# Mental health providers for EMS employees.



## bigbaldguy (Jul 12, 2012)

Ran across something interesting while doing a Google walkabout. I found a therapist that specializes in treating FD and EMS folks. After looking a little further I also found mental health folks who specialize in treating people who work in health care. For instance one therapist only treats nurses. I find this fascinating as it never occurred to me that mental health providers would be specialized by their patients profession. Makes sense I suppose because even though the symptoms might be the same the triggers might be very different. 

So my question is. Previous to reading this post were you aware that there were mental health professionals who specifically treat EMTs and Paramedics? 

I'd also be interested to hear what your thoughts are on differences in types of stress a medic or EMT would face as opposed to someone in some other high stress profession.


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## Achilles (Jul 12, 2012)

I have a question, what makes them specialize in ems/ FF? Were they a FF or EMT? Or did they treat X number of FF/ EMTs and they specialize in it.


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## medicdan (Jul 12, 2012)

Very interesting. Thanks. Is there a directory of providers with specialized practices for EMS? How could I find some contact info for a co-worker?


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## bigbaldguy (Jul 12, 2012)

Achilles said:


> I have a question, what makes them specialize in ems/ FF? Were they a FF or EMT? Or did they treat X number of FF/ EMTs and they specialize in it.



I honestly don't know how they end up specializing. I didn't see anything specific on their profiles that said why they went into these areas of treatment. 

I'll see if I can find out.


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## bigbaldguy (Jul 12, 2012)

emt.dan said:


> Very interesting. Thanks. Is there a directory of providers with specialized practices for EMS? How could I find some contact info for a co-worker?



No idea but again I'm willing to research this and find out. I think it's an important topic and something that would be an excellent resource for people here.


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## Handsome Robb (Jul 12, 2012)

We have one that's contracted by the agency I work for. She's pretty cool, knows her stuff for sure. I'm not sure how they specialize in EMS/FD/PD but it's one of her advertising points on her business card.


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## EMT91 (Jul 13, 2012)

A CEO faces....:

Deadlines
Employees who try to steal
Financial woes 


EMT faces.....:
Walking into a room and seeing a baby bloody and dead.
Finding a man cold, hard, with rigor mortis. 
Trying to work a code with family yelling and screaming at them


Not to minimize the stresses of others, but most people outside of medicine do not face such rigors.


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## medicdan (Jul 13, 2012)

EMT91 said:


> A CEO faces....:
> 
> Deadlines
> Employees who try to steal
> ...




Don't forget making sure the company is doing right for it's employees who are hurting. In some ways, the CEO has the greatest responsibility-- remember their bottom line hurts when they have hurt staff-- or staff unable to perform their duties fully.
They're not all heartless illegitimately born children.


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## OzAmbo (Jul 13, 2012)

EMT91 said:


> A CEO faces....:
> 
> Deadlines
> Employees who try to steal
> ...


Most people outside of corporate management wouldn't ubderstand the stress of ebing a CEO either

Everyone faces stress, everyone reacts differently and everyone will have a different point at which a stressor will effect them. WItshouldn't be thought about stressin a profession, it should be thought about as stress in the individual person


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## bigbaldguy (Jul 13, 2012)

What about the stress created by 

24 hours shifts. Or 36 or 48. Rotating schedules.
Being unable to discuss your day with your partner due to confidentiality rules.
Drug addiction brought on by easy access to narcotics.

These are all things which a non EMS background therapist might not understand. Also for instance with the drug addiction I think many medics would be more comfortable in a recovery group that was made up of their peers as as opposed to random people.


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## mycrofft (Jul 13, 2012)

A good therapist can boil down the issues and get to them matter what. Some are not able to do that due to their own personal issues. I think such specialization might be a means to market services or the therapist has issues to resolve also (badge envy, professional boredom). Of course, it could also be that they are rendered immune from the BS we throw out the first couple sessions such as "I've seen so much, I've been in blood up to my knees", etc.


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## bigbaldguy (Jul 13, 2012)

mycrofft said:


> A good therapist can boil down the issues and get to them matter what. Some are not able to do that due to their own personal issues. I think such specialization might be a means to market services or the therapist has issues to resolve also (badge envy, professional boredom). Of course, it could also be that they are rendered immune from the BS we throw out the first couple sessions such as "I've seen so much, I've been in blood up to my knees", etc.



That's true a good therapist can probably help anyone regardless of their background. As I understand it though part of therapy working is building a trusting relationship with the therapist. I would think having a common ground to start with would facilitate this. Being able to cut through the BS is also a very good point. I've noticed that people in EMS put so much feigned pain on the outside that it tends to mask the real pain on the inside.


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## OzAmbo (Jul 13, 2012)

bigbaldguy said:


> What about the stress created by
> 
> 24 hours shifts. Or 36 or 48. Rotating schedules.
> Being unable to discuss your day with your partner due to confidentiality rules.
> Drug addiction brought on by easy access to narcotics.



I dont think a therapist goes home and tells thier husband/wife about all the messed up garbage he get told day in / day out? Same confidentiality rules

24/36 or 48 are a retarded idea and im glad they are not legal here (though some joints do find loopholes)

Who says that therapists cant get addicted to prescription  medication?

In my mind its all splitting hairs. We are not special because we are in EMS and get stressed or PTSD or whatever you currentr mojo is. But anyone who needs help is special because they need help, regardless of career


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## WestMetroMedic (Jul 14, 2012)

I am pretty sure a spousal exemption exists, plus, i trust my wife explicitly.

Back on topic, i think a therapist can specialize in something that they just have a knack for, regardless of background.

 I fancy myself to be excellent with mental health patients, not because i have mental health issues or addiction issues, but because i just kinda figured its out.  My father is an alcoholic with 32 years of sobriety, but i was never alive while he was drinking.  This doesn't make me an expert on that topic, but it gives me a foundation, and i figured ouT what works from there.


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## Veneficus (Jul 14, 2012)

bigbaldguy said:


> Ran across something interesting while doing a Google walkabout. I found a therapist that specializes in treating FD and EMS folks. After looking a little further I also found mental health folks who specialize in treating people who work in health care. For instance one therapist only treats nurses. I find this fascinating as it never occurred to me that mental health providers would be specialized by their patients profession. Makes sense I suppose because even though the symptoms might be the same the triggers might be very different.
> 
> So my question is. Previous to reading this post were you aware that there were mental health professionals who specifically treat EMTs and Paramedics?
> 
> I'd also be interested to hear what your thoughts are on differences in types of stress a medic or EMT would face as opposed to someone in some other high stress profession.




Had no idea they existed. 

Even more surprising is they make any money.
(not because I don't agree with it, but because of the internal support offered in emergency and other high stress healthcare profesisons)

I don't need psychiatric help, I went to a psychiatrist and he said he couldn't help me...

Ok, joking aside, I was once interviewedby a psych major who was doing a study on PTSD. She didn't share her results with me, but I was in the "people who don't suffer from it in a high stress group" (so much for claiming disability)

Anyway, during the interview, several positive coping mechanisms I use were identified. The most prominent for me is "dark humor" which is their scientific way of saying "you are really messed up laughing at that."

But I have a few other positive coping mechanisms in play too. 

Maybe I am just a sociopath, but I don't ever recall being affected for more than a couple of days over a call or a patient, no matter how severe the condition or situation. 

Anytime a coworker was identified as having problerms, other coworkers came to his/her aid. 

In 20+ years, the only people I have known who killed themselves did so because of family issues, not because of work issues. 

People come and go from the entry level positions in emergency and acute care all the time. Some more accomplished ones I know occasionally take a break and do something else. 

A very smal few of us make up a hardcore, all our lives, 24/7/365 group. While we can get a little irritable at times, especially after long hours without sleep, food, or using the toilet.

I have even seen providers who needed help after they retired and were not part of the "group" anymore, but they are always welcomed when they visit the FD or the EMS station, or the Hospital.

If anyone here has any insight, I would be interested to hear (but not research myself) the similarities and differences in mental health issues between emergency service workers, professional soldiers/sailors, conscripted soldiers/sailors, civillians in war zones, and civillians in undeveloped countries.


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## mycrofft (Jul 14, 2012)

http://www.youtube.com/watch?v=CMIvjTqAKSs

Veneficus, each of those subgroups has a different paradigm about mental health, its societal aspects and how or if to treat.

Almost every culture has a way to get stoned, some for religious purposes only...but is religion a form of therapy for some?

Internal stressors which exacerbate or initiate mental illness or stress reaction syndromes include identification with patients/victims, lack of personal control (big one for military), conflict of internal paradigm/self image with what happens (feelings of failure or violation). There is also physiologic illness, including (in my opinion) preexistent mental illness.


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## Veneficus (Jul 14, 2012)

Thanks for the latest reply, it makes sense.

just to comment on this though...




mycrofft said:


> such as "I've seen so much, I've been in blood up to my knees", etc.



These providers really must refine their technique.

Even in cardiac surgery I have never been in blood up to anything more than my wrists. :rofl:


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## bigbaldguy (Jul 14, 2012)

Veneficus said:


> Thanks for the latest reply, it makes sense.
> 
> just to comment on this though...
> 
> ...



Even while kneeling?


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## Veneficus (Jul 14, 2012)

bigbaldguy said:


> Even while kneeling?



Why would you bend over?

Might hurt your back


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## Melclin (Jul 14, 2012)

EMT91 said:


> A CEO faces....:
> 
> Deadlines
> Employees who try to steal
> ...



I was talking to a bloke I went through my final exams and scenarios with and he said he spent 7 months getting shot at in Afghanistan and he never felt nervous like he was walking into those rooms to be examined. Give him a choice and I'm sure he wouldn't chose getting shot at, but different things provoke different kinds of stress and I don't think its accurate to judge them all on the same spectrum. He, like all of us there, had spent four years working towards this. The final year as interns on the road. As interns we were constantly judged as paramedics, but also as people, by the quality of the work we did. He, I and many others slowly started to blend our self esteem with our competence. I think its a mechanism to build the kind of confidence you need as recent graduate to command incredibly stressful scenes. I can handle this well because _I'm awesome_, not because I'm objectively competent at a few skills etc.

To then walk into a room where your competence, now so tightly wound with your confidence and self esteem, was being judged in single concentrated moments was incredibly stressful. 

This kind of stress where people associate success and confidence and sense of self is common in many people driven to be successful, especially CEOs. 

There isn't enough scotch in the world that would facilitate my dealing with the constant stress of managing a multinational company. 

Its just different, not better or worse. 

I do agree that there is a certain potential for a post traumatic aspect to our job that perhaps doesn't exist in most, but I don't think thats really what comprises the bulk of stress for paramedics.


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## bigbaldguy (Jul 14, 2012)

So I knew a guy who went to work every day for 22 years and loaded bags and cargo into airplanes in Phoenix Arizona. For 22 years he never called in sick for a day of work and never had an injury. He did the same job, used probably less "proper lifting technique" and would talk about "pushing through the pain". People all around him would go out on OJI and he would talk about how "I must be unique cuz I've never hurt myself" and "I guess I'm just built differently". The guy wasn't bragging he just didn't think the same rules applied to him. Couple years ago while playing with one of his kids he threw his back out. He hasn't been back to work since. Turns out his back is just shredded from repetitive motion and years of abuse. He's practically a cripple.

There are a lot of parallels between our physical and emotional health.


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## firetender (Jul 14, 2012)

Every call is a stressor.

Because we are in a humanistic field, we witness the whole gamut of debility, whether it be self- or outer-imposed. The world we navigate in is almost completely populated by people in all sorts of varieties of distress. Our one job is to relieve as much of that as possible.

I am aware of professionals who offer their counseling services to medics but they are few, far between and, for the most part, not quite there. The ones who live through the trauma (or like kinds of it) and then work through it are the ones who hold the most effective keys.

IMHO I think clinically trained counselors are valuable back-ups, but I'm a simpleton and believe that we need to take responsibility for ourselves and each other to play a bigger part in the maintenance of our sanity and humanity in the field.

Someone mentioned only knowing EMS suicides who pulled the plug due to family problems. How often do we lose track of the fact that it is most often the layers of protective armor we put on at work that we can't take off when we get home that cause so much of the craziness that leads to complete breakdown?


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## mycrofft (Jul 15, 2012)

I think often the wrong people get into EMS, especially at the volunteer or EMT-B level. It is something they are drawn to as a means to address some need they have for excitement, or to feel in control, or address some trauma they had before (a loved one dying, a near-death experience). These folks are the ones who marshal on and get the mask stuck on their face. 

Wanting to get into it to attract the opposite sex (gender) is healthy compared to those. Even a little sadism is fine if it is overlain with training and an interest in doing the job right.

Happens in law enforcement too. I've been worried about some of the officers I served with for twenty years who retired from the department to a house populated by the ghosts of two divorces, estranged grown offspring, and maybe a string of girlfriends or boyfriends seen through a haze of alcohol. So far one died of a MI, no suicides that I know of.

Knock on wood.


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