AFTER experiencing four life-threatening situations in three months, paramedic Bill* felt something within him was not quite right.
He mustered the courage to call the NSW Ambulance Service’s Employee Assistance Program to ask for help, no easy feat for a man who had spent more than a decade working in a historically masculine “just get on with it” environment.
“She told me ‘go back to work’,” he said. “It’ll get better Bill, just go back to your shift.”
It did not get better. Bill has spent the past three years living week to week, battling suicidal thoughts, feeling estranged from his colleagues and shut out from the job he loved.
Bill’s post-traumatic stress disorder (PTSD) has cost him his career, and quite nearly his life.
“I was isolated, estranged and suicidal,” he said.
“They (NSW Ambulance) did absolutely nothing.
“I think it’s a budgetary decision to cut you away as soon as there’s an alluded mental health issue.
“If there’s an indication you might have a mental health issue, then you’re no longer one of them, you’re no longer one of us. You’re a patient now, you’re on the outside.”
Tom*, a paramedic of 25 years is “living in poverty” as he battles PTSD as well as insurance agencies for adequate compensation. He said while NSW Ambulance did have support systems in place, he had seen personal information given “confidentially” to support workers passed on to management.
“When people sought help, that was sent back to management and management would use that against those people,” he said.
“I thought, ‘well I don’t think I’ll be doing that’.”
One of the difficulties for Jack*, a paramedic of 31 years who has PTSD and lives on workers’ compensation payments, was finding the time to recover following traumatic jobs.
“There was no debriefing … you may have got in passing a ‘how you going’, … but there’d be no management come and say ‘hey, job well done. How do you feel? We’ll take you off road for a couple of hours’,” he said.
Another challenge was dealing with grief.
“The whole time that I was in the job I was never taught how to deal with grief or how to handle grief,” Tom said. “That’s the hardest part. You turn up to someone who’s dead and you think ‘sorry mate, I can’t do anything for you’ but you’re trying to deal with Mum or the whole family and the anger.
"What I recall is seeing my first SIDS death and how the family is treated by the police until proven otherwise ... and there is nothing you can do and you see the hurt in their eyes and you don’t know how to deal with that.
“You see a family that has lost their beloved child and you’re not trained to deal with that, ever.”
Jack agreed. “You get more training in filling out our paperwork correctly than in grief,” he said.
Belmont psychiatrist Russell Hinton has seen first-hand the damage untreated PTSD does.
“Usually by the time emergency service workers have presented to me they have started to have significant problems being able to do their job and their personal life is suffering,” Dr Hinton said. “Not only are they rendered unable to do their job, they are often unable to lead what most of us would consider a normal life.”
He criticised a lack of information about PTSD.
“The culture … within the emergency services is one where workers are poorly educated about the risk of developing PTSD,” Dr Hinton said. “(They) are often dissuaded from asking for help because to do so is frowned upon in what is still a very male dominated and macho culture, and in some cases once people have come forward they do not receive adequate and timely treatment.
“These guys deserve much better. They have … saved us when we have been in difficult situations, now it's their turn to be helped.”
Australian Paramedics Association NSW executive and paramedic Trent McLennan said more than 40 per cent of all paramedics off on WorkCover had a PTSD-type condition, or another form of mental illness.
He said there was still a stigma regarding PTSD.
“This stigma has worked its way through the generations of paramedics, from a time when support services weren’t available and often paramedics debriefed over a beer after work,” he said.
“NSW Ambulance now has peer support officers, chaplains, grievance counsellors and other forms of support networks available. It would be nice to have more, although NSW Ambulance can only do so much with the limited funding they have.”
Health Services Union NSW secretary Gerard Hayes said research showed around 20 per cent of emergency services workers experienced PTSD.
“While we are now better at recognising the risks, sadly the NSW government is pulling the rug out from under paramedics by slashing their Death and Disability insurance protections,” he said. The scheme cut support for a permanently disabled paramedic by 75 per cent, he said.
A NSW Ambulance spokesperson said the government continued to fund an insurance scheme in addition to workers’ compensation benefits. The Death and Income Protection Award provided new income protection benefits and maintained death benefits, the spokesperson said.
The service had a focus on the mental, emotional and physical well-being of staff, NSW Ambulance said.
“NSW Ambulance takes prompt action to contact, debrief and support staff involved in traumatic patient responses,” the spokesperson said. NSW Ambulance had increased support including employing trauma psychologists, increasing its ability for debriefing, engaging more peer support officers and expanding managerial training. The service recently staged a Wellbeing and Resilience Summit and launched a 1800 information line, providing workers compensation information.
“Chief executive Dominic Morgan acknowledges that while we have made large scale improvements … it’s a work in progress,” the spokesperson said.
*Names were changed. firstname.lastname@example.org