First responder mental health: 5 stories of heartbreak and hope

More than ever before first responders are willing to talk about suicide, PTSD and mental illness in ways that support and help one another


By The Code Green Campaign

First responder mental health was frequently in the news throughout 2015. The Code Green Campaign picked five stories, from many worthy possibilities, which have had a major impact on EMS. These stories of heartbreak and hope were chosen based on their international reach and effect on the profession.

Denver Health paramedic dies of suicide
In February paramedic Debbie Kiebel-Crawford died of suicide soon after responding to a call that resulted in the death of the patient. She was a long time paramedic with Denver Health and was a mentor and friend to many.

Kiebel-Crawford chaired Denver Health’s committee tasked with addressing job induced stress, PTSD and mental illness. The story of her death was covered by local and regional news, which is uncommon for suicide deaths. Her suicide was also directly attributed to job-related stress in the news, which is also unusual. Because Kiebel-Crawford had served with Denver Health for over 25 years and had been a mentor to many, her suicide resulted in thousands of people being suddenly awakened to the information that mental health is a problem for first responders.

Canadian medics with PTSD denied relicensure
The Alberta College of Paramedics declined to renew the licenses of several paramedics with PTSD due to a debate over medical records. On the Alberta license renewal paperwork the applicant is asked if they have a medical, physical, or mental health condition that will prevent them from doing their job safely.

Several paramedics with PTSD answered yes, and subsequently they were asked to provide specific medical records in order to have their licenses renewed. They declined to supply the records, and instead submitted letters from their medical providers attesting they were fit for duty. The College of Paramedics refused to compromise and declined to renew their licenses without the records. The licensing committee was later suspended in an unprecedented move by the province.

This story caused a lot of debate, with most online commenters disagreeing with the College of Paramedics' decisions. On one hand, the question specifically asks if your condition affects your ability to do your job safely, so by answering yes, paramedics are essentially declaring themselves unsafe to practice. But, in the opinion of The Code Green Campaign, it is a poorly worded question. It is written in such a way that a person may disclose a condition even if it doesn’t affect their ability to do their job safely. The controversy resulted in first responder mental health and PTSD being a frequent topic in the national news in Canada. There has also been a lot of discussion and debate about disclosure of mental health problems, how people are deemed fit for duty, and how these issues should be addressed.

What’s killing our medics survey
In early 2015 a group of first responders working on an Ambulance Services Manager program deployed a survey to assess the prevalence of stress and suicidal thoughts in first responders. The survey went viral and received over 4,000 responses.

This survey put the astounding numbers of first responders who have considered suicide or tried to kill themselves into the spotlight. The survey also allowed those who responded to feel involved with the topic. Survey responders were able to see the results, giving a quantifiable picture to just how big of a problem mental health conditions are in first responders.

Suicide at the workplace
In January a paramedic in Edmonton, Alberta, killed himself at his station. In May a volunteer firefighter in Ohio killed himself at his station. In August an on-duty firefighter in Texas killed himself at his station. In August a paramedic in England, still on vacation leave, killed herself in uniform at her station. In October an on-duty firefighter in the United Kingdom killed himself at his station.

Suicide can be a difficult topic for people to talk about. It is not uncommon for conversations about suicide or its prevalence to be swept under the rug. With providers dying of suicide at workplaces, some on duty, there is no avoiding the discussion. It forces the issue to the forefront in a way that cannot be avoided.

First responder PTSD treatment guidelines
The Black Dog Institute in Australia released evidence-based guidelines for the diagnosis and treatment of PTSD in first responders. The treatment guidelines are applicable to first responders globally.

The authors also released the guidelines publicly for free, making them widely accessible to patients and mental health providers. While there have been some individual studies that evaluate a specific treatment modality, this is an important advancement since it establishes a comprehensive evidence-based plan specific to first responders.

Remember, other first responders have experienced mental health issues. You are not alone and you belong to a community of responders who care about you. Learn more about what you can do if you are worried about a co-worker's mental health and the importance of peer support, which is the lifeline that never fails

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