As the mental health of first responders becomes an increasingly important issue, an Ontario paramedic service is looking to those within its own ranks to protect the well-being of its members.
York Region Paramedic Services has established a proactive peer support team that sends a first responder out on every shift to check on their colleagues. The approach, which it believes is the first of its kind in the country, is staving off post-traumatic stress disorder and other mental health issues for those who deal with horrific situations every day.
"I had no idea just how many members actually felt unsupported and how much difficulty members were having in silence until the peer support team was in place," Chief Norm Barrette says during an interview at York paramedic headquarters in East Gwillimbury, Ont.
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The service has one fully equipped truck — affectionately dubbed the "Huggy Buggy" — with a paramedic who goes around 12 hours a day as part of its 20-member peer support team trained in "psychological first aid." Other team members, all nominated by their colleagues, are available at other times to deal with concerns.
Occupational stress the highest documented exposure injury for paramedics
The program has been in place for about 16 months and through monthly debriefings the service is continuously learning about the mental health needs of its members.
In the first year of the program, Barrette says there were more than 10,000 "contacts" between the peer support team and paramedics in the field. He believes the growth in those seeking help for "critical stress exposures" shows the initiative is working.
"A few years ago, physical injuries were the highest prevalence in paramedic services, but that has shifted," he says.
"Occupational stress injuries is the highest documented exposure injury to paramedics."
Paramedics' concerns range from trauma in the field to problems at home, to addictions and financial worries, Barrette says.
"It was much more than I was expecting," he says. "There had been this silent void for all of these years that these members were trying to figure things out on their own."
Vince Savoia, executive director of the Tema Conter Memorial Trust, a charity that supports the mental health of emergency service workers, correctional personnel and members of the military, says its time for first responders, especially paramedics, to be proactive about their mental health.
Statistics on the prevalence of post-traumatic stress disorder and other mental health diagnoses among emergency service workers are difficult to come by. But Tema has begun to fill that void, Savoia says.
Nineteen paramedics killed themselves last year, more than military members, police officers, firefighters and correctional workers, according to data collected by Tema.
Suicide rate 5 times higher than national rate
Paramedics have a suicide rate of 56.72 per 100,000 people, according to the organization's 2016 data. That is five times higher than the national rate for Canadians of 11.3 suicides per 100,000 people, according to the most recent data from Statistics Canada.
By coincidence, York's peer support program launched in November 2015 just weeks after 15 paramedics rushed to a horrific scene in Vaughan, Ont., where a drunk driver, Marco Muzzo, drove into a van carrying six members of the same family, killing three children and their grandfather.
Eight of those paramedics suffered from "critical incident stress" within a month after the crash, according to the service.
David Whitley, who is on the York paramedics' peer support team, recalls dealing with the aftermath of that crash.
"The program has helped. That's all I can say, really, it's confidential," he says.
Whitley is in many ways an ideal person to be on the team. He has been on the job for more than 30 years, has worked as a mental health nurse and has lived through PTSD.
'Being absolutely powerless'
His throat catches when talking about two major incidents.
The first came in 2000 when he was driving an ambulance with a sick, elderly woman in the back. The woman's daughter sat beside him in the front when the ambulance was hit by another car. That left him and the woman's daughter trapped in a smoking vehicle before being rescued, he says. The woman's mother would later die in hospital from an illness unrelated to the crash, he says.
That started a three-year odyssey dealing with the onslaught of PTSD. He found himself waking from vivid nightmares, returning to the scene of the crash and isolating himself from his family.
"I needed more care," he says. "I was denying it, trying to keep it together because I couldn't talk about it — and I was treating my patients like crap."
Therapy helped. Whitley says he also learned to "lean into the ambiguity" of life. That experience helped him deal with another awful scene in 2011 when he was among those trying to save a police officer who was dragged by a van driven by a 15-year-old boy after a traffic stop. The officer died.
"It was like trying to save the life of a colleague and being absolutely powerless," Whitley says.
He took a short leave, went kayaking with his wife, then struggled through the officer's funeral. Now, he's strong, he says, and trying to give back.
The peer support team has launched another program in the past two months -- this time to help paramedics off on mental health leave return to work radually. The chief gave them another truck so a peer supporter like Whitley will ride around with a paramedic — maybe they'll go to a call, maybe they'll go for coffee, he says.
"What I'm seeing happening at York paramedic services is an internal resiliency," Whitley says. "Let's elevate our mental health and undoubtedly we'll improve patient outcomes."