PTSD legislation inconsistent for first responders across Canada
As workers' compensation laws vary between provinces, psychiatrist calls for 'equity across the country'
Paramedic Lisa Jennings says she was in a psychiatric ward, having contemplated suicide the night before, when she decided to start a grassroots movement for emergency workers suffering from post-traumatic stress disorder.
"I never wanted another first responder to ever go through what I'm going through," she told CBC News. "And I need to honour the first responders before me that have committed suicide as a result of this pain."
Jennings, who lives in Victoria, worked as a paramedic for 24 years. But the career she describes as her "passion" ended in June 2014, she said, when she was assaulted in a store during a call.
That was the "triggering event" for her PTSD, Jennings said, and it unleashed a flood of traumatic memories accumulated on the job over the years.
"I have a 24-hour-a-day replay of horrific calls," she said, including "murder-suicide, hanging, gunshot wounds to the face," a case where a man was "gutted, literally, from neck to groin," and the gruesome death of a newborn baby.
Certain smells bother her now, and she has to cover her ears if she hears loud noises. Jennings can no longer work, and she avoids ambulance stations, places where paramedics have coffee and disturbing stories on the news.
For almost two years, Jennings has been fighting B.C.'s Workers' Compensation Board to get insurance benefits for her PTSD, she said. In the meantime, she struggles to live on income assistance of $900 a month.
Existing workers' compensation legislation in B.C. — and in several other provinces — requires people applying for insurance benefits, including first responders, to prove their PTSD diagnosis was caused by their job.
Jennings has been advocating for a private member's bill to change that, recently introduced in the B.C. Legislative Assembly by NDP MLA Shane Simpson.
Vancouver-based labour lawyer Sarah O'Leary calls the current legislation "inhumane," saying that people with PTSD are subjected to compensation board investigators "digging around" their personal lives to find stressors, such as marital issues or debt problems, that aren't work related.
"If you're a nurse and 13 children have died on you in one summer and the last one that occurs, you just crack, and a psychologist or a psychiatrist says, 'It has been too much for her and she's got PTSD and she needs some treatment' … you shouldn't have to prove that there's nothing else [negative] going on in your life," O'Leary said.
Jennings and O'Leary hope B.C. is moving in the same direction as Alberta, Manitoba and Ontario, which have all amended their workers' compensation legislation to presume that PTSD is a workplace injury among first responders, removing the onus on emergency workers to prove a connection between their diagnosis and their job.
New Brunswick recently introduced a similar bill in its legislature.
Ontario's legislation, passed on Tuesday, is the most recent. The change to the province's Workplace Safety and Insurance Act affects police officers, firefighters, paramedics and other first responders, but it does not benefit nurses — an exclusion that drew sharp criticism from the Ontario Nurses' Association (ONA).
Nurses were "shocked and so disappointed," ONA vice-president Vicki McKenna said Tuesday. "We have [PTSD] cases under appeal now that have taken a decade."
On Friday, the Registered Nurses' Association of Ontario penned an open letter to Premier Wynne urging the government to "fix its mistake" and immediately add nurses to legislation that expedites treatment for PTSD.
O'Leary said Manitoba's PTSD legislation, which does include nurses, is the "gold standard" for the country.
"It's obvious that people who are continually dealing with trauma would be more susceptible [to PTSD]," she said. "It's not far-fetched."
Need for 'equity across the country'
Dr. Jitender Sareen, a psychiatry professor at the University of Manitoba and psychiatrist with the Winnipeg Regional Health Authority, said there is clinical evidence showing that first responders who repeatedly see traumatic events are at increased risk for PTSD, and he believes nurses should be included in that category.
Sareen said delays in diagnosis and treatment for PTSD can be detrimental to recovery, and he welcomes legal changes that make it easier for first responders to get "appropriate access quickly."
The fact that legislation governing access to workers' compensation benefits varies from province to province is problematic, he said.
"We need … a national plan around post-traumatic stress disorder and equity across the country," Sareen said. "If you're a Canadian, whether you're in Ontario or Manitoba or … in Nova Scotia, you should have similar rights."
With files from John Lancaster and Jennifer Fowler