Why medics need more than one EAP referral for PTSD

Lack of suitable mental health services is just the tip of the iceberg of what is not working in EMS

There have been some positive developments for British Columbia paramedics and their ability to access mental health care for acute stress and post-traumatic stress disorder (PTSD).

British Columbia Ambulance Service (BCAS) is expanding support services for its staff in this area; this comes after recent reports of several of their paramedics not being able to receive care for their condition or financial support while disabled. 

I’m hoping that those who are suffering will be able to benefit, although it seems that there will be a legal settlement for at least one.

Given the nature of the work, the long hours, low pay and physical labor, it’s no surprise that EMS providers are subject to inordinately high levels of stress. We get physically injured at a higher rate than our fellow firefighters and police officers. I have no doubt that our “mental” injury rate is higher as well. Perhaps what is more disturbing to me is how EMS employers engage with their staff on these issues, or rather how they don’t. 

Don’t get me wrong; I’m sure most agencies have employee assistance programs (EAP) that begin to address the issue of unhealthy stress. But an EAP referral can be superficial; not all cases of acute stress can be mitigated in one or two meetings or phone calls. What about longer term counseling? Or workers compensation if the employee is temporarily disabled? A lot of EAP programs may not get beyond the initial phase of support, placing the financial burden on the employee to continue care. 

We certainly wouldn’t see this behavior in most disabilities involving a physical injury or illness, but mental illness can’t be seen, and according to some folks, can’t be real because it can't be seen. That’s got to change.

Here’s another wrinkle – many EMS providers work "part-time" at more than one job. Unlike most other workplaces, part-time in EMS may mean putting in 40 hours or more a week – without accruing health insurance, vacation or sick time, and other benefits of a full-time worker. Frankly, it’s hard to find an incentive for employment agencies to have full-time staff, with the money saved from not having to provide benefits. Sadly, that in turn artificially depresses the true cost of providing EMS, and forces EMS providers to work a lot of hours for little pay. How does this promote a stable, long-term workforce?

As much as I want to be a cheerleader for all of the progress EMS has made in the past 30 years, we have yet to make significant progress in standing up for our own people and providing them with the ability to serve for as long as they want to. A lack of mental health services is really just the tip of the iceberg of what is not working in our business. 

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