It's Time For Change

Very recently I was asked by a colleague to give a more elaborate version of the story I shared with you all several months ago for a collection that has some support for publishing.  Over the past few days I’ve had a lot of thoughts about it and probably not for the reasons that you are thinking.  I can’t help but think that by being more elaborate on my own person situation that I’d be selling industry secrets.  But the reality is that these are no longer secrets, but rather issues that need to be addressed by our administrators and leaders before we reach an even higher level of crisis than we are already in.

We as public servants see the worst things that humanity has to offer; the full spectrum from death, dying, and the chronically ill to extremes of rape and murder.  We are called to bear witness to some of the (if not the) most traumatic events in people’s lives and are often expected to do the impossible and find some resolve in situations where there is often no easy answer.  Bad things happen to good people every day, and we often (either consciously or unconsciously) carry it with us for the rest of our careers.  I cannot help but think that by being more elaborate in my own story, I will expose an industry that is woefully incapable of making significant change in a time when it would benefit those in the field at at time when it is needed most.

As of the writing of this article we have received a total of 19 requests for help - everything from issues relating to anxiety, PTSD, family issues, and substance abuse.  Every one of these people has had one thing in common - they didn’t believe that their agency had the ability to provide them the help they were seeking.  These people were drawn from a variety of public service backgrounds but a majority of them have been from EMS.  So what does that say about the industry?

In dealing with these individuals it has been made clear to me that EMS has to make some significant changes in the way it takes care of their employees.  Most have stated that no matter how well-intentioned their agency was, they were in no way equipped to provide proper resources for what they needed and that is why they came to us.  The standard response they had received was to contact their employers EAP program and go from there.  The unfortunate reality of a majority of EAP programs out there is that they provide a small amount of resources that are only available for a limited amount of time.  It is basically a patch for problems that require additional, on-going care and typically at some point specialized care.  After the EAP resources run out, these people are often left to their own devices and often become lost in a broken system.  This not only compounds the problems at hand but is of no actual service to those seeking help.

I can speak from my own personal experience that EMS doesn’t like to talk about things like mental health and especially addiction.  While some of the people in charge may actually care about an issue that you are experiencing, they are often untrained or undertrained to handle situations like this.  Some agencies are making headway in being more equipped to take on these problems, but it is largely still a work in progress.  What we need is a significant culture change - and change like that has to start from the top of the administration.  It is no secret that people in EMS do not talk about things that bother them.  There are many reasons why this occurs but most of it is a cultural thing.  From our first day of training we are taught to keep our emotions aside in order to care for our patients - and that is essentially all the training we get in dealing with emotions.  We are also taught that this strange event that happens from time to time called CISD (Critical Incident Stress Debriefing) exists but more often than not, it is sold as a joke and something of no real value.  My own personal experiences with CISD has been mixed at best.  Often the person running these events have a significant lack of understanding of what occurs in the public service sector and how we typically deal with - or do not deal with these critical events.  Thankfully in recent years, this has begun to change.  Newer models of the debriefings exist and are starting to be implemented.  But being as young as EMS is to the public service industry we often listen to those who have many years of experience, and when they have had negative experiences with these sessions they are not afraid to tell you all about them.  This is where our administrators need to step in to educate and inform the newer generation that things are beginning to change and these events may actually be of use to them now.  CISD may not be helpful to some individuals as was indicated by our survey, but I don’t think we should undersell these anymore.  They should be just one resource in a toolbox that an employer has to help those affected by adverse events.

As is common within our culture, drinking problems away has always been popular.  Alcohol is cheap, accessible, and oddly gives you exactly what you are looking for - even though it is temporary.  That is what makes it so dangerous.  Binge drinking has been - and continues to be - an acceptable coping mechanism for the stressors of the job.  Now more than ever I have seen a dramatic increase in the number of people who have received DUI’s or other negative punitive actions resulting directly from their intake of alcohol.  I firmly believe that this is directly due to a lack of education starting from initial training all the way up to employment.  Any agency can have the most solid drug and alcohol policies but in the end that does those who do the work absolutely no good.  It is only good for protecting the agency.  There has to be a culture and leadership change.  Information needs to be made available and alternatives to seeking substance over actual means of dealing with stress and trauma need to be made readily available without the threat of recourse or discord within the person’s employee record.  Substance abuse and trauma have a very clear and distinguished pattern of correlation where it cannot be ignored any longer.  We have to be willing to take care of each other before we implode.

As I've said, I feel like I’m revealing some dirty secrets on the industry, but the reality is that anyone who has been in public service for a good amount of time already knows this or is already engaged in this type of behavior.  They probably know it, but don’t know where to turn before they reach the point of self-destruction.  I know I didn’t, and that took it’s toll on me.  That is why we are here.

We have established a first of it’s kind network for first responders and veterans where we can usher people directly to help.  From the world-class care provided at the Brattleboro Retreat to local therapists, drug and alcohol specialists, trauma specialists, medication assistance, and even sleep medicine.  We can help you to where you should be in life, but we can’t force people to seek help, and unfortunately a majority of cases people have already begun to destroy their personal and professional lives before they realize that they need help.  That needs to change, and begin to change quickly, but I believe that the people who do the job have to be the driving force behind this change.  If a majority is willing to finally begin to address these issues, our leaders will have to initiate the change that is so much needed to keep our communities well.