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Supporting Psychiatric Care for First Responders

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PTSD and changing the organizational culture to support psychiatric care

In the last few years there has been increasing concern regarding the mental health of individuals that respond to emergencies. Numerous articles have been written about post-traumatic stress disorder (PTSD) and how this specifically affects the 911 community, let alone other areas of emergency management that deal with particularly stressful circumstances on a regular basis.

The concerns for mental health are certainly not isolated, as some service members have returned from Iraq and Afghanistan deployments with stress disorders. These recent events have brought PTSD to the forefront of policy initiatives in the United States, as many veterans have been in need of professional psychiatric assistance. The public safety community has also seen an increase in awareness, as there has been a lot of effort to educate the public on their mental health needs.

NAEMT study

The National Association of Emergency Medical Technicians (NAEMT) recently released a report regarding mental health services of emergency medical technicians and paramedics.

According to the report: "Multiple studies indicate that healthcare workers are exposed to high levels of occupational stress, which contributes to higher levels of substance abuse, depression and anxiety." The study also found that many emergency medical services practitioners are not satisfied with the mental health services their employers provide to them. 

While the issues of PTSD are certainly at the forefront of policy considerations, there are likely many other reasons as to why there still seems to be a disconnect between getting emergency responders the appropriate mental health are that they need. It is with this said that an emphasis on changing the organizational culture to get employees to seek out mental healthcare could be needed.

Emergency responder calls

The NAEMT calls EMS an "inherently stressful profession." According to the NAEMT: "On any given shift, EMTs and paramedics may be called on to render care to people in horrific circumstances. Many EMS practitioners can tell stories of answering calls involving violence, death or abuse that continue to haunt them."

Despite many traumatic circumstances regarding 911 calls, it doesn't always have an effect on the provider -- PTSD is far more complicated than that. An emergency responder seeing something disturbing is not always an indicator for whether or not he/she will have trouble in the future. Further, some scholarly journals ague that post incident stress debriefings can be psychiatrically detrimental. Even worse, sometimes symptoms of post-traumatic stress disorder may not show up for years.

Moving forward

There has been a lot of awareness regarding mental health services specifically for PTSD in the last few years. The public has been well educated well about the issues with it, and there are numerous awareness-designated days and weeks associated with mental health illnesses.

Despite these great outreach efforts, there needs to be more in the way of paradigm breaking within organizations that hire first responders. Employers now need to work to change the paradigm and culture in their own organizations to get people the assistance they need.

This can be very difficult to do, but any stigma associated with psychiatric services must be restructured so that employees feel they not only have the ability to get the assistance they need, but they will be openly supported by their employers to get the care they need. Employers now need to emphasize promoting a culture that actively supports employees gaining this assistance, while also educating them on when it is important to get the assistance they need. 

Outreach and education is wonderful, but if the culture doesn’t support it, few employees will get the assistance they need.

Ultimately, changing organizational culture is complicated. There are many articles published in scholarly journals theorizing on how this can be accomplished. It is nothing short of a difficult task.

Regardless, it is imperative that ambulance agencies contemplate how they will assist their employees, especially after the recent study reveals numerous inadequacies in this regard. Ambulance agencies must contemplate how they will go about changing their culture while providing mental health services to their employees and educating them about when this assistance is needed.

Allison G. S. Knox Passionate about the issues affecting ambulances and disaster management, Allison focuses on Emergency Management and Emergency Medical Services policy. Allison has taught at the undergraduate level since 2010. Prior to teaching, she worked in a level-one trauma center emergency department and for a member of congress in Washington, D.C. She holds four Master’s degrees in Emergency Management, National Security Studies, International Relations, History, a Graduate Certificate in Homeland Security and a Bachelor of Arts in Political Science. She is also trained in Technical Large Animal Emergency Rescue, is an Emergency Medical Technician, Lifeguard and a Lifeguard Instructor. She serves on the Board of Trustees for Pi Gamma Mu International Honor Society, Vice Chair of the Tactical Emergency Medical Support Committee with the International Public Safety Association, the Advocacy Committee with the National Association of Emergency Medical Technicians and also serves as the Advocacy Coordinator of Virginia for the National Association of Emergency Medical Technicians.