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TELUS Talks: British Columbia responds to emergency responders.

January 30, 2020

In this interview in our series on mental health tech, we speak with two transformational leaders at BC Emergency Health Services (BCEHS). Emergency manager and mental health advocate Marsha McCall is in charge of developing the new Critical Incident Stress Program at BCEHS, where healthcare strategist Nancy Kotani is Chief Transformation Officer. They took time out of their busy days to tell us about how they are making sure paramedics and dispatchers get critical mental health care when they need it.1

How common are mental health injuries among paramedics and other emergency responders?

Nancy Kotani: It takes a special kind of person to be a paramedic or other first responder: these are the men and women who run into the situations most of us run away from. That makes them very good at a very rewarding profession. But psychological stress injuries are an all too frequent consequence for first responders. And we need to change that.

Marsha McCall: Exposure to trauma-inducing situations is part of the role, so injury is almost inevitable over a career. But there’s an idea in these helping professions that you’re never supposed to be affected. Because they take pride in managing their emotions, many suffer silently. The suicide attempt rate for paramedics and other first responders is significantly higher the national average.

How is BCEHS supporting paramedics and dispatchers with mental health injuries?

Marsha McCall: Our first step is to offer peer support, known to be one of the most effective tools in helping paramedics and emergency medical dispatch staff. If you experience trauma from an incident, you’re matched with and connected by phone to one of 145 trained volunteer peers, who are BCEHS employees from a different but similar region. The peer is someone you can talk to who understands what you’re going through, lets you know you’re not in this alone, and encourages you to get the help you need. And that leads to our next step: early intervention with a trauma counsellor when needed.

What is BCEHS doing to help them prevent mental health injuries?

Nancy Kotani: Alongside early interventions, we’re working hard to prevent injuries in two main ways. First, our resilience training is helping people become more aware of their own emotional response to what they experience, and to recognize what they can and cannot control. Also, when it’s your job to react to other people’s emergencies, you need to be reminded to take care of yourself. Sleep, nutrition, fitness, and healthy social networks can help protect any of us from mental injuries.

Second, we’re putting policies in place to support mental health at work. The discipline of paramedicine has only been in place since the early 1970s. It’s one of the newest healthcare services, so we’re still learning. Leaders and policies at BCEHS are working to promote work-life balance. We want people to take breaks when they’re exhausted. And we want them to reach out when they need help.

What are the top 3 barriers facing paramedics today when they seek mental health support?

Marsha McCall: One is distance. B.C.’s 4,000 paramedics are spread across almost a million square kilometres. With provincial shortages of trained professionals for treating theses occupational stress injuries, the closest specialist can be a four-hour drive away, or even in the next province. The second barrier is the high cost of psychological trauma services. And the third is professional stigma around asking for help.

What role can digital solutions play in improving access to mental health support?

Nancy Kotani: Technology helps us support this mobile and geographically dispersed workforce. This might mean an “old-school” solution like a 24-hour call line to reach a paramedic trained in mental health issues. It could be as simple as a screensaver with a message like “It’s OK to not be OK” to help reduce mental health stigma across our organization. It could be resilience messages that pop up your calendar, reminders that you’ve worked a lot and you need some sleep. It could mean apps that let you self-assess and track your symptoms. It could be offering safe and anonymous opportunities to learn about resilience, ask questions and talk. We’re using technology to help healthy people stay healthy, and to get care to an injured person as fast as possible.

What role do you think health promotion days like Mental Illness Awareness Week and World Mental Health Day can play?

Marsha McCall: Mental health has always been the second sister to physical health. So raising awareness of the importance of attending to our mental health can help us advocate and apply pressure to make care more accessible. All of us need to play a part in overcoming the incredibly disabling stigma around mental health, and these events keep that conversation going.

If there was one thing we could change today to improve the mental health of our first responders, what would it be?

Nancy Kotani: Let people know it’s OK to not be OK, and to seek help as soon as they need it.

Do you have any advice for designing technology for first responders?

Marsha McCall: It’s very important to listen to paramedics and dispatchers articulate what their needs and issues are. If you want technology to create any sort of significant change, it’s critical that users play a front and centre role in designing solutions that work for them.

Thank you, Marsha and Nancy, for taking the time to speak with us, and for all you do.

British Columbia Emergency Health Services (BCEHS) paramedics (in both ground and air ambulances) dispatchers, call-takers, and other staff who arrange inter-facility patient transfers provide valuable services across BC every day. The Critical Incident Stress Management Program and peer support network has been running almost five years.

1The views expressed by Ms. Kotani and Ms. McCall may not reflect the views of their employer or TELUS Health.