# Mentally Ill EMTs/Paramedics



## Aidey (Feb 27, 2009)

So I have a general question for you all courtesy of one of my friends who volunteers at a combined Fire/EMS department. First a little background info, the department has about 60 or 70 members, there are 6 24 hour people (2 per shift) and everyone else is volunteer except for 2 chief officers and a couple of admins. 

Several months ago one of her friends, a FF/MICP, starting having a lot of issues, and eventually showed up to a training class in a full blown manic episode. They were able to convince him to go to the hospital and he was admitted and diagnosed with Bi-polar disorder. 

He took 2 months off from the department, got on meds, and from all accounts is stable and doing pretty well. Last week the chief dismissed him from the department on the grounds that his bi-polar disorder made him a risk to the safety of everyone else both co-workers and patients. He offered to get a letter from his psych saying he was ok to stay there, and to sign a contract saying he would stay on his meds and if he didn't they could dismiss him but the Cheif was having none of it and said there was no room for discussion. Since the state this happened in is an "at will" work state and he was a volunteer he has no legal recourse against the Chief. 

Now, my question is, do you guys think this was fair? Should someone be blocked out of fire/EMS strictly because they have a mental illness?


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## alphatrauma (Feb 27, 2009)

I'm going to side with the Chief here.

As nice as the "guy in question" may be, nobody's perfect. At some point everyone who MUST take a prescription will go off their meds. When disaster ensues, the first question that will be asked is, "did you know that he had a psych disorder?"


... judgment for the plaintiff


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## JPINFV (Feb 27, 2009)

^
Then we might as well not hire anyone that has a seizure disorder, on permenant pain medication for chronic conditions, is diabetic, or essentially anyone else with a chronic condition requiring medication. Also we might as well not hire people who aren't sick because everyone comes down with temporary infectious diseases that could be spread before the person becomes symptomatic. After all, when someone gets a nosocomial infection...


To the OP, without knowing the patient's baseline or anything else about the patient, I can't make a decision one way or another. My gut instinct is to say that your chief is a panzy and doing the entire "Oh my gawd, someone has a psych disorder and thus are completely crazy" stupidity routine. Unless mental illness is a protected class, akin to skin color, sexual orientation, etc, there probably isn't much you can do about it except insure that he gets his unemployment insurance and help him find a new job.


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## AJ Hidell (Feb 27, 2009)

You're screwed if you do and screwed if you don't.  If someone is harmed by him, the department is liable.  But if they don't accept him, they are quite probably guilty of an ADA violation and forced to both take him back and compensate him.  Whether it is "fair" or not, this is a situation where an attorney should to be the final word.

Unfortunately, the unregulated nature of the fire service and EMS both leave us open to this kind of thing.  Law Enforcement certifying agencies require a psych exam and clearance to be eligible for hiring.  Since we have no such thing, each agency is on it's own.


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## VentMedic (Feb 27, 2009)

JPINFV said:


> ^
> Unless mental illness is a protected class, akin to skin color, sexual orientation, etc, there probably isn't much you can do about it except insure that he gets his unemployment insurance and help him find a new job.


 
Mental illness is within the Americans with Disabilities Act (ADA).  However, it is not applicable in all situations.  
http://www.nami.org/Template.cfm?Se...tManagement/ContentDisplay.cfm&ContentID=4862


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## Meursault (Feb 27, 2009)

I can't comment on appropriateness without specifics, but I have a nagging feeling that this wasn't a very well-informed or considered decision.

As far as your general question, "mental illness" is a _very_ broad category, and categorically excluding people is generally a bad policy. I hope it's not widely believed that all psych disorders put people at risk for harming patients or otherwise unfit to be in EMS.  Individual evaluations are probably the best and fairest idea.


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## Foxbat (Feb 27, 2009)

Aidey said:


> He offered to get a letter from his psych saying he was ok to stay there, and to sign a contract saying he would stay on his meds and if he didn't they could dismiss him


Sounds like the firefighter was given an opportunity and chose not to use it. Whose fault is it?


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## Ms.Medic (Feb 27, 2009)

I agree with the chief as far as the ems/patient side of it goes. BUT, could they maybe have offered him a job just on the pumper ?  MAYBE ? IDK, is it a department where if you run fire, you HAVE to run ems as well ?


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## Sparky79 (Feb 27, 2009)

Foxbat said:


> Sounds like the firefighter was given an opportunity and chose not to use it. Whose fault is it?



If you read the OP, this is what the *firefighter* offered and the *chief* declined it.

My $0.02, the chief over reacted, but as others stated, without full details it is hard for us to judge completely.


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## Foxbat (Feb 27, 2009)

My bad, I shoud've read more carefully.


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## Sasha (Feb 27, 2009)

This is absolutely ridiculous. How sad that a people are still so ignorant about mental illnesses. 

If he agrees to stay on his medication, I really don't see where the problem is. People with mental illness did not ask for it, just like people with cancer, diabetes, etc. did not ask for their diseases. Do we deny people with diabetes a job because they might have a hypoglycemic episode and crash the truck? Do we deny people with high blood pressure the right to work because they might rupture a vessel in their brain while working with a patient? No. 

This is discrimination based on ignorance.


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## jrm818 (Feb 27, 2009)

^ ditto.  Look around your service - I guarantee there's at least one fairly..eh...unhealthy looking person who works for you.  There's a not insignificant chance they will have a massive MI and croak during a call..yet they're still working.  Yet the chance that a bipolar provider will loose control of their condition excludes them??

I know of at least one case where a medic had to wear a halter monitor...while at work.  I'd say there's' more of a chance that he has some sort of arrythmia pop up in the middle of a call than this guy will go off his meds and become uncontrolled..if, indeed, he can document that its well controlled.

the stigma attached to mental illness is powerful...and perverse.  I feel for the guy, and my gut says that this is probably an ADA violation, although I really have no idea.


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## akflightmedic (Feb 27, 2009)

Sorry but I agree with the chief and disagree with the above posts. Ignorance would be allowing the person to be on the department.

Anyone who knows anything about mental illness and bipolarism especially would agree. Hell any bipolar patient will agree the job is not for them.

A bipolar patient WILL come off their meds multiple times. First, bipolar does not mean you swing from a high to a low in minutes and that is a huge misconception many people have. It actually is able to be trended over weeks or even months. If a patient keeps a journal and has a person they can trust, it is plain as day when manic episodes are approaching or when lows are creeping in.

He is newly diagnosed. It will take a year just to understand how often his cycles will occur and if the meds will hold him steady through the transitions.

The reason a bipolar patient will come off their meds is they miss themselves. They like the highs of the manic episodes depsite the serious repercussions which typically follow. Every now and then they start to say they feel normal or they want to feel like their old selves, so what do they do? They discontinue the meds. It takes a very supportive network of family and friends to recognize some of the early subtle changes in order to support the patient and keep them from falling back down the slippery slope.

One of the main treatment therapies for bipolar patients is to maintain a routine, consistency. Emergency services is anything but.

I think the chief acted in the best interest of the department and the newly diagnosed patient. I know for a fact, in the state of Alaska, if you have been diagnosed with any mental disorder and take medications, you are precluded from holding a paramedic license.


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## sir.shocksalot (Feb 27, 2009)

I have bipolar disorder, and I have been working well in the field for almost 2 years.


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## akflightmedic (Feb 27, 2009)

sir.shocksalot said:


> I have bipolar disorder, and I have been working well in the field for almost 2 years.




And do you disagree with anything I said, regarding cycles and meds? Simply saying you are doing fine is not enough, because if you want to discuss this particular disorder in a honest format, then disagree with me and tell me why.


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## sir.shocksalot (Feb 27, 2009)

akflightmedic said:


> And do you disagree with anything I said, regarding cycles and meds? Simply saying you are doing fine is not enough, because if you want to discuss this particular disorder in a honest format, then disagree with me and tell me why.


I agree with you partially, but it is really depends on the individual with the disorder. To say that every person will go off their meds at some point is incorrect, in the 4 years I have had the disorder I have never once stopped taking my meds. I am well aware of the dangers of discontinuing treatment, and in the interests of my coworkers, patients, and most importantly myself, I refuse to discontinue my medication. In regards to the mood swings I am well aware when they come and I have a lot of good support mechanisms in place to have good control.
I have faced a lot of discrimination for my disorder, but I think when properly managed by a responsible adult it has no effect on my career.


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## devaE2 (Feb 27, 2009)

I have to disagree w/ AKFlightMedic on some points. 

First, there are several different classes of BiPolar. Some are characterized by severe mood swings and finding the right combinations of meds to keep them 'stable' can be a challenge. Other types are fairly benign and are easy to control. 

Any decent psychatrist can tell if a person w/ BiPolar illness should or shouldn't be working in a stressful situation.  

Will a person w/ this disorder go off their meds because they 'miss themselves' - probably at least once. Do they need a good support network? Can't hurt. Will a person w/ BiPolar II put a patient, co-worker, or themselves in harm's way? Doubt it.

I agree w/ a lot of what's been said about risks to patients due to EMS responders being diabetic, obese, etc.  On our Engines we carry AEDs - primarily because a FF going down w/ a heart attack is a very real possibility - so who's the greater risk to patient or co-worker?


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## trevor1189 (Feb 27, 2009)

akflightmedic said:


> I know for a fact, in the state of Alaska, if you have been diagnosed with any mental disorder and take medications, you are precluded from holding a paramedic license.



That's ridiculous. What about people with depression or anxiety disorders? They just say sorry you take medicine for a psychiatric problem you can't be a medic??? :wacko:


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## bstone (Feb 27, 2009)

If this guy gets a lawyer you can rest assured it'll end up in court.

I believe the chief was wrong. You can't fire someone for a legit medical condition that is under control. If he does something wrong then you can can him, but not before. The EEOC would have a field day with this.


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## medic417 (Feb 27, 2009)

Sasha said:


> Do we deny people with diabetes a job because they might have a hypoglycemic episode and crash the truck?



Yes.  At least many services if they hire a diabetic will have a no driving clause for them.


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## bstone (Feb 27, 2009)

medic417 said:


> Yes.  At least many services if they hire a diabetic will have a no driving clause for them.



"Many". Are you sure? I never heard of even one.


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## medic417 (Feb 27, 2009)

bstone said:


> If this guy gets a lawyer you can rest assured it'll end up in court.
> 
> I believe the chief was wrong. You can't fire someone for a legit medical condition that is under control. If he does something wrong then you can can him, but not before. The EEOC would have a field day with this.



Why waste money to fight for a free position?  If he feels he can do the job go hire on at a paid service.


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## bstone (Feb 27, 2009)

medic417 said:


> Why waste money to fight for a free position?  If he feels he can do the job go hire on at a paid service.



Oh, I thought he was one of the few paid medics. My bad.


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## akflightmedic (Feb 27, 2009)

bstone said:


> If this guy gets a lawyer you can rest assured it'll end up in court.
> 
> I believe the chief was wrong. You can't fire someone for a legit medical condition that is under control. If he does something wrong then you can can him, but not before. The EEOC would have a field day with this.



So using that logic, can we employ a pedophiliac since it is a mental disorder? I mean if he only had one episode but since then has had treatment, we should just wait and see, right?


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## Summit (Feb 27, 2009)

To those saying "no chemically imbalanced practitioners period," well, that would include Attention Deficit Disorder. That would kick out 3/4 of EMS providers. Stop and think before you scream absolutes.



akflightmedic said:


> So using that logic, can we employ a pedophiliac since it is a mental disorder? I mean if he only had one episode but since then has had treatment, we should just wait and see, right?


*Usually I respect what you have to say, but your analogy here is so inappropriate and outlandish, I'd really like to respond with some innapropriate words.

You are equating a person with a diagnosed chemical imbalance to a malicious pedophile with a criminal record?

You need to sit down and shut up, post haste.
*


medic417 said:


> Why waste money to fight for a free position?  If he feels he can do the job go hire on at a paid service.



How is he going to get a paid job when his professional history is "fired for mental issues"? He'd sue to correct that, I think.


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## bstone (Feb 27, 2009)

akflightmedic said:


> So using that logic, can we employ a pedophiliac since it is a mental disorder? I mean if he only had one episode but since then has had treatment, we should just wait and see, right?



Mental Illness being treated by physician ≠ criminal jerkface 

Your analogy ≠ logic, sense, reason, professionalism


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## medic417 (Feb 27, 2009)

Summit said:


> How is he going to get a paid job when his professional history is "fired for mental issues"? He'd sue to correct that, I think.



It is not in any professional history he was a volunteer and he was told he could not volunteer.  So it is not in his employment HX.  So a law suit again just to give away his services would be outrageous.


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## Summit (Feb 27, 2009)

medic417 said:


> It is not in any professional history he was a volunteer and he was told he could not volunteer.  So it is not in his employment HX.  So a law suit again just to give away his services would be outrageous.



ok, not getting into debates of semantics of "professional" but his experience history and reputation in the field are at stake.

If he goes to a paid service, will they not ask him his experience in the field? He can't possibly let them speak to his old department for reference. It looks extremely bad when a volly is told to get lost. It looks bad if he can't let them speak to them either. And word travels. Fire, EMS, and Law are small worlds.


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## jrm818 (Feb 27, 2009)

akflightmedic said:


> So using that logic, can we employ a pedophiliac since it is a mental disorder? I mean if he only had one episode but since then has had treatment, we should just wait and see, right?



And you accuse US of ignorance!  I just want to add to the chorus saying that was a stupid statement.  There is no recognized treatment for pedophelia.  There are treatments for bipolar disorder.  There is no recognized treatment for pedophilia.  There is plenty of evidence that pedophiliacs will act to strike another child if allowed to do so.  There is also plenty of evidence that treated biploar disorder can be coped with successfully....and without raping a child in a manic bout.  seriously...

I don't think anyone has said he should be allowed to work untreated and subject to his normal bouts of mania and/or depression.  That's assuming he even has mania...we don't know the exact sort of bipolar disorder this individual has, and its possible that depression is the primary symptom.

If he has his disorder well controlled such that a psychiatrist is of the opinion that he is stable enough to work, there is no legitimate reason not to allow him to work.  Biploar is not untreatable, and there are plenty of people who are successfully working with the disease. 

Comparisons of mental illness to criminal abuse of a child is the exact sort of rhetoric that re-enforces stigmas about mental illness, makes it extremely difficult for sufferers to cope with it, and makes diagnosis treatment and research difficult.  I would expect more from someone who cliams to be enlightened about the plights of those with bipolar...or any other mental illness.


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## akflightmedic (Feb 27, 2009)

Summit said:


> To those saying "no chemically imbalanced practitioners period," well, that would include Attention Deficit Disorder. That would kick out 3/4 of EMS providers. Stop and think before you scream absolutes.
> 
> 
> *Usually I respect what you have to say, but your analogy here is so inappropriate and outlandish, I'd really like to respond with some innapropriate words.
> ...



I simply made a non sequitor argument as others were already heading there. Everyone is so quick to defend and say sue sue sue, or the chief is wrong. I am simply standing up for what I feel was a proper judgment call; a tough one, but proper in this case.

A newly diagnosed bipolar patient who experiences a manic episode needs time to get their stuff sorted. There are medication regiments and routines that need to be developed as well as journaling or being observed to see how often the cycles will be. This is not the time to be on a department, period. In most government jobs, this would be a non issue as they would never pass the psychological portion of the hiring process anyways.

At no point have I said ALL mental illness cases are unemployable nor have I said all bipolar patients need to NOT be hired. I agreed with this chief in this particular instance based on my own personal knowledge and familial experiences with bipolar disorder. Since none of us here are mental health experts, that is all any of can do...offer input based on ignorance or personal experience. 

I made no mention of ADD or any other type of chemical imbalance conditions.

All of these other issues being brought up are irrelevant. We are talking about being bipolar, a newly diagnosed one following a manic episode which is how they are normally caught. The behaviors are there, sometimes for years, but there usually is finally a breaking point of when the light bulb goes off and we say "AH ha"...

As for my pedophile analogy, what if he has NOT acted on it yet. What if he has sought help because he realized where he was headed? It is still a mental condition. He has no criminal record, simply a mental disorder. He admits it in an interview during the psych profile or it is discovered (hypothetically) in his medical records. He takes medication to control his impulses, his urges. He realizes if he comes off what may happen. Do we deny him a job for his mental illness and wait and see?

By no means am I confused about bipolarism. I know there are many types and I do not think they are a threat to themselves or others. Most manic attacks are not as extreme as portrayed in the movies (especially that one Richard Gere movie years ago), however as a newly diagnosed patient post manic attack, the Chief did the right thing. It is definitely in the patient and the department's best interest.

As for your last comment, it is illegal to state why one is fired. You may simply confirm dates of employment and eligibility for rehire; whether or not that is always the case is irrelevant. I sure as hell would not even mention my vollie job, especially if terminated from it.


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## BossyCow (Feb 27, 2009)

Our employment application asks "Do you have any disability which will interfere with the performance of the duties listed?"

The ADA states employers must make 'reasonable accomodations' for disabilities. This doesn't mean its against the ADA to not hire a blind man as a taxi driver. Without knowing the details of the 'full blown manic episode' the vollie had in full view of the rest of the squad, its difficult to know what motivated the chief. It may have impaired the department's ability to trust the guy. The guy may have been unable to listen to or follow the instructions given by superior officers. That is a safety issue if another manic event happened on a scene. 

I know of a gal who was hired by a fire department as a medic. They found her seizing twice while on shift. The second time was on the floor of the truck bay after a call. She was let go, because the instability of her seizure disorder impaired her ability to do her job. She wasn't fired for having a seizure disorder, but for an inability to perform the job for which she was hired. 

In order to evoke the ADA, you have to be able to prove your fitness to perform the duties of the job, with reasonable accomodation. In my husband's case it required special hearing aids he can wear with his SCBA. In other cases, special adaptors for the end of stethoscopes, or magnifiers for the fine print in the protocols. 

One person's seizure disorder may not be an issue while another's is job ending. ADHD is a lot different from some bi-polar disorders. It has to be reviewed on a case by case basis. Not taking your anti-psychotics is going to have much more severe side effects work wise than missing a few doses of your anti-depressants. As in all things.. it's risk vs gain.


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## trevor1189 (Feb 27, 2009)

First of all comparing a pedophile with someone with bipolar diorder is just asinine. I'm sorry, I would expect more out of someone who is on a forum related to medicine. But that is all I'm going to say about that.

Second couldn't the department place him on temporary leave until he receives medical clearance to work? Why not let the professionals determine if he is capable of doing his volunteer job?


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## akflightmedic (Feb 27, 2009)

I did not compare them, I merely stated that they are both mental illnesses.

Since some people felt no mental illness should be discriminated against, especially if it had not affected anyone yet, I pulled an example out of the hat which everyone took offense to.

If people would read, think and use a little logic...while the argument was far reaching, it was done to prove a point. There are no blanket statements, it is case by case and if anyone with personal experience with bipolar (especially those prone to manic or even hypomanic episodes) speaks honestly, they will not disagree with the statements I made in regards to this being a time for the person to adjust to their newly diagnosed illness, medication regiment and cycles. 

We still do not know the full details of the manic episode either, but in this situation, the Chief determined him unfit at this time. A tough decision but possibly most appropriate at this time.


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## bstone (Feb 27, 2009)

trevor1189 said:


> First of all comparing a pedophile with someone with bipolar diorder is just asinine. I'm sorry, I would expect more out of someone who is on a forum related to medicine. But that is all I'm going to say about that.
> 
> Second couldn't the department place him on temporary leave until he receives medical clearance to work? Why not let the professionals determine if he is capable of doing his volunteer job?



The interesting thing, it's the SAME physicians who are certifying he has right to work under their license that are also saying he's fit to work. I guess is one case AFK thinks it's fine and in the other case isn't.

No, that doesn't make any sense at all.


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## akflightmedic (Feb 27, 2009)

Huh?

Did not quite follow you there.

The physician diagnosing him is not the same as the one who would have him work off his license, not typically anyways. Not many services have psychologists as their Med Director.


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## medic417 (Feb 27, 2009)

akflightmedic said:


> Huh?
> 
> Did not quite follow you there.
> 
> The physician diagnosing him is not the same as the one who would have him work off his license, not typically anyways. Not many services have psychologists as their Med Director.



I agree.  If a reg MD said he is fine I would not accept that either.  

I wonder if anyone researched tio see if a pediphile is actually a mental illness especially if they have never acted on the urges?  Probably not probably easier to call you names than to prove you wrong.


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## bstone (Feb 27, 2009)

akflightmedic said:


> Huh?
> 
> Did not quite follow you there.
> 
> The physician diagnosing him is not the same as the one who would have him work off his license, not typically anyways. Not many services have psychologists as their Med Director.



You are right. And psychologists do not prescribe medication. A physician who has done a residency in psychiatry and holds a valid medical license does prescribe medication for mental illness. The protocols about psychiatric emergencies are usually written by psychiatrists and these same psychiatrists sit on the medical boards which license EMT.

I am glad to help explain how this aspect of EMS to you. Any other things about EMS you are unfamiliar with?


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## trevor1189 (Feb 27, 2009)

I'm out, this one is going downhill fast.


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## bstone (Feb 27, 2009)

trevor1189 said:


> What are the odds his psychiatrist/PCP is the medical director? :wacko:



See my above post. I describe how psychiatrists sit on EMS licensing boards and develop our protocols about psych emergencies.


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## trevor1189 (Feb 27, 2009)

bstone said:


> See my above post. I describe how psychiatrists sit on EMS licensing boards and develop our protocols about psych emergencies.



Noted. Thank you.


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## akflightmedic (Feb 27, 2009)

bstone said:


> You are right. And psychologists do not prescribe medication. A physician who has done a residency in psychiatry and holds a valid medical license does prescribe medication for mental illness. The protocols about psychiatric emergencies are usually written by psychiatrists and these same psychiatrists sit on the medical boards which license EMT.
> 
> I am glad to help explain how this aspect of EMS to you. Any other things about EMS you are unfamiliar with?




Ahh, so we resort to cheap pot shots now instead of logic when someone asks you to explain a jumbled post. I am with you but will not sink to that level. Cheers...


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## medic417 (Feb 27, 2009)

akflightmedic said:


> Ahh, so we resort to cheap pot shots now instead of logic when someone asks you to explain a jumbled post. I am with you but will not sink to that level. Cheers...



Names are easier than researching and proving you wrong dont cha know.


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## akflightmedic (Feb 27, 2009)

bstone said:


> See my above post. I describe how psychiatrists sit on EMS licensing boards and develop our protocols about psych emergencies.



See and you are referencing your particular area where it seems that you have statewide protocols...am I correct?

In most states, protocols are service driven by individual physicians, not a statewide thing.

I still do not see the relevance of your protocols for psych emergencies and how they apply to one's employability with a diagnosed mental illness.


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## bstone (Feb 27, 2009)

akflightmedic said:


> See and you are referencing your particular area where it seems that you have statewide protocols...am I correct?
> 
> In most states, protocols are service driven by individual physicians, not a statewide thing.
> 
> I still do not see the relevance of your protocols for psych emergencies and how they apply to one's employability with a diagnosed mental illness.



Nor do I see the relevance of your comparing a stable, medicated, treated bi-polar patient with a pedophile.

I'll be taking leave of this thread now. It's irrelevant.


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## Mateo_1387 (Feb 27, 2009)

It is hard to believe that all of these 'medical professionals' cannot recognize that a sexual offender, such as a pedophile, is suffering from a mental illness (MI).  I think AK's argument is justifiable.  

Sexual offenders do not suffer from the more pretty MIs such as schizophrenia or OCD, but SO's do suffer from mental illness.  It is still a chemical fix, as with anyone who suffers from OCD, drug addiction, serial raping or killing.  Just because we, as a society, do not fully understand the disease, does not exclude it from being a MI.  

We consider things far outside of abnormal to be issues of mental illness and of a mental origin.  I, as anyone else in their right mind (pun intended), can see that SO's are in that range of abnormal.  They do suffer from MI.


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## medic417 (Feb 27, 2009)

bstone said:


> Nor do I see the relevance of your comparing a stable, medicated, treated bi-polar patient with a pedophile.
> 
> I'll be taking leave of this thread now. It's irrelevant.


1


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## akflightmedic (Feb 27, 2009)

bstone said:


> Nor do I see the relevance of your comparing a stable, medicated, treated bi-polar patient with a pedophile.
> 
> I'll be taking leave of this thread now. It's irrelevant.




I explained my position quite clearly, several times actually. Have yet to be disproven in that regard but oh well, I digress. It is easier to insult and run than explain your position with logic or facts so that others (including myself) may learn something new and walk away a better person for it.

And I never said a stable, medicated bipolar patient could not work in the field. This particular individual is not any of those things yet as it is too soon.


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## Lone Star (Feb 27, 2009)

The way I see it, AK is fully justified in the 'leap' he took from newly diagnosed bi-polar and the pedophile.  As it's been said many times, that while pedophilia (or any other sexual predatory behavior) IS in fact, a 'mental illness', certain actions MUST be taken to protect the integrity of the employing organization.

What most have failed to realize is this...even though the firefighter/medic offered a 'contract solution', the agency is STILL an 'at will employer', which means that they don't need to fully justify the termination of employment agreement.

Do I agree with what the chief did?  YES!  It is the chief's responsibility to protect that agency from any and all potentaial litigation.  

Was the firefighter's 'contract solution' enough to correct the 'problem'?  Probably not.

While AK brought up a very 'distasteful' analogy, it IS valid.  Aside from the 'knee jerk emotional outbursts' that I've read following his example, shows that there are alot of people here that are unable to debate this topic with LOGIC  and  FACT!

Bottom line is this, since the agency is an 'at will agency', there is no real recourse for the firefighter/emt.  And to bring litigation in order to get back into a position to donate their services is just a waste of time and money.

In today's job market, there are certain questions that a potential employer cannot ask the applicant, as well as certain questions that cannot be asked of previous employers.  Furthermore, there are certain topics that the previous employer cannot breech with a potential employer.

As far as taking time to regulate med levels, and adjust them ....it only makes sense!  Even a newly diagnosed epileptic needs a year to regulate their antiseizure meds (speaking from personal experience), (no, I'm not an epileptic, but was on anti-seizure meds after the repair of a cerebral aneurysm). We don't know that the chief has made this termination an ABSOLUTE.  No one knows that after a year of regulating the meds that the firefighter/emt can come back to that agency.


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## MSDeltaFlt (Feb 27, 2009)

Aidey said:


> So I have a general question for you all courtesy of one of my friends who volunteers at a combined Fire/EMS department. First a little background info, the department has about 60 or 70 members, there are 6 24 hour people (2 per shift) and everyone else is volunteer except for 2 chief officers and a couple of admins.
> 
> Several months ago one of her friends, a FF/MICP, starting having a lot of issues, and eventually showed up to a training class in a full blown manic episode. They were able to convince him to go to the hospital and he was admitted and diagnosed with Bi-polar disorder.
> 
> ...



OK, getting back on topic.  Your comfort level and my comfort level might necessarily be the same level; especially when the tones go off and lives are at stake.  What makes us think that the crews at the FD are any different?  Their comfort levels might be different within their own ranks.  Did the other crew members not feel comfortable?  Did they feel unsafe with him?  Did they "vote him off the island" for lack of a better phrase?


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## medic417 (Feb 27, 2009)

MSDeltaFlt said:


> OK, getting back on topic.  Your comfort level and my comfort level might necessarily be the same level; especially when the tones go off and lives are at stake.  What makes us think that the crews at the FD are any different?  Their comfort levels might be different within their own ranks.  Did the other crew members not feel comfortable?  Did they feel unsafe with him?  Did they "vote him off the island" for lack of a better phrase?




We had a diabetic fall out on duty twice.  He was finally voted off the island.


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## AJ Hidell (Feb 27, 2009)

AK is correct on all issues, including the pedophile analogy.  If it's in DSM, it's mental illness.

Of course, what is and is not in DSM is a political football these days.  I personally see zero difference between pedophilia and homosexuality, in psychological terms.  Both are an unnatural sexual attraction, and nothing more.  Yet political correctness caused homosexuality to be removed from DSM.  So now, even though it is an abnormal psychological condition, it no longer is qualified as a "disease" because, well... I dunno why.  Because they gave up on trying to cure it, I guess.  But since it is no longer in DSM, they had to write it in along with handicaps, race and religion as a protected status since ADA would no longer apply to homosexuality.

But BPD is still in DSM, so it is still a protected status under ADA.  And since there is no state board requirement in any state that medics meet some kind of mental fitness certification, as do cops, it's going to be a long and expensive battle for any department to exclude these people, even with compelling evidence that they represent a threat.  If he wants it -- and if this actually is a job, and not just some volly hobby thing -- he will get the job back.


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## MSDeltaFlt (Feb 27, 2009)

medic417 said:


> We had a diabetic fall out on duty twice. He was finally voted off the island.


 
And that's my point.  I don't know where I stand with regards to the prudency of what the Fire Chief did.  One thing I do know is that, with that state being an "at will" state, it's not my call.  I'm not in that situation.  I can't say what I will and what I will not say, think, or do.


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## sir.shocksalot (Feb 27, 2009)

AJ Hidell said:


> AK is correct on all issues, including the pedophile analogy.  If it's in DSM, it's mental illness.
> 
> Of course, what is and is not in DSM is a political football these days.  I personally see zero difference between pedophilia and homosexuality, in psychological terms.  Both are an unnatural sexual attraction, and nothing more.  Yet political correctness caused homosexuality to be removed from DSM.  So now, even though it is an abnormal psychological condition, it no longer is qualified as a "disease" because, well... I dunno why.  Because they gave up on trying to cure it, I guess.  But since it is no longer in DSM, they had to write it in along with handicaps, race and religion as a protected status since ADA would no longer apply to homosexuality.
> 
> But BPD is still in DSM, so it is still a protected status under ADA.  And since there is no state board requirement in any state that medics meet some kind of mental fitness certification, as do cops, it's going to be a long and expensive battle for any department to exclude these people, even with compelling evidence that they represent a threat.  If he wants it -- and if this actually is a job, and not just some volly hobby thing -- he will get the job back.


But if you exclude everyone with a mental illness, what about the few of us that are able to adequately work while suffering from a mental illness? Personally I think there need to be better psych exams so that those that are unstable aren't eligible to work in the field for the time being, those of us that are aren't excluded from our career choice.


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## akflightmedic (Feb 27, 2009)

sir.shocksalot said:


> But if you exclude everyone with a mental illness, what about the few of us that are able to adequately work while suffering from a mental illness? Personally I think there need to be better psych exams so that those that are unstable aren't eligible to work in the field for the time being, those of us that are aren't excluded from our career choice.



First, thank you for not attacking and bringing the topic back into relevant tangents without being an arse.

For the sake of exploring the tangent you just mentioned, I do believe we have had similar discussions before about this.

Even though it is YOUR career choice, it does not mean the career needs you. There are tons of job and careers in this world that exclude on many various qualifiers. Unfortunately, some people who are "unaffected" or able to perform their job despite being afflicted are going to have to be singled out or excluded due to the fact that not every employer or state can make rules for individuals. Sometimes, they have to make large blanket policies which fair or unfair are legal and a necessity.


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## ffemt8978 (Feb 27, 2009)

Well, since this thread started to get back on topic as I was closing it, I'll reopen it for now....with a caveat.  If I have to close it again, it's going to stay closed.


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## Aidey (Feb 28, 2009)

I honestly don't have answers to the specific questions you guys have asked because I never worked with the guy (or at that department), and I don't know him personally. My friend told me about the situation, and I was mostly just curious if other people thought the chief was overreacting, or he was justified. I don't know if he was "voted off the island" or not, but my friend told me she had no problem working with him, and since he had been back from his LOA he had been acting perfectly normal. 

From what my friend said he showed up to a documentation training and it was as if he was on speed, or had drank way too much coffee. He was hyper, bouncing off the walls, fidgety, couldn't hold a conversation or topic for more than 10 seconds etc. 

She didn't know specifically what kind of Bi-Polar disorder he was diagnosed with but she said it was the kind that has manic episodes and then normal episodes. (Hopefully that makes sense to someone because I haven't looked it up yet). 

I personally think the chief overreacted a little bit. I can definitely understand not wanting someone around who can't perform their job, but if they can, why fire them? It sounded like the FF/Medic was willing to make concessions and prove he was fit to work and the chief wasn't working with him at all. In the examples given in this thread, even people with seizure disorders were only let go after they proved they couldn't perform their job.


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## JonTullos (Feb 28, 2009)

Let me preface my comments by telling you my story.  In November of 2007 I was diagnosed with generalized anxiety disorder and mild depression.  I was so stressed out with life and had let things build up for years that I was having panic attacks at the drop of a hat for no apparent reason.  I was working in radio at the time and that was a huge stresser, so big that I had to just walk out on my job in order to protect my health.  I was on Welbutrin and anti anxiety medication (I don't remember the name of the second one but the first one I was put on was Tranxene - that was some wacky stuff) for several months and then I weened myself off of them.  I haven't been in meds for about nine months and I honestly don't remember the last time I had a panic attack.  Blood, guts, stuff like that never bothered me and doesn't to this day and yet being in a radio station was enough to make me run out of the room (although not anymore but it was at the time).  So, there you go.

Now... knowing that about me, would you now say that I shouldn't go forth with my plan to be an EMT?  

Being an EMT is something I've wanted to do since I was a kid and I really think that not initially following my dreams, and instead following the wishes of other people, is one of the things I bottled up.  At any rate, I'm also no longer under the care of any kind of doctor or councilor for anxiety or depression and I'm not taking any drugs.  Granted, my situation is different than other peoples but my take is that as long as its controlled and there's reasonable belief by a qualified pro that things will be fine, I say go for it.

The chief was right if he really believed that this person wasn't going to do his duties safely.  However if he did it simply because of a blanket judgment on people with mental issues then he was totally wrong.


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## trevor1189 (Feb 28, 2009)

JonTullos said:


> Let me preface my comments by telling you my story.  In November of 2007 I was diagnosed with generalized anxiety disorder and mild depression.  I was so stressed out with life and had let things build up for years that I was having panic attacks at the drop of a hat for no apparent reason.  I was working in radio at the time and that was a huge stresser, so big that I had to just walk out on my job in order to protect my health.  I was on Welbutrin and anti anxiety medication (I don't remember the name of the second one but the first one I was put on was Tranxene - that was some wacky stuff) for several months and then I weened myself off of them.  I haven't been in meds for about nine months and I honestly don't remember the last time I had a panic attack.  Blood, guts, stuff like that never bothered me and doesn't to this day and yet being in a radio station was enough to make me run out of the room (although not anymore but it was at the time).  So, there you go.
> 
> Now... knowing that about me, would you now say that I shouldn't go forth with my plan to be an EMT?
> 
> ...


I asked a similar question a few pages ago. I take medication for anxiety. That is a psychiatric condition, should I not be allowed to be an EMT or eventually a paramedic? Just curious as to what your thoughts are.


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## firecoins (Feb 28, 2009)

akflightmedic said:


> So using that logic, can we employ a pedophiliac since it is a mental disorder? I mean if he only had one episode but since then has had treatment, we should just wait and see, right?


pedophiliacs are banned in NYS from operating ambulances.  Bi Polar disorder is not.  Not all mental disorders are created equal.  There is a big difference between the common cold and TB.



AJ Hidell said:


> AK is correct on all issues, including the pedophile analogy.


As I said Bi polar controled on meds is not equal to pedophile.  Meneal Illnesses are not equivalent. 



> I personally see zero difference between pedophilia and homosexuality, in psychological terms.  Both are an unnatural sexual attraction, and nothing more.


 Really?  One is mutual attraction between two consenting adults and the other has one consenting adult/party attracted to a party than can not consent.  Yes they are exactly the same.


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## Aidey (Feb 28, 2009)

Guys, can we move on from the pedophilia thing? I really don't want this thread to get locked again. 

I think if your condition (and the side effects from the meds) don't interfere with your job then it's fine.


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## medic417 (Feb 28, 2009)

Newly diagnosed I would say no.  If a at least one year controlled and you have proven compliant with meds and therapy yes.


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## benkfd (Feb 28, 2009)

*My humble opinion*

Just to put my humble opinion in on this one....... If we were to exclude all mental illnesses from the EMS profession who would be left to actually work here?  :unsure:   If we were all truely humble and honest with each other we have all had our days when we were depressed, lonely, angry......Need I go on.  We are all human and we all have our days when we are not completely stable.  
  My point is that we need to be sure that we treat each other with dignity and respect. Now, I know it's hard to be respectfull of the drunk who tells you to :censored: off at 0200. But, let's think about what we're saying here.  I think that most of us are in EMS to help other people, I know it wasn't for the money! Anyway, just food for thought!


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## AJ Hidell (Feb 28, 2009)

benkfd said:


> Just to put my humble opinion in on this one....... If we were to exclude all mental illnesses from the EMS profession who would be left to actually work here?


There are multiple professions and vocations where pre-determined mental illness is excluded from the workforce, including law enforcement.  Many fire departments even test for it prior to hiring.  Not sure why you think that this would be impossible in EMS, or what evidence you have that mental illness is so endemic among EMS personnel.


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## AJ Hidell (Feb 28, 2009)

firecoins said:


> As I said Bi polar controled on meds is not equal to pedophile.  Meneal Illnesses are not equivalent.


Pedophile fondles kids.  Bi Polar kills co-workers.

Big improvement there.  So glad you clarified that for us.


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## ffemt8978 (Feb 28, 2009)

That's enough...


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