Challenging the Paradigm

We have spent so much time talking about mental wellness issues with First Responders. Politicians, activists, writers, therapists and anyone else with a stake in this conversation has leapt up and screamed that we need support for PTSD.  

 And, we do.

But, there is a dilemma. We are focused on the wrong area to invoke real, long lasting change. With our unfortunate, myopic viewpoint, we are tackling a problem at its most difficult state. By the time ‘PTSD’ is on the table for discussion much of the damage to the person’s family, career, and personal life has already been done. We are effectively stating, “No. No. You don’t get any help until you have the worst case scenario for your mental wellbeing”.

 It seems even in our mental wellness struggles we continue to demand to be treated from a macho heavy, hero state: as in, wait for the toughest folks to be in the toughest position. But, for all of our attempts, for all our training programs and awareness discussions, here we still sit, in continued despair.

The reason is because we continue to ignore all other aspects of mental wellness. It has done wonders for the First Responder field to have growing public awareness of the potential impact of viewing car accidents, the deceased and dismembered, and the destruction of people’s homes and lives. Make no mistake, a First Responder does work in a field of trauma. But, a little support can go a long way. Educating them effectively on how to take care of themselves will actually become the preventative interventions we dream of.  Hopefully, we can avoid making this career in trauma, a “traumatic career”.

Moreover, this raises an entire diagnosing issue. First Responders will soon recognize that in order to get any support from the government, their organizations, and recognition from their peers they will have to have a PTSD diagnosis. Nothing other than that will be accepted. First Responders, then, need to seek out those that might be able to offer them this diagnosis, so that they can receive support, and, may push back against those who offer a different diagnosis in the face of their symptoms. In essence, denying the support they have received because it isn’t the “right” support they need or assume they should have.

The overwhelming irony is that by following the timeline necessary for a PTSD diagnosis, people need to remain unwell. A claim is difficult to make if, at the time of it being honoured, the person has been able to effectively manage through their own means. Unfortunately, many have been forced to manage through their own means, because wait times for mental health treatment remain an insult to those who reach out for help. When people finally do reach out, the response they hear is "Hurry up and wait."

Real conversations do need to happen. More importantly, however, there needs to be a commitment to real change within our organizations. In order to do this, we need to recognize that the rigid, one-size fits all mental health training we are currently proctoring as the savior to our mental anguish, is going to fail. It will help some, and the argument could be won there. But, “some” is not enough. We need to remove the veil of heroism to understand that First Responders are exercising an immense amount of mental currency to remain focused on the job. First Responders often wish to identify themselves as “burying” these emotions, however, for anyone who has experienced the unfortunate events of having their emotions explode out of them, you realize that emotions can't be buried. They are compressed, shelved and constrained, and compression only works for so long.

When we continue to deny our friends and family in the First Responder field the proactive approach of programs and support allowing for the decompression of those emotions, we encourage them to spiral into mental illness; not mental wellness. For some, this results in the development of PTSD.

In order to overcome this, there needs to be a change of approach. We need to challenge the paradigm that reactive services are going to best support First Responders. There has been a lot of talk and not a lot of change. We are feeding our First Responders bread and water; enough to sustain a few, and to ensure our budgetary requirements for other “operation based demands” remain intact. We continue to ignore the very fact that anxiety, depression, and other issues will quickly boil over and while an individual case is vastly complex, a more global viewpoint is quite linear. If organizations don’t provide the opportunity for support and proactive wellness, the costs will be greater with sick leave and long term disability. With folks engaged in extensive psychological interventions in order to garner some semblance of normality back in their lives.

The loss of time, then, is placed on those still at work. But, overtime in this field can often mean overexposure of negative events. Therefore, the failure to provide effective mental wellness across the board doesn’t just affect one individual, it carries on to affect those still working.

If we wait until First Responders develop one of the most difficult and life changing disorders to get support, we are effectively leaving them to languish in utter mental hell and chaos.

The most acutely problematic irony here is that they continue to work and suffer in the midst of this mental hell and chaos, and that we ask them to do so.

And, in their time of desperate need, we ask them to continue suffering until they meet the right “check box” for support.