HEALING THE HELPERS
“The things that (first responders) see can be extraordinary,” says Chris McIntosh. who co-chairs an Alberta Health Services EMS mental health committee.
It’s the kind of profession that is, at times, tough to fathom.
When the unthinkable occurs, it’s the work that takes place behind the barricades and the flashing lights, in the first moments of crisis.
But while it’s the kind of help that first responders are trained to provide daily, professionals in the public safety field are far from immune to the trauma stemming from tragic calls.
After a week of multiple fatalities in the city, including two involving young children, some in the field waded in on social media to extend their thoughts to the families involved in the tragedies, and also to the first responders.
“It is never easy for us to attend scenes where a person has been killed,” Calgary police digital communications officer Const. Chris Martin wrote in a post shared on Twitter.
“It is even harder when it is a child that has been seriously injured or killed. Having personally attended four calls involving child fatalities, I can attest to just how difficult it can be. Not only while dealing with the call, but in the days and weeks that follow.”
Chris McIntosh, co-chair of the Alberta Health Services EMS Psychological Health and Safety Committee, said the hearts and thoughts of other paramedics this week went to the families of the victims, then to the health and welfare of the first responders.
“We’re up to the challenge as first responders … but it doesn’t mean that we shouldn’t recognize and understand that the things that we see can be extraordinary,” McIntosh said.
Mental-health supports for EMS range from proactive training, such as ways to recognize concerning symptoms, to supports, if the mental health of a responder declines following an occupational stress injury.
McIntosh noted the committee he co-chairs came into force in 2015, the year a paramedic in Edmonton died by suicide in the workplace.
Since he joined the group in 2016, McIntosh said he knows of specific instances when “the things that we’ve developed have saved lives.”
“To a paramedic or a healthcare provider, there’s no more attractive calling than saving lives, whether it’s defibrillating someone’s heart or saving them from a psychological crisis,” he said.
Some of the help available to paramedics includes a criticalincident stress-management program, which involves paramedics trained to help peers after a challenging call.
“It helps the person who’s experiencing the stress response to understand that it’s normal, and that these are some of the things that you may expect to see in the coming days and weeks as your body processes this exposure to trauma,” McIntosh explained.
AHS is also looking to hire a clinical psychologist for EMS across the province. While it’s early in the process, McIntosh said it will involve looking at what capacity such a professional has for short-term interventions “in the moments of highest crisis.”
At the Calgary Fire Department, a three-year trial program involves an optional consultation with a mental-health professional as part of an annual medical exam. Fire Chief Steve Dongworth said the program has been well received by employees, with the majority seeing psychologists as part of their medicals.
Dongworth described the issue of mental health as one of his most important as head of the department.
“The fact that our people struggle with mental health is not acceptable, and it’s certainly attracted now the appropriate level of attention in the media,” Dongworth said. “Anywhere I go and talk with my colleagues across North America, it’s No. 1 on their radar as well in terms of the health of their employees.”
In November 2017, Calgary firefighter Barry Dawson took his own life after dealing with post-traumatic stress disorder — an incident that prompted public discussion of mental-health issues and first responders.
Dongworth said while many supports are available, barriers remain to accessing them, including stigma associated with seeking help.
“There’s a stigma still, unfortunately, attached to admitting that you’re struggling from an emotional-health perspective in what is predominantly, unfortunately, still a male culture,” he said. “It’s not always easy to admit that you’re struggling.”
But Dongworth said he believes there is a growing acceptance of seeking help, particularly with an increasingly younger generation in the workforce.
“Just the same as if you’d hurt your knee and you go and see a specialist, you get into that place where, when the disability is emotional or mental in nature, having that same willingness to go and seek specialist help is where we need to get to, and recognizing they’re really the same,” he said.
Firefighters have access to a critical-incident stress-management team, which gives staff the option to sit down with peers trained to provide “an ear to listen to how they’re doing,” Dongworth said.
The department also offers a proactive training program designed to prepare responders with tools to cope during a difficult call and with information about the resources available to them afterward.
In the Calgary Police Service, officers have access to psychological services, with therapists trained in assessing and treating trauma and post-traumatic stress disorder.
Stacey Ferland, manager of psychological services with CPS, noted public safety officers are at a higher rate of exposure to stress, trauma and tragedy.
While the lifetime prevalence of PTSD among the general population is about eight to 12 per cent, that doubles among first responders, Ferland said.
“We know … they’re going to be exposed to those types of events that really are out of the ordinary for the rest of us,” she said.
“A police officer who has done that for 10, 15, 20 years … the cumulative effect of stress and how that impacts the person’s physiological responses and psychological responses over time, that can have a significant impact on a person’s coping, their resiliency, functioning, and then can lead to mental-health disorders, such as post-traumatic stress disorder, anxiety disorders, depression and addiction.”
She said the service is trying to create processes focused on prevention and early identification of mental-health disorders.
Options for officers who need help include referral to an external service provider at no cost, and support through the employee and family assistance program. The service also offers critical-incident debriefings and peer-support coordinators who will go to a scene or district office when needed.
“Whenever these types of events happen, we will organize criticalincident debriefings,” Ferland said. “It’s about, let’s really learn what are the warning signs, what should I be looking for, if I’ve attended this call and I’m noticing I’m not sleeping as well these days, or I’m having more nightmares.
“Not everybody needs professional help after these types of events. It really is about if people are still struggling, usually four weeks post the traumatic event, that’s the time to then seek some additional support.”
Like police officers, Calgary Transit operators and other city employees also have access to supports through the employee and family assistance program, including counselling services.
The provider of that program also offers crisis management services, involving the deployment of trained clinicians following a traumatic incident.
“The City of Calgary is prepared for these types of unfortunate events and has supports available to help employees who require additional support,” the city said in a statement.