We Need to Talk About Paramedic Mental Health

17/01/2022

Time to Talk Day Article – 3rd February 2022

We Need to Talk About Paramedic Mental Health

March 23rd, 2020, a day that may forever be etched on our minds as the day that the coronavirus pandemic was declared in the UK, and Prime Minister, Boris Johnson, instructed us to ‘stay at home’. This was quickly followed by a collective sense of fear within society, & led to ‘clap for carers’ from 30th April 2020, whereby members of the public stood on their door steps, clapping NHS and vital workers in a visual show of gratitude for their work and the risks they were taking in the face of potential contagion. We now know how this was to pan out, and how the pandemic has continued to affect all of our lives, from the impact of school closures, caring for elderly and/or vulnerable relatives, and of course, the significant impact on our work and healthcare systems. 

So, where has this left us? Well, even under ‘pre-pandemic’ circumstances, we know that paramedic’s psychological wellbeing has been a cause for concern. However, the outbreak has seen us particularly exposed and the effects of the pandemic have exacerbated the stresses and demands placed upon us. As such, organisations and charities have provided supports and encouraged us to talk about how we’re feeling – after all, talking is good for us, and there is much research documenting so. But, talking is not always an easy thing to do, especially within the ambulance sector, which has a long cultural history of ‘man-up and get on with it’ – aka ‘be stoical and strong - showing your emotions is a sign of weakness’. 

Fortunately, these days, we’ve become more aware of these ‘old’ beliefs and assumptions within our culture which have for years, perpetuated stigma around mental wellbeing and reaching out for support. With the help of national campaigns, such as Time to Talk Day (established by Mind and Rethink Mental Illness), there is real opportunity to bring to the fore and address stigma and discrimination associated with mental ill-health.

In his 25 years as a paramedic, Matthew Syrat, thought that he’d seen it all. In this time, he had attended most things that ambulance work can throw at you, but some particularly tough and tragic incidents had unknowingly left him with unresolved feelings. ‘They’d affected me more than I realised’ Matthew said, in my interview with him. He added that ‘one day, a colleague at work noticed an acute change in my personality’. It was this conversation which was the catalyst to him booking an appointment with his GP. 

Matthew was subsequently diagnosed with post-traumatic stress disorder (PTSD); an anxiety disorder, reportedly affecting 11% of the ambulance workforce (Petrie et al, 2018). Newly diagnosed, Matthew shared how his mind ‘went into a bit of a whirlwind, not knowing what it meant, how I would be able to function, or even if I would be the same person anymore’. By this time, it was nearly Christmas. Despite his loving family, Matthew found it a lonely time and felt isolated. It was in the new year, that he began eye-movement desensitisation and reprocessing (EMDR) therapy, and quickly realised that the traumas that he had experienced had affected him far more than he’d realised. ‘I was sceptical about EMDR at first. I really didn’t understand how it was going to solve the mystery of my sudden change of behaviour’ but it soon became apparent to him that through EMDR he was able to identify those memories that were still unprocessed, raw and lingering, but importantly, through the techniques, could process them safely. ‘After five sessions, things were clearer, and I felt lighter, somehow. I was able to think straight again, and felt confident in moving on’ he added. 

Eighteen months later, the pandemic hit. For Matthew, as for many of us, ‘work was relentless with demands being put on everyone.. I wanted to remain stoic for my family and my team’. But by July 2021, Matthew had begun experiencing changes within himself and his behaviour. He said ‘I couldn’t quite put my finger on it, but I was losing interest in most things, work, play, and in general life… work had become pretty unbearable… I had put everything into ensuring my team were ok and had everything they needed to do their job, but I forgot to look after myself along the way’. With this self-awareness and realisation, Matthew knew that he needed to take some time off work and take another trip to see his GP. He was experiencing burnout and diagnosed with anxiety and depression, conditions which he never thought would affect him, a family man in his forty’s and an experienced, long-standing paramedic. 

In his reluctant admission to take some time away from work, and in the weeks and months that followed, Matthew sought to address balance within his life and rekindled his love for motocross; ‘I wanted to ride again, to see if I could still do it, but also to have something positive to aim for’. It felt exciting to focus on purchasing a new bike, and brought great reminiscence of his younger years. The next goal, was passing his CBT test, which he did with flying colours. Importantly, Matthew shared how critical it was to just take one step at a time and to find a sense of meaningful purpose; for him, this was motorbikes! Invigorated by his newly acquainted passion, Matthew went on to pass advanced tests and set his heart on a Honda African Twin Adventure (AT) which after some searching, he found and purchased with great enthusiasm. 

As I listened to Matthew talking of his experiences, it is crystal clear that his journey from that initial conversation with his colleague, through to diagnosis, treatment and beyond, has not been easy. There have been up’s and down’s, and added life and work challenges along the way including the ‘small’ matter of a global pandemic. However, underneath this, has been his emotional courage – to speak out, to seek help and support, and to value himself – to give himself the time and space to heal, and to develop helpful coping strategies. As a manager leading a team, this is particularly important, to not only role model positive wellbeing behaviours, but also to psychologically permit team members to also look out for their own and each other’s mental health. This will undoubtedly go some way to breaking the stigma that has been so inherent within our culture. 

Talking of his recovery and return to work, Matthew added, ‘I feel good. The world has changed since I’ve been away, but in myself, and my personal life, things have continued to evolve for the better. I guess this is what’s meant by a ‘work-life balance’. For me, the balance had tipped the other way, and I hadn’t felt happy for a long time. That conversation with my colleague was a turning point. Speaking out and getting help was the best thing I did. The treatment has helped, and I’m so glad to be riding again… I haven’t smiled so much in a long while. For me, biking has been the best anti-depressant; the feeling of being free and leaving stresses behind, has truly been the best remedy. I feel a sense of achievement in what I’ve done, I’ve got my life back and biking has helped me to do this’. 

With grateful thanks to Matthew for his openness in sharing his experiences with us.

#HaveTheConversation 
#TimeToTalk
#EndTheStigma

 
By Jo Mildenhall, Paramedic Mental Health Project Lead, College of Paramedics

Reference:
Petrie K et al (2018) Prevalence of PTSD and Common Mental Disorders Amongst Ambulance Personnel: A Systematic Review and Meta-Analysis, Social Psychiatry & Psychiatric Epidemiology, 53, 9, 897 – 909.