The day everything changed: Paramedic’s story shows impact of mental health

Nothing would prepare Rita for the afternoon of Sept. 22, 2020. It seemed like a regular workday with her partner as they sat in the back of their EMS vehicle. Every call was predictably unpredictable in her two-decade plus career.

A call came in, and the pair jumped into action – activating the lights and siren as they raced to the scene of an emergency.

She was trained for this. In school, they were taught that paramedics were a special breed of professionals built to “see anything” without being affected. But in the months-long battle with COVID-19, and almost two decades of being witness to violence, emergencies, and accidents on the frontlines, Rita had been feeling the job taking a toll on her mental health, and keeping focus had never been harder.

They arrived at the scene of the call: a pediatric VSA (vital signs absent).  Amidst efforts to keep herself together and remember the newest COVID-19 protocols, a rush of panic took over her.

She froze and collapsed. The toddler did not make it.

It’s been two years, and Rita remains off work as she deals with the trauma and guilt for freezing in the moment she knew she was needed most.

The growing numbers

Injuries associated with post-traumatic stress disorders (PTSD) were identified as the top occupational hazard emergency first responders (EFR) are most exposed to, according to a recent study by the Public Services Health and Safety Association (PSHSA).

Ruth is not an isolated case – nor are the mental health issues in EFRs. One in five Canadians suffer from mental health illness, as stated in Assembling the Pieces: An Implementation Guide to the National Standard for Psychological Safety in the Workplace of the CSA Group. In fact, there are around half a million people in Canada that miss work each work because of psychological issues.

Considering that two thirds of Canadians spend more than 60 per cent of their time at work, the workplace has a significant affect on the mental health of employees. Therefore, employers have an opportunity to advocate for and create psychologically safe workplaces.

“The stats that we have on talking about mental health in the workplace – whether it’s work-related or not – still have room for improvement,” said Tanya Morose, Health and Community Sectors lead of PSHSA. “There is still a stigma attached to mental health in Canada regardless of the profession you’re in. It’s not a first responder issue – it’s a Canadian societal issue.”

Work: A traumatic place or a safe space

Years before Ruth experienced that harrowing day, she had already noticed how accumulated traumas changed her: she began losing sleep, became irritable around colleagues and drank more alcohol after work. Unfortunately, the work culture she was in shared the same ideology she learned in school: paramedics are invincible to trauma. She did not find have a support system.

“There can be a culture of machismo in the workplace. It can be counterproductive, and in some cases, the culture itself can be traumatizing,” said Dr. Chris Carreira. “There is a culture of ‘sucking it up,’ and of individuals who are experiencing psychological distress as somehow being weak, unreliable, and unfit for the job.”

In hindsight, “the pandemic put the whole world in a level-playing field,” said PSHSA health and safety consultant Jackie Sam.

“Everybody was suddenly exposed to this event that caused stress, chaos and uncertainty.”

“People who may have not experienced mental health issues or have not talked about it, now all have this commonality.”

“The pandemic has shown the gaps that have been there for a long time. A light has been shed on (mental health) issues, and people have developed a momentum to discuss it both inside and outside the workplace,” said Sam.

What it means for employers

Employees suffering from mental health issues can lose the ability to perform physical tasks by 20 per cent and can experience decrease in cognitive performance by 35 per cent, according to the Centers for Disease Control (CDC). This gravely impacts employee’s productivity and employability.

From 2019 to 2021, there was an increase of 2.3 per cent in mental health-related disabilities among employed Canadians, according to Statistics Canada. That accounts for about 30 per cent of disability claims and has been costing the Canadian economy $50 billion dollars annually.

“There can be economic burden for employers aside from moral and ethical responsibilities,” said Morose. “Companies need to consider the cost of losing a staff member over mental health issues versus investing in programs to prevent them. Employers need to invest in creating a psychologically safe workplace for business continuity.”

Create a trauma-informed workplace

Creating a trauma-informed workplace is a process and starts with the company’s recognition and understanding that physical or emotional trauma – whether in the workplace or at home – affects people at work.

Educating the workplace is another point that Sam of the PSHSA deems important: “Organizations might already have a lot of policies and programs in place, only they are not working together and structured. Those may already be present but are difficult to access.

“Now is the time employers should think, take a step back and see how these (programs) can actually work for the people in the organization.”

“Anything outside the realm of normal that is observed can be a source of trauma,” said Dr. Bill Howatt of Howatt HR Consulting. “Start by educating the workforce about trauma, its causes; and normalize the discussion around it, then you can move to identifying solutions for them.”

Howatt shared concrete steps on how employers can facilitate a trauma-informed workplace:

• Create a psychologically safe culture that supports trauma – Pay attention to the words used and promote compassion. Advocate for judgment-free discussions and promote help-seeking behaviors.
• Educate workers about trauma and its signs and symptoms to normalize how people exposed to trauma behave – Be clear on which trauma support systems are available.
• Train leaders on how psychologically safe leadership can build trust and collaboration and empower workers – Leaders can be the first layer of support to protect workers from harm.
• Provide coping skills training – Introduce basic coping skills to assist workers exposed to trauma
• Promote self-help strategies – The presence of peer support, diversity and inclusion initiatives and mental fitness programs can help traumatized workers feel supported.

Mental health issues are prevalent both inside and outside the workplace. With recent policies of disconnecting from work and shortened work week, the landscape of a psychologically safe environment is chaning – but it’s not a one-and-done event. Take the first step if you haven’t yet.

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