecting the health of these workers. After all, if we don’t care for the carers, then who can we expect to care for those that need them?

So, what can we all do to make a difference?

Start Talking

Paramedics the world over are all guilty of a common flaw. We think we’re tough and don’t need to talk about our feelings. The attitude of sucking it up, or “growing a pair”, means we try to brazen out our experiences, to the point where if a colleague tries to ask us if we are alright, our response is, “Don’t ask me that.” This unspoken rule of letting people know you’re not ok but you don’t want to talk about it is one I saw on an almost daily basis. I did it myself, for a long time. But the more we try to bury these feelings and thoughts down, the greater the chance will be that, at some point, we will likely break.

So, by all means, suck it up when it matters. But if a colleague asks if you’re alright afterwards and you’re not, say you’re not.

At the same time, if we start discussing mental health in a more positive way, before the point of needing to speak about it because we are broken, we can encourage a more open atmosphere and better understanding amongst our colleagues. We can show them that it’s ok if there’s a problem and that it is ok to ask for help if they need it.

Utilise Resources

There are some amazing charities out there doing fabulous work in this field. In the UK, Mind are doing some amazing things for members of the emergency services, while here in Canada there are many small groups that have been set up by people who have been affected by their experiences, such as ‘You Are Not Alone BC’.

Some UK ambulance trusts are making greater efforts to recognise the stress levels of their staff, by introducing processes such as the TRiM debrief, which aims to recognise the early signs of PTSD. As a person who utilised this system on several occasions, I can definitely say it works. But it’s not a perfect system and there are still many people slipping through the net.

Early Education

With the number of paramedic students increasing and with many of them being young school-leavers, education in traumatic stress management is becoming increasingly important. It is up to those of us who have experienced life as a medical responder to share those experiences with our younger and less experienced counterparts, along with the tools we have learned to deal with them.

I whole-heartedly believe that the discussion of emergency service workers mental health and wellbeing should be dealt with in a fully interactive session in every student paramedic’s course. After all, like anything in medicine, prevention, early recognition and early treatment of symptoms goes much further and is likely to have greater success than after the damage has already been done.

It’s possible for each and every one of us to make a difference and to start changing the conversation today.

All of these articles and stories are my way of changing the conversation and I have many more stories to share. If you would like yours to be one of them, or you would like to chat with me about anything I have shared, please drop me an email at [email protected]. I would be thrilled to hear from you.

Sarah is a former paramedic from the UK, now living in British Columbia, Canada, with her paramedic husband and their two cats. She is a full-time freelance writer and photographer who also has several personal projects she undertakes in her free time. This article is part of her ‘PTSD in the Emergency Services’ Project and stems from her own experiences as a First Responder. If you would like to talk to Sarah about your own experiences, please email her: [email protected].