Paramedic PTSD double that of other health professionals

Rates of PTSD among Australian paramedics are estimated to be twice as high as other health professionals, according to a new study.

The research, commissioned by the Ambulance Employees Association (AEA) and conducted by Flinders University, found that paramedics are the ‘forgotten profession’ within the healthcare system and are not receiving enough help to overcome psychological injuries caused by accumulated traumas they confront in their work. The AEA commissioned the review to assess how emergency medical service work affects paramedics’ psychological, physical and social wellbeing.

“Work-related stress goes far beyond coping with critical incidents,” said Flinders University’s Professor Sharon Lawn, lead author of the report. “It also includes the impact of repeated stresses present in the nature of the work itself, including operational and work-culture factors producing an interactive effect with critical incidents.

“Paramedics report that their access to appropriate care is made difficult through obstacles including a failure in the workplace to acknowledge stress, a lack of confidentiality, use of inappropriate therapies, poor return-to-work mechanisms, isolation and stigmatisation — and compounded by concerted efforts to obstruct access to workers compensation provisions, and a lack of post-retirement support.”

The findings in this report have important ramifications for how the industry moves forward to improve the safety and wellbeing of paramedics said Phil Palmer, AEA General Secretary.

“Governments need to reconsider the workforce planning model for ambulance, to ensure the needs of the responders are taken into account rather than the simplistic supply/demand equation,” Palmer said.

The report notes that pressure to achieve high levels of productivity and efficiency are resulting in inadequate time for recovery, long hours of overtime or missed meals, and a failure to address the stigma associated with help-seeking.

Palmer said, “Staff resilience is significantly dependent on organisational resilience and support, and current funding and staffing models do not consider these factors. Governments pay more heed to the bottom line than to staff wellbeing.”

The researchers found that traumatic incidents that occurred during paramedics’ routine call-outs had a negative impact on staff and were often cumulative in nature, particularly the impact on their family life and relationships. The nature of their shifts, including pressure to go from one job to the next without sufficient time for rest, were also identified as contributors.

The situation is often compounded by the fact that WorkCover (called Return to Work in South Australia) claims are prolonged, stressful and often difficult, as burden of proof is hard to establish and the onus is on an individual to provide evidence of psychological injury while they are unwell. Claims are generally not accepted if there is any potential or link to a “reasonable action taken by employer”.

The report also shows that many of the existing supports and programs available to ambulance personnel to support their psychological wellbeing fall short on meeting their needs.

Key recommendations from the report include:

• Ambulance services should be funded to provide members and their families (employed and retired) with financial support to seek their own confidential psychological wellbeing counselling outside of the organisation, with no financial cap put on resource use.
• Workers compensation claims process should be streamlined and accepted for conditions that are often chronic in nature and which require long-term support.
• Funding for return-to-work programs for paramedics, and better training and understanding of the nature of the work for counsellors working in this space.
• Cover and support should be extended to volunteers, who make up a large component of the emergency response.
   

The report — titled ‘Ambulance Employees Association: Scoping Literature Reviews drawing on qualitative literature to address the physical, psychological, psychobiological, and psychosocial health of operational ambulance staff and interventions to address the impact of workplace stressors’ — was compiled by the research team of Professor Sharon Lawn, Emeritus Professor Eileen Willis, Dr Louise Roberts, Dr Leah Couzner, Leila Mohammadi and Elizabeth Goble.

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