B.C. Ambulance Service is overhauling its psychological support for paramedics struggling with the emotional stress of their jobs after acknowledging it has not done enough to help employees cope with the traumas they see every day.
“What we realize is the stress our employees are under because the nature of their job is quite different to a lot of other workforces,” said Julie Wengi, B.C. Ambulance’s executive director of human resources. “We are hoping that this provides a level of support that our paramedics haven’t had in the past.”
Two Vancouver Island paramedics, Lisa Jennings and Joanne Trofanenko, told the Times Colonist they have post-traumatic stress disorder related to experiences in their jobs, but there are many more suffering in silence.
Bob Parkinson, health and wellness director for the Ambulance Paramedics of B.C. union, said an estimated 25 to 30 per cent of paramedics suffer from PTSD, a much higher rate than for other professions.
The proposed changes by B.C. Ambulance include an educational campaign for senior managers and staff. “We realized it was something that we didn't have in place,” Wengi said.
The ambulance service will also bring in a clinical psychologist who specializes in critical incidents and paramedic operational stress scenarios to provide support after traumatic incidents, either through debriefing sessions or one-on-one. The measures will be introduced in the new year, and Wengi hopes the whole program is running within six months.
But Jennings and Trofanenko want the province to take action to support paramedics financially. Both are fighting for compensation from WorkSafe B.C.
B.C. NDP health critic Judy Darcy wants B.C. to follow Alberta in adopting presumptive disability legislation for PTSD in first responders. That would make it easier for paramedics, police officers and firefighters to get compensation from WorkSafe B.C. as they wouldn’t have to prove their PTSD was work-related. It is assumed to be a hazard related to the job.
“For ambulance paramedics, don’t we need to recognize that there could be a cumulative effect of these kinds of [traumatic] incidents and experiencing it time and time again?” Darcy asked. “I think we do.”
Parkinson said WorkSafe B.C. should treat mental injury as seriously as physical injury.
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In her 24 years as a paramedic, Lisa Jennings witnessed the aftermath of dozens of horrific tragedies: Murders, fatal car crashes, infant deaths.
But it was a routine call — a woman with chest pains — that triggered the 49-year-old Esquimalt resident’s mental-health crisis, leading to suicidal thoughts, flashbacks and stays at the Archie Courtnall Centre psychiatric facility.
Jennings and her partner attended the call on June 15. Two other paramedics arrived and Jennings was disturbed by how one of the paramedics was treating the patient. She said the verbal abuse was so bad that the patient filed a complaint.
She could not get the incident out of her head for several days.
“Every patient that is in my care gets the utmost respect, from the homeless to [patients in] the Uplands,” Jennings said. “When I saw what was going on, I couldn’t fathom medical personnel treating someone like that. That was my trigger.”
Afterward, Jennings said, she felt sick all the time and started having nightmares about the call, which quickly worsened into nightmares and flashbacks about more traumatic calls.
“I’ve seen murders, stabbings, gunshot wounds, infant deaths, children thrown from vehicles,” Jennings said, fighting back tears. “I have seen some horrific things in my life.”
Four hours into a shift on June 24, Jennings felt so angry she couldn’t concentrate, so she booked off sick. She hasn’t been back.
Jennings is now unable to work, ineligible for extended medical benefits through her employer because she was a part-time employee (despite often working full-time hours). She filed a claim with WorkSafe B.C. saying that she’s entitled to compensation for post-traumatic stress disorder, or PTSD, caused by her line of work.
While her family doctor and an emergency-room physician told Jennings she has PTSD, WorkSafe B.C. denied the claim because her primary psychiatrist did not make that diagnosis, she said.
According to WorkSafe documents, the psychiatrist “advised that the worker did have PTSD-like symptoms but that there had been no ‘catastrophic event.’ ”
WorkSafe B.C. said it will accept that a succession of incidents can lead to PTSD, but the disorder must be diagnosed by a qualified clinician, such as a psychiatrist or psychologist.
“Whether their claim is accepted or not, these are people with stress in their lives. We treat them with respect and compassion,” said spokesman Scott McCloy, noting that it’s necessary for WorkSafe to conduct a follow-up investigation to verify claims.
Jennings has requested an appeal and has sought the opinion of another psychiatrist.
She also contacted Joanne Trofanenko, a B.C. Ambulance paramedic based in Port Alberni who is suffering from PTSD.
Trofanenko was first on the scene after an ambulance plunged over a cliff into Kennedy Lake on Oct. 19, 2010, killing both paramedics inside.
Her close friend, Joanne Fuller, was the driver.
Trofanenko was diagnosed with PTSD in 2013, but her claim was denied by WorkSafe because she didn’t file it within a year of the incident.
She remembers the feelings of helplessness, the depression and suicidal thoughts.
In her darkest days, she contacted a paramedic in New Brunswick who went public with his PTSD struggle. She’s glad she could be that person for Jennings.
“When I first talked to her, initially it was just heartbreaking because I identified so much with her story,” said Trofanenko, who now has a service dog to help with her PTSD.
Jennings said it was the first time she felt she was not alone. “It was a feeling that somebody gets this.”
Vince Savoia, executive director of the Tema Conter Foundation, an Ontario-based organization that advocates for first responders suffering from PTSD, said that while there’s been a national dialogue about suicides among Canadian Forces personnel, first responders such as paramedics are still off the radar.
Savoia said anyone who wants to understand why a paramedic might be suffering emotionally should ask themselves one question: How many tragedies have you experienced in your lifetime?
“Paramedics see it every single day. They witness people’s tragedy every single day.”
Savoia said it’s common for paramedics to be traumatized by certain incidents, but they keep working because they can’t get the help they need.
“It comes down to funding and how much willingness, how much support the British Columbia government is going to offer their first responders financially,” he said.
B.C. NDP health critic Judy Darcy is pushing for “presumptive disability” legislation for PTSD, similar to what Alberta passed in 2012. It means first responders don’t have to prove their PTSD is work-related because it’s assumed the claims are the result of traumatic work-related incidents.
In the current system, Darcy said, the onus is on individuals to prove their PTSD is related to the workplace, a process that can renew the trauma.
Bob Parkinson, health and wellness director for the Ambulance Paramedics of B.C. union, said an estimated 25 to 30 per cent of paramedics suffer from PTSD.
Paramedics’ benefits cover short-term counselling, but not the type of prolonged treatment necessary to treat PTSD, Parkinson said. “Our benefits package is dismal when it comes to mental health.”
Julie Wengi, B.C. Ambulance’s executive director of human resources, said the organization will roll out a new program in January. “We recognized we weren’t doing as much as we could for our employees in terms of their psychological support.”
B.C. Ambulance’s current program includes a group of trained paramedics and dispatchers who can provide immediate support after a critical incident.
Starting in January, a clinical psychologist specializing in critical incidents and first responder or paramedic operational stress scenarios will be available to provide support during debriefing sessions or one-on-one.
There will also be a training, education and awareness program on critical incidents and PTSD that will be offered to staff and senior managers.
“One of the things that struck us quite solidly when we announced this review on the psychological support structure … was the number of paramedics who reached out to us, they said this is well overdue, we definitely need this,” Wengi said.
Jennings said she’s encouraged by the proposed improvements and hopes it will open up a dialogue that makes other paramedics feel more comfortable in asking for help.
“There’s so much stigma and shame to go forward and to say you have it,” Jennings said. “PTSD is not a one-incident disease, it is a cumulative disease.”
Jennings’ neighbour, Teya Danel, has organized an online donation page to help Jennings deal with the financial stress of being off work. "She's helped so many people in her career. Now she no one and is in need of help herself," Danel said. To donate, visit http://www.gofundme.com/gq0k7w