They’re first on scene and there when you need them.
But for public service members who dedicate themselves to helping others, sometimes the biggest challenge is taking care of themselves.
It’s a lesson Michael Swainson learned the hard way.
“A lot of people suffer in silence … First responders put everybody else first – that’s the nature of the beast – we’re really shitty at taking care of ourselves.”
Swainson worked in the Yukon for 25 years as a paramedic, emergency medical services supervisor and dispatch supervisor, firefighter, professional ski patroller, and a disaster trainer and evaluator. As a paramedic alone, he went on roughly 6,000 calls in Whitehorse. For that area it was normal. If he had been working somewhere like Vancouver, he said that number could have easily been double.
“For first responders it’s a conveyor belt of trauma, eventually you run out of coping strategies,” Swainson said.
And there is no magic number of calls a first responder can take before the damage is done. In Canada 145 first responders died by suicide from 2015 to 2017, according to Tema Conter Memorial Trust, an organization dedicated to helping emergency, public safety and military members.
Vince Savoia, Tema executive director, said even though the organization does its best to track deaths some are missed. To date, they are aware of four first responders committing suicide this year.
“The one thing we’re not prepared for is how this job will effect you,” Savoia said, emphasizing a need for more pre-incident training. “PTSD strikes when you least expect it.”
It’s not just post-traumatic stress disorder first responders have to worry about. Savoia noted compassion fatigue and vicarious trauma are more prevalent in the industry but not talked about as much.
“When the first responder has given so much to others they just don’t have any more to give,” Savoia explained, adding they’ll do whatever they can to take some of the pain away from victims, often internalizing it.
A study, published in The Canadian Journal of Psychiatry in August 2017, found that nearly 45 per cent of the more than 5,800 first responders surveyed reported symptoms consistent with at least one mental health disorder.
In January 2009, Swainson was officially diagnosed with PTSD, although he had probably been struggling with it for at least a decade. At the time he thought that now that he knew what it was he could treat it and move forward. But it’s not as simple as taking a pill for a headache. Swainson has had three more flare-ups, with the latest last year.
|Michael Swainson worked as a first responder for 25 years and now teaches other about PTSD. (Photo by Norm Hamilton)|
Now, he works to arm other first responders with the ‘psychological body armour’ they need to survive. He owns and operates Rescue 1 and specializes in post traumatic stress education and prevention.
“What I teach is not so much how to respond mentally after a bad call but how to prepare for a bad call … and it will happen. It’s not a matter of if but when and how many,” he explained.
Despite extensive protocols mandated by governments on everything from how to correctly sit in a fire truck to filling out paperwork, what’s missing is training to prepare for the mental traumas of the job. It’s up to local departments to find and pay for programs or classes such as Swainson’s – which are few and far between.
Regardless of the size of community they’re working in, first responders will be involved in a number of critical incidents during their careers: duty deaths, colleague suicides, work-related injuries, even multi-casualty terrorism incidents or disasters. Events with a high degree of threat, or involving children or a victim is known to responders, or any significantly powerful event can have an effect.
After one of these incidents, Swainson noted first responders will suffer fromtraumatic stress symptoms including re-living the event, avoiding reminders, difficulty sleeping, withdrawal, extreme emotional or physical reactions, losing interest, being on guard, anger or irritability, or emotional numbness.
“It’s entirely normal to have some or all of those symptoms for three to seven days,” he explained. However, when those symptoms persist for more than a month, it shifts to PTSD.
His third time “going down the PTSD drain,” as Swainson puts it, was the worst. It was while he was working as a dispatcher, a tough job because you live every call you take, he noted. “That was basically the nail in the coffin … It ended my career as a first responder.”
As everyone reacts differently to a call, it is almost impossible to predict if and when an individual will develop PTSD, Savoia noted.
“We encourage first responders to find a mental health professional they can work with and go see them twice a year.”
Local departments have a number of critical incident protocols in place to help protect members after a bad call, which can include internal education and awareness programs, peer counseling, debriefings and a referral network. But again the onus is on the department and often the individuals within the organization to make sure they and their colleagues are getting the help they need.
Swainson referenced a portion of the speech Abbotsford Police Chief Bob Rich made during a service honouring Const. John Davidson, an officer that died last fall after being shot in the line of duty.
Rich told the roughly 8,000 first responders in attendance, including bus loads from Greater Victoria, to take the time they needed to heal, whether that was making a claim, taking some sick days or leaning on family for support.
“The time for ‘sucking it up’ is over,” Swainson echoed. “That’s the change in mentality … it used to be ‘have a couple of drinks and get over it.’”
In 2012 Alberta became the first province to recognize PTSD as a presumptive workplace injury – removing the burden of proof from first responders. Other provinces with similar legislation include Manitoba, New Brunswick, Nova Scotia, Ontario, Saskatchewan and the Yukon
Earlier this month, B.C. announced amendments to the Workers Compensation Act. If passed, they will add mental injuries to a list of presumptive conditions for some public service personnel. However, Cameron Eby, provincial president of Ambulance Paramedics of B.C. (CUPE 873), noted emergency service dispatchers were not among those included in that legislation.
Until it is passed, and all are included, first responders will have to continue to prove their injuries are caused by their occupation.
“The work paramedics and other first responders do, they’re exposed to pretty much the worst situations imaginable … For too long we’ve had people ending their careers and even their lives because of the burdens of work,” Eby said,
He noted the new legislation will remove some barriers and help decrease the stigma surrounding mental health injuries.
“It’s becoming OK to put your hand up and say you’re affected and you need help. The tide is starting to change on that.”
For Swainson, it took 13 months to have his claim approved in the Yukon after a judicator agreed his PTSD was caused by his career. “I shouldn’t have been treated that way,” he said.
But he too is starting to see a shift. “My caseworker now is unbelievable … She phones me just to see how I’m doing.”
Swainson, who now lives in Kelowna, was stopped by a police officer one evening. While chatting, Swainson explained he taught first responders about PTSD and asked the officer what he knew about the injury.
“He said to me: ‘we all have it.’”