How Many More Must Die? SSM Paramedic on Spike in First Responder Suicides

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Richard Bennett has worked 17 years as a paramedic. Twelve of those years have been served with the Sault Ste. Marie Ambulance Service- where he is today. His interest in medicine bloomed in cub scouts with the acquisition of his first First Aider Badge and then he was hooked for good in high school.

“I was doing a high school co-op placement and on my third shift I ended up doing CPR on somebody. By the time we got to the hospital the patient was fully revived and he ended up walking out of the hospital. That was it. I was just a high school kid and I saved a life. There was no doubt in my mind that this was what I wanted to do.”

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Since April 2014 twenty-six first responders inclusive of police officers, correctional workers, firefighters and paramedics, have killed themselves. Of those twenty-six, nineteen lived in Ontario. The issue of post-traumatic stress disorder (PTSD) has been a growing concern among the Canadian military but the alarming spike in suicides has called attention to the condition as suffered by first responders at home.

In 2008 New Democrat MPP, Cheri DiNovo, introduced Bill 67 -a version of today’s Bill 2. The Bill proposes amendments to the Workplace Safety and Insurance Act that would make claims of PTSD among first responders a presumed occupational injury unless evidence could prove otherwise.

There have been three attempts to pass the amendment but the bill never made it to a second reading. However, the release of the Ministry of Labour’s report Roundtable on Traumatic Mental Stress may create an opportunity to put Bill 2 back on the table. DiNovo has indicated that it is likely that the Ontario government will expedite this process.

Amendments to WSIA proposed through Bill 2 are not unlike recent legislation passed this spring that automatically enacts coverage for certain WSIB cancer claims from firefighters. Bill 2 is presumptive legislation which means if passed it would presume that first responders suffering from PTSD acquired the mental injury on the job.

Should it pass Bill 2 would expedite PTSD claims submitted to the Workplace Safety and Insurance Board (WSIB) which are decided on a case by case basis and can take years to resolve. During this lengthy process claimants are often forced through the process of retelling the triggering incident, thereby reliving the traumatic event repeatedly.

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Richard 1Richard has had his share of upsetting calls. “Anything to do with children is always a bad call, especially more so now that I’m a parent. When you’re parent it’s easy to transfer what happened to the child you are attending to your own child.”

Ironically it was on the last day of his high school co-op that Richard experienced his first call where a baby had died. “Those calls stay with you- the children, assaults, drunk driving accidents- you can’t get over those.”

Its calls like those ones that keep Richard up on many a night. So far he has been able to manage work related stress by talking through difficult periods with a support network of trusted friends and blowing off steam doing the things that he loves- fishing, hiking or heading to the camp. “I’ve told myself if one or two down days turns into a third down day that I need to reach out and talk to someone. I don’t want there to be a fourth down day.”

Richard has supported many of his peers who have struggled with post-traumatic stress disorder. At 6 feet, 5 inches and cuddly stature, Richard is the human teddy bear. His warm nature has won the confidence of many of the men and women that he works with. Being exposed to his colleague’s experiences with PTSD has inspired Richard to become an unrelenting advocate for Bill 2 and the need to improve resources for first aid responders.

As a representative on the Joint Health and Safety Committee he has been pushing for peer to peer support. “Supporting our peers is something that we do naturally but I’d rather be trained so that I don’t say the wrong thing and so I’m more aware of the red flags I should be looking for. We can access counselling through the Employee Assistance Program but if I’m in crisis the wait time is just too long. I’m dead by the time they can fit me in.”

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The Ministry of Labour’s report- mentioned above, “brought together employer and labour representatives from a range of organizations in sectors where traumatic events are more likely: transit services, police services, nursing fire services and emergency medical services.”

Over the course of a year roundtable members discussed exposure to trauma on the job and developed possible strategies that would “promote healthier, more productive workplaces across Ontario”.

Eight key themes were identified:

  • Cultural change– both in the work environment and general population to remove the stigma associated with traumatic mental stress
  • Peer-oriented approaches– educate workplaces about how to support colleagues who are returning to the workplace following a traumatic event
  • Organizational leadership- leaders need to be educated to promote recognition and acceptance of mental health issues in the workplace
  • Policy and government leadership- Government needs to take a leadership role; more involvement from the WSIB given its role in administering and adjudicating traumatic mental stress claims
  • Access to resources and support– more of and ongoing
  • Education and Training– education at all stages of career, including before entering and exiting careers about traumatic mental stress
  • Knowledge sharing– how to share knowledge across sectors as well as across organizations within sectors
  • Communication– among all who are affected, the individual, family members and the workplace

The report sets out a clear direction but implementing next steps will require a concerted effort among all stakeholders.

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The recent swell of suicides among first responders has sounded alarm bells across Canada. The Paramedic Association of Canada identified through a survey that of the 1,000 or so respondents almost 28% have contemplated suicide in the past.

Tema Conter Memorial Trust, an organization dedicated to supporting first responders and raising awareness about the mental health risks associated with workplace trauma, began logging police suicides in April 2014. In an interview with the CBC the group reported that as of October 5th 2014 there were “12 instances where actively serving officers took their own lives.”

The statistic is similar to the number of suicides tracked through the military. “In a three month stretch from November 2013 to February 2014 the military recorded 10 confirmed suicides.”

Tema Executive Director, Vince Savoia, commented that the “comparable numbers are not altogether surprising considering the similar challenges faced by both soldiers and cops. Both groups tend to attract driven, ambitious people who are averse to admitting weakness.”

In a 2011 article published in the Globe and Mail statistics provided by Veterans Affairs Canada showed that more than 1,700 Royal Canadian Mounted Police officers were receiving post-traumatic stress disorder pensions- up from 1,437 in 210 and 1, 239 in 2009.

In 2012 Alberta passed legislation which stated that first responders with a diagnosis of PTSD did not have to prove that the condition was acquired on the job in order to be eligible for worker’s compensation. According to a report to the CBC, “since the legislation was enacted, 36 claims have been filed- 17 by paramedics, 11 by firefighters and eight by police officers. Thirty-two of those claims have been accepted.”

In the same article Vince Savoia wasn’t surprised by the low number of claims stating, “I need to wonder if many of the first responders are fearful of coming forward. It’s seen as a sign of weakness, when in fact it should be seen as a sign of strength.”

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On October 20th and 22nd Canadians everywhere reacted to the tragic events that claimed the lives of Warrant Officer Patrice Vincent and Corporal Nathan Cirillo. And the next day many of the first responders who responded to the multiple shooting on Parliament Hill returned to work- including Canada’s newly christened hero, Sergeant-At-Arms Kevin Vickers.

Following the events MPP Cheri DiNovo stated in the legislature, “I think all members of this house would agree that the events of the past week in Ottawa have demonstrated once again, the enormously important role that police and other first responders play in protecting our safety and our security. There would be no better way for this house to show its gratitude and respect for those first responders than to pass Bill 2 on post-traumatic stress disorder and the WSIB.”

On April 30th 2014 WSIB chair Elizabeth Witmer reported that WSIB was carrying 10.6 billion of unfunded liability. WSIB is financed through premium charges on the insurable payrolls of employers.

Sault Ste. Marie Ambulance and Fire Services are managed through the City. Sault Ste. Marie’s Chief Administrative Officer, Joe Fratesi, expressed concern that municipalities would be financially strained should presumptive legislation – Bill 2, receive Royal Consent.

“People in emergency services are generally paid a higher wage than others in the employ of the municipality based on the fact that they are exposed to more dangerous situations that could cause stress in the workplace or during the work day. So this would be another component where municipalities are being pressed to find even more resources and monies.”

Fratesi believes that adopting presumptive legislation would also place employers in the undesirable position of having to determine whether or not WSIB claims are legitimate. “It ends up becoming awkward to administer because nobody wants to prove against an illness. I think that would be problematic- it puts someone in an adversarial role.”

Further to his above considerations, the SSM CAO believes that the current WSIB procedure of evaluating each claim on an individual basis ensures a more fair approach across the board. “Any worker where it can be shown that they have suffered an injury or stress that has rendered them to temporarily or permanently not be able to work ought to be compensated under worker’s compensation. I think the presumption that this proposed legislation is for certain job categories is what most people will react to.”

Fratesi also expressed, “Not everybody’s make up is such that exposure to the stresses of that job gives you that kind of stress level that causes you to be off permanently or temporarily. I don’t want to short change police or ambulance drivers who are dealing with critically ill or wounded people. I wouldn’t want that job. But then again people enter those jobs because they think that it’s something that they would like to do for a career.”

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“People always think that we knew what we were getting in to- but no. No we didn’t,” Richard is sitting in his lazy boy at home. He rests his head on the back of the chair and glances up at the ceiling for a moment before continuing. “They can’t prepare you for it. They can’t shock you into being numb. We’re not robots, we’re not a machine. At the end of the day you can take your uniform off but everything still rattles around in your head.”

Richard believes that legislation such as Bill 2 and advancing support for first responders in the forms of access to resources and education is just a start. The greater challenge will be confronting the stereotypes held about first responders and the stigma that exists around seeking assistance to manage a mental injury.

“It’s the macho brand. You put on your uniform and then you try to keep up. As a professional you have to be strong for every call, every day. The people that are calling for help don’t want you breaking down on them at their doorstep. When they’re at their weakest we have to be at our strongest.”

Referring to a colleague and a friend Richard addressed the stigma associated with having to seek help for mental injuries. “He really struggled to tell me what was going on. He told everyone he was off on a back injury. But when he did start opening up to me- it was like looking in a mirror and hearing myself talk. It really made me take a long hard look at myself and re-evaluate everything.”

Richard believes that a national conversation about PTSD and first responders is important and the time for action is urgent. “There was a time when people wouldn’t speak about medical conditions like diabetes- there was too much stigma around it. Breaking the stigma and helping the general community understand that first responders are human and are affected by the trauma they witness means that we have to keep talking about this. God forbid that another first responder commits suicide. God forbid that it happens here.”

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Do you need to talk to someone?

Tema Conter Memorial Trust, Peer to Peer Support and Family Assistance: 1-888-288-8036 

Connex Ontario Mental Health Helpline: 1-866-531-2600

Algoma District, Central Access: 705.759.5989 or 855.366.1466

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