Supporting the Mental Health of Paramedics

Paramedics en route to helping others.

Source: Ilan Kelman

“The Culture of Coping in Paramedics” is the bold title of the Ph.D. dissertation by Elizabeth Goble at Flinders University’s College of Nursing and Health Sciences in Australia. Using an Australian ambulance service as a case study, Goble identified and offered recommendations for paramedics coping with the mental health trauma that can emerge from their work.

Supporting Emergency Personnel

Emergency workers deserve respect and support from us, yet it can be understandably hard. As they perform CPR on a loved one, we know that they are trying to save the life, yet we are terrified of dealing with it not succeeding. As they stem the bleeding while we are trapped in a mangled vehicle, they are putting themselves in danger, yet our response will be mainly to our pain, not their help. As the flashing lights and sirens rush us to hospital, we accept that due to their expertise we will survive the horrible life-changing injury, but we also know that we face a longer journey in living with the loss of a limb.

Paramedics are subject to abuse. They are screamed at by understandably wild parents desperate for news of their child. They are, less understandably, jeered at by onlookers videoing and insulting them for social-media likes. They can have acid and rocks thrown at them for assisting.

Paramedics deal with these situations daily. They respond to some of the worst times of people’s lives, especially when those affected are barely in a position to say “thank you."

Psychological trauma is unavoidable. We owe it to these life-savers to understand and mitigate the consequences as best as possible.

Researching How Paramedics Cope

Goble’s work contributes to this need. It leads the way in documenting and trying to improve formal and informal strategies used by paramedics to create meanings from, and to manage, their job’s mental health impacts. It defines and analyzes a “culture of coping."

Why conduct this work? Goble explains, “A 2018 Australian government inquiry revealed that emergency services personnel felt it difficult to gain management and organizational support for their mental health needs, while management’s perspective was that the resources were there, but hindrances prevented access to them. This research was intended to shed more light on the experiences of paramedic personnel and gain a more in-depth understanding of strategies that they use to cope."

To achieve this goal, she completed semi-structured interviews in ambulance stations with 23 paramedics across three places in Australia: rural area, a town, and a city. Interviewee ages ranged from the 20s to the 70s, spanning three generations. All of the older individuals were male, but the younger workers were split approximately evenly between males and females.

The experience was difficult, yet enlightening and rewarding. “It was fascinating to have preconceived ideas amended before being granted a sincere and unrestricted view of the world of paramedic experience,” said Goble. One key is that researchers in this field need to consider and take care of their own mental health. The results were worth it, especially the unsurprising diversity of coping approaches across generations and locations. Mental health professionals are aware that there can be no one-size-fits-all, although useful patterns emerged among specific groups.

Older paramedics tended to be reticent about using workplace supports, preferring instead conversations with peers closer to their age whom they viewed as friends or family. Humour, typically black humour, was prevalent. They would not always admit to or seem to be aware of their mental-health responses and difficulties.

The younger workers, however, indicated greater awareness of their mental health, adverse experiences, and how to support themselves. Examples included taking a break from work, meditating, exercising, and writing and talking about their experiences and feelings. Humour was deemed to be less acceptable. Ultimately, it was about recognizing the importance of admitting what they were going through in order to seek a balance between the trauma of others they dealt with and being healthy for themselves.

Trauma Essential Reads

4 Ways That Cognitive Processing Therapy Can Help Heal PTSD

Talking It Out: Psychological Debriefing After Trauma

Help the Helpers

We are all too familiar with “Who will watch the watchers?” a loose interpretation of the Roman poet Juvenal’s question “Quis custodiet ipsos custodes?” about ensuring that guards and law enforcers do not abuse their power. We must also address “Who will help the helpers?” so that they can continue to help us.

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