Paramedics & Mental Health Trauma

When most people think paramedic, they just think ambulance driver. Paramedicine lacks the mystique of the other emergency services – kids don’t grow up wanting to be paramedics the way they grow up wanting to be police officers or firefighters. But while the rising popularity of cop shows and the recent mental health renaissance has increased awareness of the long term effects of trauma exposure on police officers and firefighters, it’s taken longer for this to trickle down to Emergency Medical Services.

“I’ve been in the service now for 27 years,” says Glen Gillies, an Ontario paramedic. “I’ve seen a number of my colleagues suffer in various ways to the point of becoming angry with life, angry with the job, angry with what society views us as being. It’s cost them their marriage, it’s cost them their personal relationships. It’s unfortunately led to a few of their suicides.”

There’s much more to being a paramedic than just driving the ambulance.

There’s much more to being a paramedic than just driving the ambulance. “We never deal with you in your good moments,” says Gillies. “We always knew we would see bad things, but they never tell you that these bad things might never go away.” Post traumatic stress disorder and suicide are common. “PTSD is now presumptive in our profession,” he continues. “Since the beginning of 2016, there have been at least 36 suicides in Canada among Emergency Service personnel. Very high numbers, higher than any other segment of the population. But the stigma of mental health is slowly starting to wane. We’re starting to see more and more proactivity.”

In the past, it was difficult for paramedics to “prove” to Worker’s Compensation that they suffered from PTSD. An extensive paper trail was required, which was difficult to produce in practice. Paramedics respond to an average of ten calls per shift, and they don’t always have time to file a personal report while the iron is still hot. This takes a further toll on paramedics. Gillies explains: “Knowing that you’re suffering, while worker’s compensation is making you continually prove it – and in a way, making you go through that same trauma over and over and over again in order to get compensation for it… We’re a victim for being victimized. We continually have to prove that we’ve been exposed to some pretty nasty shit.”

But things are changing. Through their own lobbying efforts, and with the help of the provincial government, presumptive legislation now exists, qualifying every emergency service worker for PTSD diagnosis without a paper trail. Gillies continues, “Hopefully for our colleagues of the future, it will be less of a stressor to claim stress.”

This increase in PTSD awareness is starting to make its way into the education of new paramedics: “The education wasn’t there when I started. I’m happy to see that educational institutions are now preparing students a little bit better – I emphasize a little bit better,” says Gillies. “It could go a long way further. New paramedics coming into the field now are at least aware of PTSD.”

A cursory glance at what paramedics do should make all of this self-evident – after all, they are constantly exposed to freak accidents, vehicle collisions, murders and so on. But this doesn’t seem to be the greatest source of trauma: “Everybody thinks that trauma always deals with big events, but that’s not necessarily always the case. They do affect you, but it can be the smallest of triggers that can set somebody off. Personally, I can deal with blood and guts and trauma all day long and it doesn’t bother me. I’ve seen the human body in various forms of trauma, and it’s something that I’ll never forget, but I wouldn’t say those are the moments that send me off the deep end and make me unstable. The calls that bother me are the fairly benign ones. When I was a new paramedic, we responded to an elderly gentleman who had passed away during the night. It was a normal thing. He died of natural causes in his sleep. The most difficult thing I had to do was deliver that death notification to his significant other. That person had been with him for sixty some odd years. He was her rock. They did everything together, they raised a family, they travelled… Having to tell that person that their significant other was never going to be there again… very, very hard to do, and it still bothers me to this day.”

Paramedics have to deliver death notifications on an almost daily basis.

Paramedics have to deliver death notifications on an almost daily basis – so much so that they now receive special training for it. Gillies continues, “that’s what bothers me most. Especially if it’s a child. Telling a child that their parents have died, or a telling parent that their child has died… I could stare at gunshots, eviscerations, decapitations all day long – they don’t get under my skin.” But Gillies doesn’t think that any amount of training can properly prepare someone. “As paramedics, we deal with people every day. They’re not necessarily going to remember you if you’re dealing with a broken arm or a cut forehead, but if you’re telling them that a person that they dearly love has died, they’re going to remember everything about that moment for the rest of their lives. They’re going to remember the colour of your eyes, the socks you were wearing that day… That’s a hallmark moment for them, and that’s something that needs to be done very professionally, and very delicately. It’s not all, ‘rescue, ra-ra, put them on the stretcher, take them to the hospital.’ There’s some stuff that we do in a home that the general public doesn’t know. Those are the calls that sometimes bother us the most.”