By Rory O'Connor MCPara, Northern Ireland Trustee and Paramedic with Northern Ireland Ambulance Service.
Mental health and wellbeing are important topics both for the wider public, but also for members of the paramedic profession and wider health services. Unfortunately, an online poll carried out by MIND in 2016 found more than one in four (27%) people had contemplated taking their own lives due to stress and poor mental health while working for the emergency services, while nearly two thirds (63%) had contemplated leaving their job or voluntary role because of stress or poor mental health. This is allied to the fact that the Office for National Statistics has found that the paramedic profession has proportionally one of the highest rates of suicide.
Behind each of these statistics there are personal stories and experiences. For some, years of working in and dealing with hugely traumatic events can cause a gradual deterioration in their mental health, and for others single traumatic events can trigger a crisis.
I have been working as a paramedic on a double crewed ambulance for six years. In this time, as is relatable to most of my colleagues, we unfortunately can experience events and situations which are tragic, traumatic, stressful, upsetting and on occasion all of these.
We all have our own experiences and thought we can turn to when our colleagues mention ‘bad cases’. But, whilst the causes are diverse, our experiences I have found are shared, acute and unique to those who work in a frontline ambulance.
After attending several ’incidents’ in a short space of time, my mood was low, I could not sleep, I was irritable with family and friends, had no time for my children whom I love, and became more introverted and closed off. However, I am a paramedic and this is what we do, so I soldiered on and continued to work. This was most certainly the wrong decision, but it is a decision many of us make in the profession for exactly the reasons I have outlined. I thought, this is the job, I need to be tougher, I need to keep going, this is what we signed up for and I need to just keep going to work and eventually everything will be ok. Whilst this is my own personal experience, and this how I rationalised going to work day after day whilst on the verge of mental breakdown, I have learnt and can assume that my reasons are not uncommon amongst ambulance staff who continue to go to work even when being acutely impacted by the work we do.
I had not recognised that in fact I was in the midst of a mental health crisis and was barely functioning on a day to day basis. I marched on and kept going until I had one bad incident too many and couldn’t march on and go on any longer. It all caught up with me like a tsunami and I ended up home from work in the middle of a night shift completely broken.
Once I could not go on and made the decision to go home from work, I experienced crushing lows which I had never experienced before. Day after day of struggling to get out of bed and go on. I sought help via the external counselling service offered by my employer, but initially found this of little benefit as I was not placed with a counsellor with any understanding of our job or how it can impact on us. Eventually, my extremely supportive line manager arranged counselling with a specialist trauma counsellor who recognised that I was suffering with PTSD. It was not PTSD like the movies, it was how we experience it in real life. Flashing images of tragic events, not sleeping, lucid memories of awful scenes and incidents, things that I thought were long in the past and dealt with coming back and causing me to doubt myself, my profession and my ability to ever do the job again.
Thankfully, the second counsellor I attended was fantastic. It was difficult confronting my issues, but with a wonderfully supportive family and appropriate help I did so, and managed after an extended period of sick leave to go back to full operational duties.
I work and feel comfortable being back at work. However, I am not the same paramedic or man that I was prior to this. I feel like I carry my experiences with me every day, and some days are good and some are not, but I am acutely aware of the warning signs and dangers of my own mental health.
My advice is, we are not super human. We should not soldier on. We should not keep on going regardless. Don’t just say this is the job and I have to do it. Don’t feel worthless or like a failure. Don’t worry what anyone else will think, you will find that almost all of your colleagues will be supportive, understanding and will want to help you. If you need it, get help. Get help from your employer, from your GP, from a confidential service, from any service you think will help. But ask for help, and if you don’t feel like it helped the first time ask again.
For further support:
Blue Light Infoline: 0300 303 5999
Or, the Samaritans: 116123