Volunteer firefighter is met with challenges in getting PTSD diagnosis

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Barriers to PTSD treatment for volunteer firefighters
WATCH: A volunteer firefighter in Nova Scotia says even with insurance, there are still barriers to PTSD treatment. Alicia Draus reports – Oct 24, 2018

Justine Keast has always wanted to help people.

When she was young she wanted to be a paramedic. She now does rehabilitation work at a hospital and in her spare time volunteers with the Rawdon Fire Department.

Keast has been a volunteer firefighter for four years and with the Rawdon department for a year and a half. At first, she said she would keep things inside.

“There’s a bit of a stigma. If you’re a firefighter, you gotta be tough, you can’t let your guard down,” she said. “As a female in the fire service I especially didn’t want to let my guard down and you know, let anybody think that I was weaker than any of the guys.”

READ MORE: PTSD, suicide and first responders — A lot of talk, and not much progress

But she said that stigma is starting to go away and there is more of a focus on taking care of your mental health.

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“I had a peer say there’s something going on, I don’t know what it is but you’re not yourself,” said Keast in regards to why she decided to seek help.

She said her peer had noticed she was more angry and would lash out. Keast admitted that at the time, she had started to withdraw. While she had previously been social and outgoing, she started staying in more and hiding.

She arranged to see a counselor through work.

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“They gave me three sessions and basically said, ‘Well oh, no you’re fine.’ But I didn’t feel fine,” said Keast.

“I felt worse after I went to three sessions cause I started talking about things but didn’t really have any closure.”

After that Keast went to her doctor to get help through MSI. She first spoke with a social worker, but was then referred to a psychiatrist because the social worker was not specialized in post-traumatic stress disorder [PTSD].

READ MORE: Nova Scotia aims to decrease lengthy mental-health wait times

Keast said she only had one session with the psychiatrist.

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“[He] asked me a few questions and really didn’t give me a diagnosis because, again, he didn’t specialize in PTSD,” said Keast.

Psychiatrist Dr. Abraham Rudnick said typically if a psychiatrist is unable to diagnosis PTSD they will refer the patient to someone who can. He said for the most part diagnosing PTSD is relatively straight forward and something most doctors and psychologists should be able to do.

But he said that getting someone to help treat it is more rare.

“There are some scientific treatments for diagnosis, most of them are based on cognitive behavioral therapy approaches which is about helping people change the way they think about some of the issues related to the trauma,” he said.

But Rudnick said many psychiatrists do not have the training to do that type of treatment.

One of the challenges is that some of that training is only done out of province, but Rudnick said that he is starting to see a shift.

“Many provinces, including Nova Scotia, are recognizing the importance of trauma in peoples lives, are training more people and putting more resources into that,” he said.

WATCH: Volunteer firefighters seek additional PTSD services

Click to play video: 'Volunteer firefighters seek additional PTSD services'
Volunteer firefighters seek additional PTSD services

Keast has been able to find a social worker near who who does specialize in PTSD and trauma. She tries to meet with him biweekly but has to go through her private insurance which has an annual cap.

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“Now that I’ve talked about it, it’s actually helped me heal and move forward,” said Keast, but she added that something is still missing. Social workers are not able to diagnosis people and so she still has no official diagnosis.

“I think at the end of the day, I think I need a diagnosis. Almost for closure, for again, that full circle, to know exactly what’s going on with me.”

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