Is there enough mental health support for first responders?
WATCH ABOVE: Meet two people who are trying to stop the PTSD crisis among first responders. Laura Zilke reports.
TORONTO – As a paramedic responding to emergency calls, Jim Harris says he often saw people going through the “worst day of their life.”
The former frontline paramedic was on the job for two decades. First responders – police, paramedics, firefighters – come across violence, substance abuse, and severe health emergencies on a day-to-day basis.
“You have to go into situations that often times are some of the worst days of the individuals we’re treating. [First responders] are asked to do this daily, it can’t help but affect you over time,” Harris, now a manager of paramedic training programs at Lakeridge Health, told Global News.
In the past 10 weeks, 13 Canadian first responders reportedly killed themselves, according to Tema Conter Memorial Trust, an organization that promotes mental health awareness among Canada’s emergency workers.
Those who took their lives were a mix of police officers, paramedics and federal corrections officers.
Now, former frontline emergency responders and the organizations they represent say they aren’t surprised by these reports on the recent string of deaths.
They say that training in recognizing mental health issues is bare bones, and the resources aren’t sufficient.
Mental health support for first responders varies depending on where you live, according to Dwayne Forsman, who represents the Paramedic Association of Canada.
Toronto Emergency Medical Services – the largest EMS service in the country – is the only service that provides its frontline workers with a dedicated staff psychologist, for example.
Other health authorities filter their first responders in need to the regional mental health professionals, but they may not understand the intricacies involved with their line of work, Forsman said.
“You might go to a psychologist who really doesn’t understand what it is that you do. In our view, there needs to be dedicated staff – not simply on retainer – but attached to the service, who appreciates what goes on and is talking to people whether they need the help or not,” Forsman said.
He’s a former Winnipeg paramedic with over 37 years of experience in the field. He said that during training on the job, educators quickly skim over mental health issues that may come up. Pamphlets, business cards and counselling information are doled out. It isn’t revisited again in some cases.
“It becomes one big glob of information, so these things tend to get lost in the conversation as you’re wide-eyed trying to take it all in. Then the expectation is that you just know where to go if something happens,” he said.
Even if education on mental health and coping mechanisms were built into the training curriculum, the experts wonder if new frontline workers would be interested in the information.
There are also EAPs (employee assistance programs), debrief teams and peer support groups, according to Harris.
With EAPs, employers enlist the help of a third party service so first responders can speak to counsellors anonymously about issues they may be dealing with. It doesn’t have to be about mental health either – staff can call about financial woes, marital issues or discuss a trauma they encountered that day.
With debrief teams, colleagues from various sectors are deployed to speak to you following an extreme incident.
That’s Harris’ concern – while there’s emphasis on care following a major shooting, a colleague’s death or injury or large emergency events, the daily buildup of stress is overlooked.
“There’s very little in place in most organizations to provide support or even acknowledge the cumulative stress issues. It’s that stress that’s affecting more people,” Harris said.
Dr. Jeff Morley, a registered psychologist and Tema mental health officer, says that in his practice, he typically comes across three issues first responders present with.
Some patients deal with primary trauma – when they’ve been physically assaulted or threatened, secondary trauma – when they’ve had to deal with unfixable trauma, and organizational stressors, which has to do with workplace harassment, bullying or feelings of betrayal.
Depression is the most common diagnosis for first responders, according to Morley. Addiction issues and sleep disorders follow.
Morley is a veteran RCMP officer with 23 years in the field in B.C. before he became a psychologist. Being acquainted with both worlds offers him a leg up when he’s treating patients.
“First responders are a very mistrusting group, and they’re hyper vigilant so they need to find a psychologist they can trust and know the culture,” he said.
What’s critical is resources that are delivered in a timely manner, he suggests.
Emotional responses are doled out in the moment, Morley explained. When your son scores a goal at the soccer game, you cheer. When your grandmother passes away, you cry. But first responders on the job at the most grisly scenes have to keep their composure.
“They have to go into work mode, which is fine, but to keep these folks healthy, you have to get that emotion out as soon as they leave that scene,” Morley suggested.
Instead, they’re whisked off to respond to the next call, and the trauma they encountered isn’t fully processed and addressed.
In Morley’s case, psychologists were readily available but his superiors knew who was going for treatment. He said that employees feared the stigma, wondered if their jobs were in jeopardy or if they’d have to take time off.
Toronto EMS says that it has “open conversations” with employees about their mental and physical health. It also provides support based on the latest, best practices, including access to a full-time psychologist, a service physician, peer support teams on call 24/7 and debrief teams.
“Toronto EMS takes a proactive, and therefore preventive approach, to health and wellness in all areas of our service, including the maintenance of mental health,” Kim McKinnon, its superintendent of public information, said in an email.
Durham Region police did not yet respond to comment.
There may be room for improvement, but the experts are certain first responders’ employers are on the right track.
When Harris began his career as a paramedic 30 years ago, there were expectations of being stoic.
“Nothing bothers you and we don’t talk about things, we make jokes about them and that’s how we deal with it. Many paramedics struggled throughout their career with issues because of stress buildup,” he told Global News.
Now, with mental health thrust into the forefront, it’s an issue organizations are forced to address. He suggests a cultural shift needs to happen in the profession, the same way mental health stigma needs to be shed in other parts of society.
In our series, Invisible Wounds, one of the common things we heard from the soldiers and veterans we spoke with is that sharing their story has helped them in their healing process – they want to encourage others to break their silence.
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