# EMT and mental health



## ellexruth (Dec 30, 2019)

Hey all,

I'm new to the site. I'm very passionate about EMS and after a year of solid pondering I decided to go for it. I'm enrolled at a school and starting in mid-January. I literally couldn't be more thrilled. However, I'm diagnosed with bipolar II, anxiety and ADD. I've been stable on medications for quite some time now. I'm really anxious about pursuing this type of career - I don't have any self-doubt, but I'm afraid about any bias I might face either at school or in the hiring process or even while working. Is it best not to disclose this sort of information officially? Does anybody else have a mental illness and is an EMT/paramedic? It's just after high school (graduated 2007), I felt very pressured to go to college. After almost 10 years and like 6-7 majors I just gave up because I was wasting a colossal amount of money. : /
But now I finally feel real passion about something, and I don't want to set myself up for disappointment.


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## DrParasite (Dec 30, 2019)

Plenty.  Our field is full of people with mental disorders. Seriously.  One of my favorite partners has a history of depression, and jumped off a bridge.  and now he has an MBA and is one of the best instructors I know, and we got along great on the ambulance.  And I would trust him more than I would trust many other providers.

Here is the bottom line: does your diagnosis prevent you from doing the job?  Does your medicine keep you (pardon the phrase) sane?  Can you work days, night, long shifts, and deal with a lot of physical and emotional crap?  If the answer is no, yes, and yes, and you still want to work in EMS, than go for it.

Would I tell someone in the interview process what your mental history is?  no.  on a physical, would i list my medications that I take and why?  yes.

I wouldn't hide it, but I wouldn't broadcast it to people who don't need to know, because, quite honestly, it's none of their business (just like any other medications you take).  As long as it doesn't affect your job, there is no need for anyone else to know.

That all being said, there is nothing wrong with having mental health issues.  Yes, there is a stigma associated to it (especially on the job acquired ones), but places like the Code Green Campaign are working on ending it, and supporting getting help with it.  Everyone has medical history, and it's your business who you share it with, and who you don't.  

As long as you can do the job, and don't let it interfere with school, you will be fine.


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## mgr22 (Dec 30, 2019)

Ellexruth, I agree with DrParasite. I'll just add that I've known several paramedics with histories of depression and several who were treated for it. I also know five who attempted suicide, two of whom were successful. I'm not sure any of us here are qualified to assess your chances of maintaining your health, so you'll have to do that. Just remember that the stressors in EMS are greater than those in most occupations. I'm not saying you couldn't succeed; I'm just saying that if I were, say, hearing impaired, I probably wouldn't take violin lessons.

If you do proceed with EMS, I suggest you tell the truth about your medical history, but only when asked. Good luck with whatever you pursue.


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## ellexruth (Dec 30, 2019)

DrParasite said:


> Plenty.  Our field is full of people with mental disorders. Seriously.  One of my favorite partners has a history of depression, and jumped off a bridge.  and now he has an MBA and is one of the best instructors I know, and we got along great on the ambulance.  And I would trust him more than I would trust many other providers.
> 
> Here is the bottom line: does your diagnosis prevent you from doing the job?  Does your medicine keep you (pardon the phrase) sane?  Can you work days, night, long shifts, and deal with a lot of physical and emotional crap?  If the answer is no, yes, and yes, and you still want to work in EMS, than go for it.
> 
> ...



Thank you so much! I'm in the process of completing my physical for school (it's all filled out, except for a letter from my psychiatrist and meds that I take...). I didn't tell BEMS (the state bureau of emergency medical services --I'm in Louisiana) but I didn't know if I should disclose my meds and why on my physical. Thank you!


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## ellexruth (Dec 30, 2019)

mgr22 said:


> Ellexruth, I agree with DrParasite. I'll just add that I've known several paramedics with histories of depression and several who were treated for it. I also know five who attempted suicide, two of whom were successful. I'm not sure any of us here are qualified to assess your chances of maintaining your health, so you'll have to do that. Just remember that the stressors in EMS are greater than those in most occupations. I'm not saying you couldn't succeed; I'm just saying that if I were, say, hearing impaired, I probably wouldn't take violin lessons.
> 
> If you do proceed with EMS, I suggest you tell the truth about your medical history, but only when asked. Good luck with whatever you pursue.



Thanks for your response! Believe me, I've done a lot of soul searching on if I could handle the things I would see / encounter on the job. I feel like a lifetime of dealing with certain traumas has made me able to handle. A lot of people have asked me if I could handle all of it, actually. I feel like that's part of the calling I feel towards EMS. I feel like I could handle a lot more sh** the most people because of what I've been through and because of that I feel like I could make a difference.


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## ellexruth (Dec 30, 2019)

DrParasite said:


> Plenty.  Our field is full of people with mental disorders. Seriously.  One of my favorite partners has a history of depression, and jumped off a bridge.  and now he has an MBA and is one of the best instructors I know, and we got along great on the ambulance.  And I would trust him more than I would trust many other providers.
> 
> Here is the bottom line: does your diagnosis prevent you from doing the job?  Does your medicine keep you (pardon the phrase) sane?  Can you work days, night, long shifts, and deal with a lot of physical and emotional crap?  If the answer is no, yes, and yes, and you still want to work in EMS, than go for it.
> 
> ...



Also, thank you for the Code Green Campaign resource.


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## DrParasite (May 18, 2021)

While I try to avoid sharing commercial links, I'm going to make an exception here (and @ffemt8978 can remove it if he feels it's inappropriate).  It's a military-supporting company & website, but I think it's apt here too.  I'm thinking of buying two of these shirts myself.









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					tilvalhallaproject.com
				












						Mental Health Awareness
					

We make plaques for the families of Fallen Heroes and fund it with apparel.




					tilvalhallaproject.com
				




and I do have this on my desk at work:








						I Will Never Quit - Laser Etched Tumbler
					

Keep Your Cold Drinks Cold, and Your Warm Drinks Warm with this 30oz. tumbler.  Nothing sucks more than your ice melting or cold coffee, right? Drinks will stay cold for 24 hours or hot for 9 hours. Our Tumblers are made from double-walled, vacuum insulated stainless steel and are laser etched...




					tilvalhallaproject.com


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## ffemt8978 (May 18, 2021)

DrParasite said:


> While I try to avoid sharing commercial links, I'm going to make an exception here (and @ffemt8978 can remove it if he feels it's inappropriate).  It's a military-supporting company & website, but I think it's apt here too.  I'm thinking of buying two of these shirts myself.
> 
> 
> 
> ...


I'm okay with it.  While your post was in response to a spammer, you're post isn't spam.


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## HunterTMars (May 18, 2021)

ellexruth said:


> Hey all,
> 
> I'm new to the site. I'm very passionate about EMS and after a year of solid pondering I decided to go for it. I'm enrolled at a school and starting in mid-January. I literally couldn't be more thrilled. However, I'm diagnosed with bipolar II, anxiety and ADD. I've been stable on medications for quite some time now. I'm really anxious about pursuing this type of career - I don't have any self-doubt, but I'm afraid about any bias I might face either at school or in the hiring process or even while working. Is it best not to disclose this sort of information officially? Does anybody else have a mental illness and is an EMT/paramedic? It's just after high school (graduated 2007), I felt very pressured to go to college. After almost 10 years and like 6-7 majors I just gave up because I was wasting a colossal amount of money. : /
> But now I finally feel real passion about something, and I don't want to set myself up for disappointment.


Hi there.... a couple of things..

First, I have ADD and depression and have worked in EMS for 20 years. I work for a large EMS agency and have worked in high ranking positions including management and education. So yes, you can be successful but there can also be obstacles and biases that can create barriers at times. Overall, the Americans with Disabilities Act will protect you from discrimination, but remember, the employer is only required to make a “reasonable” accommodation, and in some cases that may mean a non field position.

Finally, almost all EMS agencies require that their employees have a valid Department of Transportation physical exam with a Medical Examiner’s Certificate. In some cases medical conditions or medications can exempt you from field work. Some examples; Seizure conditions, Insulin Dependent Diabetes, visual or hearing impairment and chronic use of benzodiazepines and/or other CNS depressants. Depending on the examiner, they may decide not to provide certification. It simply depends on how closely they follow DOT regulation. The good news is that many companies provide the DOT physical during the early phases of hiring, so often times if there is an issue with obtaining the certificate you know this before investing a significant amount of time in EMS. Just make sure you’re honest regarding your meds and conditions during your DOT physical because failure to disclose those conditions to the examiner can nullify your certification and expose you to potential liability.

Happy to help if you have other questions.


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## Comfort Care (May 21, 2021)

Prior to switching careers I had the same doubts. I suffered with severe social anxiety, alcoholism(not out of the woods yet), and depression. I remember having severe panic attacks prior to going to EMT class, self medicating etc.  It was bad, I almost tapped out, but as time went on and the more I put myself out there, I realized my anxiety was starting to get better and really enjoyed working on the ambulance. EMS helped mold me into a more confident EMT. 

My advice is to do it!! This is your dream and passion. Start with EMT, get some experience and see if you want to continue to Paramedic. EMT will open up alot of doors to the healthcare field. I ended up going Nursing SICU/ Emergency, but I miss EMS.


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## NomadicMedic (May 21, 2021)

NateJack745 said:


> Finally, almost all EMS agencies require that their employees have a valid Department of Transportation physical exam with a Medical Examiner’s Certificate.



Just as a point of interest, there is NOTHING like this in any state where I’ve worked in EMS. Washington. Delaware. Pennsylvania. Georgia.

Sounds like more California stuff


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## Rano Pano (May 21, 2021)

NomadicMedic said:


> Just as a point of interest, there is NOTHING like this in any state where I’ve worked in EMS. Washington. Delaware. Pennsylvania. Georgia.
> 
> Sounds like more California stuff


More specifically LA County


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## ffemt8978 (May 21, 2021)

Rano Pano said:


> More specifically LA County


The OC doesn't count anymore?


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## Rano Pano (May 22, 2021)

ffemt8978 said:


> The OC doesn't count anymore?


Do they do the DOT too? I couldn’t remember.
But yes, it counts haha


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## akflightmedic (May 22, 2021)

No DOT exam in SC, FL, LA, OR, AK, ME, AZ, or NM. Every other state I have worked in was under emergency provisions, so I cannot state for fact. 

It's always fun when Californians just blanket the rest of their country with what they think is normal...nope, it is only YOUR normal, and typically, CA is the ONLY one doing it. LOL


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## DrParasite (May 23, 2021)

akflightmedic said:


> It's always fun when Californians just blanket the rest of their country with what they think is normal...nope, it is only YOUR normal, and typically, CA is the ONLY one doing it. LOL


I would also add nothing like that exists in NJ, NY, NC, VA, and PA.  Not that it's not a bad idea, but rather, LA county seems to be unique in what they require to get a minimum wage job on an ambulance.

The first time I ever heard of a Medical Examiner’s Certificate to drive an ambulance was on this website.


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## Mitchellmvhs (May 23, 2021)

DrParasite said:


> I would also add nothing like that exists in NJ, NY, NC, VA, and PA.  Not that it's not a bad idea, but rather, LA county seems to be unique in what they require to get a minimum wage job on an ambulance.
> 
> The first time I ever heard of a Medical Examiner’s Certificate to drive an ambulance was on this website.


California is pretty intense with the certifications lol. I needed the Med Examiners to work in Orange County as well as Riverside. Our DMV in California requires the Medical Examiners In order to even receive an ambulance drivers license if I remember correctly.


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## HunterTMars (May 24, 2021)

NomadicMedic said:


> Just as a point of interest, there is NOTHING like this in any state where I’ve worked in EMS. Washington. Delaware. Pennsylvania. Georgia.
> 
> Sounds like more California stuff


Your company doesn’t require a Department of Transportation physical in order to drive an ambulance? Ok. Do you have a physical through “employee health” or “occupational med”?


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## HunterTMars (May 24, 2021)

akflightmedic said:


> No DOT exam in SC, FL, LA, OR, AK, ME, AZ, or NM. Every other state I have worked in was under emergency provisions, so I cannot state for fact.
> 
> It's always fun when Californians just blanket the rest of their country with what they think is normal...nope, it is only YOUR normal, and typically, CA is the ONLY one doing it. LOL


Assumptions are also fun.  Not from California. And you are incorrect.  Some of the states above do require a DOT certification.  They may have different names for example, Commerical Driver's License (CDL).


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## DrParasite (May 24, 2021)

NateJack745 said:


> Assumptions are also fun.  Not from California. And you are incorrect.  Some of the states above do require a DOT certification.  They may have different names for example, Commerical Driver's License (CDL).


Are you saying that if you are in those states, you need a CDL to drive an ambulance?  Because I'm pretty sure that isn't the case, but I'll let @akflightmedic answer definitively.   But we aren't talking about CDLs, so I am guessing that is unrelated info



NateJack745 said:


> Your company doesn’t require a Department of Transportation physical in order to drive an ambulance? Ok. Do you have a physical through “employee health” or “occupational med”?


many/most companies require a physical, however, they don't need the medical examiner's certificate which runs contrary to your claim of "almost all agencies require".  in case you want to say you didn't say that, I have it quoted below for your reference:


NateJack745 said:


> Finally, almost all EMS agencies require that their employees have a valid Department of Transportation physical exam *with a Medical Examiner’s Certificate.*


so requiring a pre-employment physical and requiring a medical examiner's certificate to drive the ambulance are two completely different things   If you want to be picky, just because you can't drive the ambulance, doesn't mean you are ineligible for employment.


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## HunterTMars (May 24, 2021)

DrParasite said:


> Are you saying that if you are in those states, you need a CDL to drive an ambulance?  Because I'm pretty sure that isn't the case, but I'll let @akflightmedic answer definitively.   But we aren't talking about CDLs, so I am guessing that is unrelated info
> 
> 
> many/most companies require a physical, however, they don't need the medical examiner's certificate which runs contrary to your claim of "almost all agencies require".  in case you want to say you didn't say that, I have it quoted below for your reference:
> ...





DrParasite said:


> Are you saying that if you are in those states, you need a CDL to drive an ambulance?  Because I'm pretty sure that isn't the case, but I'll let @akflightmedic answer definitively.   But we aren't talking about CDLs, so I am guessing that is unrelated info
> 
> 
> many/most companies require a physical, however, they don't need the medical examiner's certificate which runs contrary to your claim of "almost all agencies require".  in case you want to say you didn't say that, I have it quoted below for your reference:
> ...


No, I’m saying that at least one of the states listed does require a medical examiner’s certificate. Also, I have no intent of claiming I didn’t say something that I said - especially in print. I guess for us to really know we would need to look at all ambulance service requirements in the nation to determine if my claim is correct or close to correct - but I was under the impression that they did. If not, then I’m incorrect and I am ok admitting that.  A DOT physical with a medical examiner’s certificate is qualified to have a CDL in some states - even if you drive a semi truck.

I do find it shocking that people approved to drive ambulances may not have to have a medical clearance. Seems to me that it would be prudent to assure that the operator is medically cleared to drive an ambulance. But, alas, what do I know, I mean, I’m merely an EMTLIFE forum crew member.


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## mgr22 (May 24, 2021)

NateJack745 said:


> But, alas, what do I know, I mean, I’m merely an EMTLIFE forum crew member.



I think that's higher up the food chain than being a member of Space Force.


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## NomadicMedic (May 24, 2021)

NateJack745 said:


> Your company doesn’t require a Department of Transportation physical in order to drive an ambulance? Ok. Do you have a physical through “employee health” or “occupational med”?



No.


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## HunterTMars (May 24, 2021)

NomadicMedic said:


> No.


Fascinating.


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## ffemt8978 (May 25, 2021)

HunterTMars said:


> No, I’m saying that at least one of the states listed does require a medical examiner’s certificate. Also, I have no intent of claiming I didn’t say something that I said - especially in print. I guess for us to really know we would need to look at all ambulance service requirements in the nation to determine if my claim is correct or close to correct - but I was under the impression that they did. If not, then I’m incorrect and I am ok admitting that.  A DOT physical with a medical examiner’s certificate is qualified to have a CDL in some states - even if you drive a semi truck.
> 
> I do find it shocking that people approved to drive ambulances may not have to have a medical clearance. Seems to me that it would be prudent to assure that the operator is medically cleared to drive an ambulance. But, alas, what do I know, I mean, I’m merely an EMTLIFE forum crew member.


First, the DOT physical/medical clearance required to drive a semi-truck is required and specified in CFR 391.41.  There is no CFR that requires it to drive an ambulance, since the don't meet the 26000lb minimum gross vehicle weight that requires a class B CDL (some fire apparatus meets this requirement, but not many).  The other thing that would require a CDL of some sort is on vehicles with air brakes.  Not many ambulances out there with those.  A state requiring a DOT physical/medical certification or even a CDL to drive an ambulance is doing so because they a) can, b) micromanage, or c) see some benefit in it.

Second, your "forum crew member" title is based soley on post count as described in this post:   https://emtlife.com/threads/answers-about-the-forum.2040/post-25674


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## akflightmedic (May 25, 2021)

HunterTMars said:


> Assumptions are also fun.  Not from California. And you are incorrect.  Some of the states above do require a DOT certification.  They may have different names for example, Commerical Driver's License (CDL).



Comprehension is helpful as well, because I did not state YOU were from CA. What I did was tie the comment to a common occurrence on this site for a laugh. I ended my statement with "typically, CA is the only one doing it" which basically opened the door for you to reply with whatever state you are referencing particularly. 

Anyways, please advise which state I listed requires a DOT cert or CDL, as I speak from personal experience of being licensed in all those states and operating an ambulance within those states. Some employers required a medical physical, some did not. None of the employers in any of those states sent me to an occupational medicine doctor for a specific DOT or Medical Examiners certificate or whatever you want to call it. It just did not happen. 

There are HUGE differences between pre-employment physical and what you are stating.


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## HunterTMars (May 25, 2021)

ffemt8978 said:


> First, the DOT physical/medical clearance required to drive a semi-truck is required and specified in CFR 391.41.  There is no CFR that requires it to drive an ambulance, since the don't meet the 26000lb minimum gross vehicle weight that requires a class B CDL (some fire apparatus meets this requirement, but not many).  The other thing that would require a CDL of some sort is on vehicles with air brakes.  Not many ambulances out there with those.  A state requiring a DOT physical/medical certification or even a CDL to drive an ambulance is doing so because they a) can, b) micromanage, or c) see some benefit in it.
> 
> Second, your "forum crew member" title is based soley on post count as described in this post:   https://emtlife.com/threads/answers-about-the-forum.2040/post-25674


Yes, I understand my title - I was trying to engage in some tongue ‘n cheek behavior. Everyone on this website considers themselves  an expert - it’s like EMS Facebook ya know.

Look, this is simple - I was trying to help a young aspiring EMT on information I believed to be true and am aware that my company is not the only company requiring this. I will, in the future, be very careful about any advice given on here.


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## ffemt8978 (May 26, 2021)

HunterTMars said:


> Yes, I understand my title - I was trying to engage in some tongue ‘n cheek behavior. Everyone on this website considers themselves  an expert - it’s like EMS Facebook ya know.
> 
> Look, this is simple - I was trying to help a young aspiring EMT on information I believed to be true and am aware that my company is not the only company requiring this. I will, in the future, be very careful about any advice given on here.


Feel free to keep giving advice...just steer clear of absolutes and thinking that they way you're familiar with is the only way.  This goes for everyone here.


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