By Jared Oscarson
Mental health and PTSD in EMS providers has become a focus of national EMS membership organizations, workforce advocacy campaigns and professional websites. These efforts have encouraged me and many others to reflect on our EMS careers.
There are those of us who shake off traumatic stress and don’t want to discuss the way it made us feel. Some of us find strategies to manage traumatic stress and there are others who don’t know how to express how they felt about a call and never get the help they need. This has led to talented EMS providers and our colleagues leaving EMS. In the worst case scenario, leaving the rest of us with a Class A uniform and a pocket full of funeral programs from colleagues who died by suicide.
Minnesota legislation to classify PTSD as an occupational disease
State of Minnesota Senators Schoen, Abeler, Hoffman, Rosen and Frentz have raised the bar in the United States for public safety mental health to include EMS providers. They introduced bill S.F. No. 125 to categorize post-traumatic stress disorder as an occupational disease in state law.
I applaud these legislators for their efforts to care for public safety. This is important legislation in public safety and every lawmaker should be taking notice that the essential services that protect a community need to be protected.
Legislation has to be well thought out and crafted to enable and advocate for EMS providers. This must not be a Band-Aid on the gaping head wound EMS is suffering right now in the area of mental health.
This proposed legislation, though, is not without risks. For a small or large agency this type of legislation could increase workers’ compensation insurance costs and lead to short or long-term losses of EMS providers from the workforce.
EMS cultural change
As the dialogue on mental health starts or continues in your agency, I urge you to consider your recruitment and hiring practices. Ask and answer these questions:
- How can psychological evaluations be used in the EMS hiring process?
- How can EMS agencies tell some recruits that this job might be more than the applicant can handle physically and mentally?
- How does the physical well-being of an EMS provider factor into their mental health?
We must not be afraid to set a high standard for mental and physical health at the entry point into the career. It is time for leaders to decide what the benchmark is going to be and chart a course to get there.
EMS leaders have acknowledged that as an industry we must change the culture to offer a support mechanism, treatment and maintain the mental health and wellness of EMS providers. This has to be done across the industry, and not have the stigmatisms that can prevent or chase providers away from seeking help. This standard of care must be as strong as the care we provide to our patients.
EMS-specific support system
Many organizations, like Reviving Responders and The Code Green Campaign, who advocate with aggressive social media campaigns for EMS providers, developed from the obvious need for mental health awareness in EMS. Many providers use these sites and social networks to share personal stories of struggles with PTSD and the failures of the systems in place to care for them.
Too many EMS providers, struggling with mental health issues from traumatic incidents, activate the employee assistance program system they are referred to a marriage and family therapist. Despite the increasing awareness of traumatic stress and the need for EMS specific support, providers are referred to a well-intentioned therapist or counselor who doesn’t have the slightest clue what goes on in the back of an ambulance or on a scene.
The EAP is a catch all system that might work for someone who works an office job and is struggling with a marriage, money or just can’t function in life for various reasons. But it is rarely well-suited to helping an EMS provider understand and process the feelings from horrible, often chaotic and stressful situations. These services must be offered by a specialist in public safety mental health.
How has your agency solved this problem of providing an EAP or therapist with EMS-specific knowledge and experience?
The only way to make change is to lead change. Join me in exploring and implementing viable solutions for the unique needs of our EMS providers.
About the author
Jared Oscarson is a paramedic and ambulance director at Dodge Center Ambulance, a small community-based ambulance with a combination of paid and volunteer staff in Dodge Center, Minn. His 13 years of experience in EMS include high-volume ALS and rural hospital-based systems across Nevada. He worked at HGH EMS as deputy chief, building an air ambulance program and community paramedicine program. Jared chaired Nevada EMS Advisory Committee and was part of the Nevada Community Paramedicine legislation. He has lectured at conferences on various topics in EMS including rural sustainability, air operations at mass gathering events and EMS integration in to the hospital. Jared, his wife and children reside in Rochester, Minn., where he loves coaching and playing ice hockey with his kids. You can contact him at JaredOscarsonEMS@gmail.com.