Emergency First Responders

“PTSD is a greater cop killer than all the guns ever fired at police officers.”
           
Lt. James F. Devine, former director of NYPD Counseling Services

Operational Stress Injuries (i.e., PTSD, depression, anxiety) are common among law enforcement officers.  For instance, the RCMP cited that by March 2013 there were 2,236 of its members (both serving and retired) in receipt of partial or full disability pension for PTSD (link).  This should come to no surprise given that police officers respond to calls of horrific scenes and life-threatening situations.  Yet, unlike physical injuries, psychological injuries have a very strong stigma attached to them which hinders officers’ willingness to seek help (Kates, 2008).  Leaving PTSD untreated often leads to terrible consequences such as substance abuse and suicide.  On July 3rd 2013, the Kelowna Daily Courier published an article about the case of a highly respected RCMP detachment commander pleading guilty to stealing and consuming cocaine evidence.  This former commander had been suffering with depression in silence after experiencing a horrific critical incident twelve years ago. 

Badge Of Life Canada is an excellent educational resource regarding OSIs in law enforcement (link).

Operational Stress Injuries are also common in other emergency first responder professions.   Fire departments across Canada have seen an increase in PTSD symptoms among firefighters (link).  In 2009, a joint study by the University of Ottawa and the University of Washington revealed that 17.3 % of Canadian firefighters surveyed had PTSD, in comparison to a prevalence of 1.2 % in the general male population.  In 2011, the Canadian Association of Fire Chiefs resolved to lobby the federal government to create a committee to examine the issue of PTSD.  As in law enforcement, there is a strong stigma attached to mental health issues which discourages firefighters to seek help.  Moreover, the coordinator of the wellness and fitness center for the Calgary Firefighter Department explains that there is a “rescuing mindset” in emergency services that is not conducive to getting help for oneself.  Unfortunately, it is a counter-productive attitude since PTSD can actually greatly hinder firefighters’ ability to rescue others. 

The North American Firefighter Veteran Network and Grieving Behind The Badge (link) is an excellent resource for firefighters about OSIs.

The rate of PTSD seems equally high among paramedics.  Sterud et al. (2006) reviewed 49 studies done in various countries (including Canada) pertaining to work-related health problems in ambulance personnel.  They found the rate of PTSD to be 21.5%.  Similarly high prevalence rates were reported for anxiety.  Being exposed to frequent critical incidents is endemic to paramedic work.  Halpern et al. (2009) noted that incidents labeled as critical by paramedics involved patient death, often combined with poignancy.  Such events appeared to produce vulnerable feelings of inability to help and intense compassion, which led to further emotional distress.   Difficulty in acknowledging vulnerable feelings and fear of stigma presented significant barriers to accessing support.

In sum, many researchers and clinicians believe that the nature of Emergency First Responders’ work, like that of military personnel, renders them particularly susceptible to acquire OSIs.  It should not be surprising that chronic exposure to critical stress comes with psychological cost.

References

Halpern, J., Gurevich, M., Schwartz, B., & Brazeau, P. (2009).  What makes an incident critical for ambulance personnel? Emotional outcomes and implications for intervention.  Work & Stress, 23, (2), 173-189.

Kates, A. R. (2008). CopShock: Surviving posttraumatic stress disorder (PTSD).  Holbrook Street Press.

Sterud, T., Oivind, E. & Hem, E. (2006).  Health status in the ambulance services: a systematic review.  BioMed Central Health Services Research.