Saving lives for a living sounds glamorous. However, the reality is often far less so. Not every call has a happy ending, and EMTs witness some of the most horrific things that can happen to other human beings.
More people must understand the connection between EMS and mental health so that these dedicated professionals can get the support they need to do their jobs effectively while avoiding burnout, anxiety and depression.
How can organizations improve EMT mental health training to encompass handling personal crises, not only the problems of patients they encounter in the field? How can paramedics protect their mental health while engaging in work that has them called to accident and crime scenes?
This field presents unique challenges. It isn’t easy to switch off from a job that entails routine horrors. That’s why you need this paramedic’s guide to mental health care. Here are three things you should know.
EMS and Mental Health
The connection between EMS and mental health is complex. The heavy responsibilities involved in this work, the long hours and the realities of the job all contribute to burnout, anxiety and depression among many professionals in the field.
Working in emergency medical care has never been easy, but the recent pandemic increased the burnout among these professionals considerably. The problem isn’t unique to the United States. A survey of physicians in 89 countries recently published in the European Journal of Medicine reveals that 62 per cent reported one or more symptoms of COVID burnout syndrome. 31 per cent demonstrated two or more.
EMTs certainly weren’t immune to COVID’s ravages. They faced considerable risks in helping sick people, even entering their homes to assist them onto stretchers while encountering countless germs. They had to bear the psychological burden of these risks while continuing to provide quality care.
Many of them also saw their home lives interrupted, particularly those with family members with a high risk of complications from contracting the virus. They may have had to temporarily move out of the family home or into a separate section. Their already burdened workload became even more onerous as they did countless loads of laundry, even washing their shoes, to protect those they loved and shared homes with.
They also had to attend to their traditional patient load. For example, EMTs are critical in responding to the opioid crisis by providing immediate care to overdose patients. Sadly, more people turned to substance use thanks to the additional stress brought on by the pandemic, tightening the vice on these first responders even further.
Is it any wonder that many emergency medical professionals find burnout permeating every aspect of their lives? Over half of the participants in a recent Medscape survey rated the impact as severe, taking a particularly harsh toll on their relationships.
Trouble on the homefront further increases stress among these providers who rely on their support networks to remain calm amid the stormy seas they encounter on the job.
Experts define burnout as long-term, unresolved job stress leading to cynicism, exhaustion, detachment from job responsibilities and a lack of a sense of personal accomplishment. This condition can be particularly hazardous among EMTs.
A paramedic who feels detached from their job responsibilities can make careless mistakes that needlessly endanger patients.
Furthermore, they may harm their patients with offhand negative remarks and a poor bedside manner. Nearly a third of respondents admitted that their depression made them more exasperated with patients and less careful when taking notes.
Reduced staff levels mean remaining EMTs often have to work longer and harder hours, putting them in contact with more patients and further testing their patience.
Many paramedics suffer from anxiety, depression and substance abuse disorders. Despite their medical training, many EMTs shun professional treatment for their mental health issues, preferring to handle them independently. Nearly half of them report fearing repercussions if they sought treatment through work.
However, such resistance too often results in tragedy. Suicide rates among these individuals are considerably higher than that of the general population.
Substance abuse is much higher among EMTs than among other emergency responder professionals such as firefighters. Experts remain unsure of the exact reason, but they suspect the easy accessibility of potent narcotics helps fuel the crisis.
For example, paramedics often keep various sedatives on hand for calming patients — it isn’t difficult to appropriate some of those for themselves.
EMT Mental Health Training
EMT mental health training often involves learning to manage such calls in the field. Such knowledge is essential. Paramedics are often a patient’s initial point of contact during a crisis, and how they handle it can de-escalate a volatile situation and ensure safety for all parties.
Both EMT-Bs and paramedics take requisite mental health training courses as their curriculum. To become an EMT-B, you must undergo a 2-year community college program and pass a state licensing exam.
Upon passing, you can work for various ambulance companies. Many such professionals then opt to go through an additional 1,200 to 1,800-hour training course to become a paramedic. Many jurisdictions require you to work as an EMT-B for at least six months before commencing the extra training.
The skills these professionals learn through their education are transferable, perhaps explaining why many workplaces shun mental health interventions with a “physician, heal thyself” dismissal. However, it is one thing to de-escalate a crisis as a neutral third party than it is to launch an intervention for yourself.
You are too close to your situation to see it objectively, and your emotions cloud your judgment.
Fortunately, some areas now offer speciality training focusing on the mental health needs of paramedics — for paramedics. EMTs can earn continuing education credits while mastering techniques that can help them manage on-the-job stress.
They can also find support groups with other people in the industry who understand the unique challenges of dealing with the emotional aftermath of 10-car pile-ups.
How Paramedics Can Protect Their Mental Health
Here’s a brief crash course on how paramedics can protect their mental health. You may refer to one or all of the tips on this list as you navigate your career’s challenges.
Those who know and love EMTs can gently suggest these activities to help someone they suspect may be struggling.
1. Maintain a Support Network
Having a positive support network is a must. These should consist of people you trust.
They should also be upbeat — stay away from those folks who only want to commiserate about how awful humanity can be. Yes, they can be, but they can also be beautiful, which is why you do all you can to help others.
It also benefits you to talk with others who can understand your unique pressures. If you feel uncomfortable attending an in-person support group, you can investigate online resources that can help you process traumatic experiences.
Such networks prove invaluable when you witness something that crushes your soul — but isn’t the kind of thing you want to discuss with your spouse or another family member.
2. Debrief After Difficult Days
Witnessing the aftermath of vehicular accidents, violent altercations and suicide attempts can cause enormous mental distress.
It doesn’t matter how long you have worked in the field; such episodes remind you of your mortality. They may create anxiety, causing you to panic about loved ones, especially if the patient resembles your spouse or child.
Many organizations require mandatory debriefing after traumatic calls. However, the quality of these interventions varies. Those providing help to first responders in the wake of a tragedy should reassure individuals they did their best under challenging circumstances.
However, time may be the best healer. Evidence suggests a brief downtime following a traumatic event may help emergency medical personnel avoid PTSD and depression in its wake. Facilities should do their best to resolve staffing shortages to ensure all members have adequate time to take a mental reset after witnessing a death or similar tragedy.
3. Stay Active
When your body undergoes chronic workplace stress, it elevates levels of certain hormones like cortisol. This substance can indirectly affect mood, spurring cravings and making you feel perpetually on edge.
Exercise helps mitigate cortisol levels by dropping them the way nature intended. It taps into your body’s innate fight-or-flight reflex. Best of all, you shouldn’t go hard — about 45 minutes of moderate-intensity work does the trick.
4. Maintain a Healthy Diet
Certain nutrient deficiencies can adversely affect your mood. For example, magnesium deficiency contributes to depression, so much so that participants in one study who were given a supplement recovered better than those taking a tricyclic antidepressant.
You can find mind-enhancing nutrients like magnesium, selenium and zinc in nuts and seeds. They also proliferate in seafood, so go ahead and indulge in fish Friday like the Catholics.
5. Drink Responsibly
As a medical professional, you know what alcohol can do to your body. Its impact on your mental state may cause the most problems as an EMT. Alcohol upsets the balance of various neurotransmitters governing mood.
Your best bet is to avoid the bottle. However, please drink responsibly if you choose to indulge. A reasonable limit is one drink a day for women and two for men.
6. Quiet Your Mind
Science now supports the efficacy of meditation to calm anxious thoughts. It can even rewire your brain over time, improving your stress response.
You don’t need to go on a retreat to learn to meditate. Start with as little as two minutes per day, which can seem like an eternity if you’re not used to sitting quietly. If you struggle with your practice, you can find guided meditations in many mental health apps and various free channels on YouTube.
7. Take Breaks
Please, use your paid time off — you need this period to recover. Taking a break is even more vital after witnessing a traumatic event.
Ensure you take adequate time between shifts whenever possible. It’s unrealistic to do six 12-hour shifts in a row without a break.
8. Seek Professional Help
Finally, you may shy away from asking for mental health care as a paramedic. However, you should seek professional guidance if your symptoms begin interfering with your daily life.
If you don’t feel comfortable going through your workplace, consider outside options. Many of today’s best mental health apps come with in-person therapy meetings for a reasonable weekly fee.
You can also get unlimited text support with a licensed provider. You may be able to pay for your treatment with an FSA if you need therapy for a medical purpose.
A Paramedic’s Guide to Mental Health Care
There’s a crisis with EMS and mental health exacerbated by pandemic pressures. Many professionals struggle with burnout, anxiety, depression and substance abuse issues. Furthermore, they may avoid seeking treatment despite their EMT mental health training out of fear of repercussions.
How can paramedics protect their mental health? The guide above presents three considerations and eight steps to follow for protecting your psyche while you rescue others.
My name is Beth. I’m a health writer with 3+ years of experience, and I run an online wellness magazine, Body+Mind.