A study from Cook County Health was recently published online in the “Journal of Trauma and Acute Care Surgery.” The researchers examined levels of post-traumatic stress disorder and related factors in paramedics and police officers who interacted with victims of trauma at a Level 1 trauma unit in Chicago from April through September 2019. For the study, “Heroes in crisis: Trauma centers should be screening for and intervening on post-traumatic stress in our emergency responders,” 258 participants were asked to provide basic demographic information and complete two surveys, the Post-Traumatic Growth Inventory (PTGI) and PCL-5 scale.
The PTGI is a survey which asks participants to rate various questions on a six-point scale from “not at all” to “a very great degree” following a traumatic event. These questions can be separated into five categories:
- Relating to others
- New possibilities
- Personal strength
- Spiritual change
- Appreciation of life
The survey is designed to examine positive personal growth following a traumatic event, while the PCL-5 is a 20-item questionnaire that evaluates post-traumatic stress symptoms.
Researchers found that the mean PTGI score was 52.1 while 64.3% had a score above 45, indicating that they had experienced significant positive growth following a traumatic event. Most commonly reported was a greater appreciation for life.
While the mean PCL-5 score was 17.2, nearly 20% (19.7%) of participants met criteria for a diagnosis of PTSD with a score above 33. Additionally, it was found that participants aged 46-50 and divorced participants scored significantly higher than their comparison groups.
Memorable quotes on screening EMS, police officers for PTSD
Here are three memorable quotes from the study.
“A large majority (68.5%) of participants stated that they rely on their families and friends for support when it comes to work-related stress.”
“Having an independent, no-cost, confidential PTSD screening and intervention program through the trauma center, as is supported by 82.5% of our participants, could quell concerns surrounding careers, stigma and structural barriers.”
“All emergency responders should be screened for PTSD, and services should be offered to all who seek it out, not just those who screen positive for symptoms.”
Key takeaways on screening EMS, law enforcement personnel for post-traumatic stress
Here are two key takeaways on PTSD screening in EMS:
1. Barriers to mental health support include availability, cost
We already know that fire, EMS and police officers have incredibly stressful jobs that have a high risk of leading to long-term health effects such as PTSD and alcohol use disorder. This study further emphasizes the importance of having mental health resources available for those who are exposed to traumatic events.
We need to decrease the barriers to those seeking help including:
- Career consequences
- Stigma
- Availability of services
- Cost
EMS personnel are at high risk for PTS and we should be supporting them as much as possible.
2. Rates of PTSD are likely underestimated
The literature review the authors preformed reported that 11% of EMS personnel have PTSD, but their study found that 25% of paramedics met criteria for PTSD. Many more EMS personnel may be experiencing PTSD but aren’t being screened or diagnosed. This study also noted that some participants were unable to recognize the symptoms in themselves or in their peers.
Listen for more: Inside EMS Podcast: How to change the stigma of PTSD
