# Why we don't talk.



## NomadicMedic (Jul 15, 2016)

I think a lot of us don't talk about our problems or stress or suicidal thoughts because we've seen how disrespectful our EMS coworkers can be when they encounter the mentally ill. And we've all been in the facilities where xyprexa flows like water and the medicated zombies shamble from room to room. Scary to ever think about winding up there.  After listening to an EMT make fun of a patient we just dropped off, I'm not sharing anything ...


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## TransportJockey (Jul 15, 2016)

This is a big reason the Code Green Campaign is aiming to help break the stigma of speaking out


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## SandpitMedic (Jul 16, 2016)

Yeah, but those thoughts and troubles are out there. We are the step children... So there are less resources for private EMS for us to deal with such things. It's a sad state of affairs.

Also, yes.... None of us want to be on the other end of that psych hold.


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## nightmoves123 (Jul 16, 2016)

The US government puts all of its resources into the military, and for fear of political repercussions they put on the facade of being seen to care for former military veterans via the VA. The reality is <10% of the military are fighting/spearhead soldiers, much less are involved in combat, much less than that are involved in _regular_ combat. The government and military campaign to be seen to helping those personnel has gathered so much publicity that everyone associates the military in general with the term 'PTSD'.

Flip that around- first responders within the US frequently are put in hazardous, stressful and traumatic situations on a daily basis- yet the same level of support is not there as for a large body/group of people who do not see/or are put in the same constant levels of stress or trauma. Politics...EMTs and Paramedics not getting a decent support system for these issues will never advance to the level the military has- even though in my opinion first responders require it MORE.


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## vc85 (Jul 16, 2016)

It's not stigma if it really is as bad as people claim it to be. 

For example, especially if someone is a volunteer admitting to mental health issues could ruin multiple careers especially if the persons paid position is in law enforcement or has a security clearance. 

This could then cause a vicious cycle of PTSD -> losing job -> depression etc. 

No one has ever been able to give me a satisfactory answer as how to avoid this situation


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## NomadicMedic (Jul 16, 2016)

A good friend of mine who had a series of bad calls called me one night and was in tears. He was afraid to talk to anyone because he didn't think he'd be able to ever get past any recorded instance of mental health treatment when he applied for a new job. 

The calls were bad, but the fear of talking to anyone was worse.


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## Tigger (Jul 16, 2016)

Fortunately we do not have much of an issue here with staff denigrating the mentally ill. While it happens, most of our people are very, very good about being empathetic with mental health patients.

Nonetheless I still find it intimidating to talk to most of my coworkers who are veterans of the industry who have seen many worse things than I. Rather than leveraging their experiences, they seem more likely to provide "you think that's bad, back in 99 I had a patient who was twice as jacked up!" That stings. I understand there are worse experiences, but that isn't what we're talking about.

After having a recent and rough call that was bothering me a little bit I brought it up informally to see how it felt to talk about that. That part helped, being forced to defend how we treated the patient and the subsequent nitpicking was not. 

I honestly find it more helpful to talk with non-EMS folk, I just don't like the idea of making them listen to what can be traumatic things, but they are less likely to judge.


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## RocketMedic (Jul 17, 2016)

I would never admit to weakness or a need for treatment. It would be career suicide.


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## gotbeerz001 (Jul 17, 2016)

RocketMedic said:


> I would never admit to weakness or a need for treatment. It would be career suicide.


Still beats actual suicide. 


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## vc85 (Jul 17, 2016)

The point I am trying to make is that in those situations is that losing a career for seeking treatment can lead to actual suicide just like the PTSD itself. It is a recognized psychological fact that especially for men their identity is tied more strongly to their career and losing the career can cause depression which is a major risk factor for suicide. It is a catch 22. 

The progressions could be

Incident -> PTSD -> suicidal ideation

Or 

Incident -> PTSD -> treatment -> deemed unfit for duty/ lose clearance-> depression -> suicidal ideation. 

Notice the end result is the same.  Or at the very least you get into a feedback loop where the depression begets more treatment which begets more depression because it would be harder to get your job back and so forth. 

I would love for someone SAMHSA, NAMI, code green campaign to actually address this problem but they don't seem to care. For me the ideal solution would be that mental health treatment would not effect employment suitability in all but the most extreme circumstances. In those events, if a person is to be taken off the road they are to be reassigned to meaningful work with a treatment plan designed to get them back to full duty as soon as possible. If that is impossible they will be given the option of permanent reassignment or medical retirement just like for a physical injury

Some or most public services already do this, the private ones are much more of a wildcard.


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## Daniel G (Jul 18, 2016)

What is this degrading of the mentally ill your speaking of??


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## Daniel G (Jul 18, 2016)

gotshirtz001 said:


> Still beats actual suicide.
> 
> 
> Sent from my iPhone using Tapatalk



Suicide is a persons right to act and should be respected . As counsel, I highly advise against it, but tacit knowledge of the world has shown me that everyone has a breaking limit.


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## Bullets (Jul 18, 2016)

Because PTSD is an entirely subjective thing. So while you and a partner my be on the same call, you might have issues and your partner may not. So its hard to talk to each other when there is a decent chance the reply is going to be something like "It wasnt that bad, why are you upset about it"


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## gotbeerz001 (Jul 18, 2016)

Daniel G said:


> Suicide is a persons right to act and should be respected . As counsel, I highly advise against it, but tacit knowledge of the world has shown me that everyone has a breaking limit.


"Right to die" issues such as terminal illness and the like get all of my support. 

Somebody killing themselves over EMS - whether PTSD or some notion that life is over if you are no longer fit to endure the abuse of an industry that does not care about you - is a hard pill for me to swallow. I am an advocate for education, understanding and investing in those who endure the suffering. To view this job as a calling, which without it life is not worth living, is a fool's move. 

For every responder who commits suicide, I see that as an industry/culture failure to take care of those who needed it. 

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## Underoath87 (Jul 18, 2016)

Daniel G said:


> What is this degrading of the mentally ill your speaking of??



You've never worked with someone who, after transporting a psych patient, would say stupid, insensitive things like "God, that guy was a ****ing psycho.  What kind of idiot would try to kill themselves over... [blah blah blah]"?  

Must be nice...


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## Reynolds One (Jul 18, 2016)

RocketMedic said:


> I would never admit to weakness or a need for treatment. It would be career suicide.



Really? Have you seen people's careers suffer that much because they came forward about their issues?

I'm not challenging you, I'm still a student so I'm coming from a place of ignorance to the "real world" of EMS.


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## TransportJockey (Jul 18, 2016)

Reynolds One said:


> Really? Have you seen people's careers suffer that much because they came forward about their issues?
> 
> I'm not challenging you, I'm still a student so I'm coming from a place of ignorance to the "real world" of EMS.


There were medics who came forward in Canada and had their licenses pulled.


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## RocketMedic (Jul 18, 2016)

Reynolds One said:


> Really? Have you seen people's careers suffer that much because they came forward about their issues?
> 
> I'm not challenging you, I'm still a student so I'm coming from a place of ignorance to the "real world" of EMS.



Would you hire someone who admitted to PTSD or stress to the point of being unable to work?


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## Reynolds One (Jul 18, 2016)

RocketMedic said:


> Would you hire someone who admitted to PTSD or stress to the point of being unable to work?



If a person applied for a job, and it was known, or more accurately clinically shown, that the patient suffered from PTSD to the extent that they could not do the job, then no (assuming that that decision does not violate the American's with Disabilities Act).

But, are we talking about hiring someone with known, documented issues, or a current employee who comes forward?

If an employee, who otherwise is a good, productive employee who does his/her job, admits to their employer that the obvious, well known stresses of the job are creating problems for them, and that employer fires them...not only is that ridiculous, but that company may very well be violating law.

I'm not doubting it's happend, but I absolutely believe that in those cases, there had to be something more to it. I mean, think about a situation like that, if an employee was fired (after admitting to suffering psychologically and wanting treatment) and then went the legal route and sued for wrongful dismissal/termination. How could that company defend itself in the eyes of a jury (assuming it got that far), or the public for that matter? If you knew a company treated their people with that kind of callous disregard for the well-being of their employees, would you want to work for them? 

I saw guys in the military who "silently suffered" - the keyword there being "suffered." I understand the fear of opening about these things, but I would never advise someone to NOT come forward.


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## RocketMedic (Jul 18, 2016)

That's the thing though. You assume that there need be a direct causal relationship. Truth is, in most states, you can be terminated for anything or nothing and the employer can find justification to separate employees. Yes, plenty of good companies take care of their people...but plenty more don't. And finding a job in this industry with that reputation is a greater challenge.


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## Reynolds One (Jul 18, 2016)

That's a good point. Small world, and word gets around.


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## Seirende (Jul 20, 2016)

DEmedic said:


> I think a lot of us don't talk about our problems or stress or suicidal thoughts because we've seen how disrespectful our EMS coworkers can be when they encounter the mentally ill. And we've all been in the facilities where xyprexa flows like water and the medicated zombies shamble from room to room. Scary to ever think about winding up there.  After listening to an EMT make fun of a patient we just dropped off, I'm not sharing anything ...



I have around five people that I can talk to when I'm having a rough time. These are all people that I've know for years and trust completely. EMS or not, I don't trust just anyone to respond appropriately when I tell them that I am hurting at that moment. When I'm outside of that stress/depression/suicidal ideation, I'm happy to be open about my mental health struggles, because it might help someone else or give someone a new perspective. When I hear fellow EMS professionals denigrate the mentally ill, it's not so much that it prevents me from talking, but that it gives my depressed brain another way to tell me that I'm obviously a worthless piece of sh*t. Words hurt.

On the positive side, I've received a ton of support through words. Sometimes I just need someone on the outside to tell me that my brain is lying. Side note: shoutout to EMTLife for letting me know that I'm not the only one in EMS who goes through these things. I'm not a wuss after all! 



vc85 said:


> The point I am trying to make is that in those situations is that losing a career for seeking treatment can lead to actual suicide just like the PTSD itself. It is a recognized psychological fact that especially for men their identity is tied more strongly to their career and losing the career can cause depression which is a major risk factor for suicide. It is a catch 22.



Even apart from predisposing a person to losing the desire to live, having your worth/identity tied to something like your job just doesn't seem healthy.



Underoath87 said:


> You've never worked with someone who, after transporting a psych patient, would say stupid, insensitive things like "God, that guy was a ****ing psycho.  What kind of idiot would try to kill themselves over... [blah blah blah]"?
> 
> Must be nice...



That would be nice...

After years of trying to pretend that depression and suicidal ideation don't really affect my life, I've come to the realization that I need to work with what I have. When I'm in a bad place, I need to talk to my trustworthy friends and stay away from certain conversations with people who might knock me further down. When I'm in a good place, I can go and have those conversations and just generally aggressively ignore stupidity. If a service doesn't hire me or fires me because of my mental illness -- first, I'm pretty sure that would be illegal; second, probably not a good place to work anyway, and they're out one good provider. There are plenty of employers in this field.


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## chriscemt (Jul 20, 2016)

Reynolds One said:


> I mean, think about a situation like that, if an employee was fired (after admitting to suffering psychologically and wanting treatment) and then went the legal route and sued for wrongful dismissal/termination.



You don't have to be fired to suffer negatively from what your employer might know about your mental health.


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## QRScomplex (Jul 20, 2016)

It's one of those contradictions that I see in EMS that I don't see in my day job in the private sector. If someone needs help to do their job you give it to them. You put them on a track to try and address the problem but the goal is always to try and set the individual up for success and not failure. Sometimes even with the best of intentions I have to make the assessment that the person isn't suited to do the job. But that's only after trying to work with the individual to overcome the issue. 

In EMS we are trained to care for others. To look at their needs and to try and make their terrible day less of one. But what we don't do is a good job of taking care of each other. It's ok to be empathetic and understanding and sensitive to a patient but not one another? It would seem that we would take care of each other first and the patient second or at least take care of each other as well as we take care of our patients. If one of us has an issue we all should share in that issue. Why don't we want to encourage each other to talk about the issues?

One of the issues I see in changing this paradigm is the desire in ourselves to fix or solve problems. EMS are trouble shooters. We look at problems and through the practice of medicine apply intervenes to improve the situation. However when dealing with issues of the mind a lot of times what we need aren't problem solvers but people to be good listeners and empathetic. Many times the problems that we face mentally can't be fixed with some magic bullet comment or adage. It takes time to talk through it, to understand it and most importantly to know there is a support system in place to ask for help and to receive the help that will most benefit that person (since everyone's needs are different we can't apply a one size fits all methodology). 

We need to do a better job to not only say we support each other but to actually then do support each other. That isn't to make a joke of everything and to keep things jovial at the station. That isn't to carry on a stoic bravado to save face. That isn't to bury your emotions to give the false sense of stability. To make this change we need to both be comfortable and able to be approachable by someone in need but to also make yourself vulnerable to openly and candidly talk about your own issues with others. It's a two way street here and it requires a change in how we support each other and how we let others in to our own inner workings. 


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## Daniel G (Jul 22, 2016)

You wanna talk about suicides?
SWIM was a patient at Walter Reed/ Abrams Hall. Ive been around alot of suicides.

I never like remember it as taboo, but rather a rational/irrational choice.


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## Daniel G (Jul 22, 2016)

Daniel G said:


> You wanna talk about suicides?
> SWIM was a patient at Walter Reed/ Abrams Hall. Ive been around alot of suicides.
> 
> I never like remember it as taboo, but rather a rational/irrational choice.


Alot of those people were in psychological pain/hell. I think about it all the time, except i have way better reasons to live.


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## Daniel G (Jul 22, 2016)

Daniel G said:


> suicide because you lost your job or because of your job is dramatic?
> SWIM was a patient at Walter Reed/ Abrams Hall. Ive been around alot of suicides.
> 
> I never like remember it as taboo, but rather a rational/irrational choice.


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## Daniel G (Jul 22, 2016)

I keep messing this up when i edit. Sorry


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## DrParasite (Jul 22, 2016)

Seirende said:


> On the positive side, I've received a ton of support through words. Sometimes I just need someone on the outside to tell me that my brain is lying. Side note: shoutout to EMTLife for letting me know that I'm not the only one in EMS who goes through these things. I'm not a wuss after all!


You think your the only person in EMS who is crazy?  oh please, I took an abnormal psych class, that listed various mental illnesses, as well as their symptoms..... the professor couldn't understand why i was smiling so much; my supervisor showed signs of 3 of them, my partner had others, most of my coworkers demonstrated the signs of one disorder or another.  And that doesn't include the functional alcoholics.....

But in all seriousness, I totally agree, talking about things is career suicide.  If you can't handle A, can you handle B or C?  if you are shaken up after A, can I trust you to handle A again?

Even worse, would you want to be partnered up with the EMT or Paramedic who has spent time in the psych ward?  Or what would you think of a coworker who you saw in the psych ward?  It's a small world, and people talk, probably more than they should, even if they don't know all the facts.

I love this guy's art work (http://www.dansunphotos.com/), because most of us have been in this position :
	

	
	
		
		

		
			

























If you can't do the job because of what the profession has done to your mind, what options do you have?  And with many EMS workers working 60 to 80+ hour weeks to pay their bills, the problems don't go away, but they just try to ignore them to see what happens.  and You can imagine the results


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## Tigger (Jul 23, 2016)

DrParasite said:


> But in all seriousness, I totally agree, talking about things is career suicide.  If you can't handle A, can you handle B or C?  if you are shaken up after A, can I trust you to handle A again?


This to me is the root of the issue. You can be roughed up by bad calls but still be able to run them. There is no correlation between the two but we assume there must be.



> Even worse, would you want to be partnered up with the EMT or Paramedic who has spent time in the psych ward?  Or what would you think of a coworker who you saw in the psych ward?  It's a small world, and people talk, probably more than they should, even if they don't know all the facts.


I had a partner that did, there were no issues. She got the treatment she needed and was a fine paramedic and easy to work with. But might as well just assume that she'd be damaged goods right?

So many make assumptions about mental illness and the ways people cope. Not everyone copes the same way and to suggest that someone is a weaker provider for the way sought help would be unfortunate.


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## RocketMedic (Jul 24, 2016)

I've literally never thought about ghosts or anything in the back of trucks. I won't lay on the cot because dirty people get put there, but I have never, ever had a problem with ghosts or any of that crap.


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## cruiseforever (Jul 24, 2016)

I had a severe mental breakdown approx. 20 years ago.  I was going thru a divorce that I did not want.  A couple of my co-workers became concerned about my time off activities.  They voiced their concern to our Medical Director and Ambulance Director.  I was asked by them to be assessed by a mental health worker.  I was diagnosed as being depressed and placed on Paxil. It helped a little. 

 Until the day it struck me on how much I was missing my kids.  I was going shopping for a birthday present for my daughter and I can mark the spot on the highway to this day, that if I had a gun or a semi was on the road I would have used them to kill myself.  Knowing that I had sunk that low, I drove to ambulance director's office and told him what had just happened.  He drove me 30 miles to be admitted to a pysch. unit.  While I was there I was visited by a couple of close co-workers and felt very supported by them.   I am very blessed to work at a place that does care about it's employees. But with that being said I will not say anything to new co-workers.

I feel working EMS gives me a reason to keep moving forward.  I have worked  as a medic for over 25 years.  I have never had a thought of harming myself due to a call or a build up of stress due to EMS.  If anything it keeps showing me how good I have it.


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## ViolynEMT (Jul 24, 2016)

I think that looking for someone to talk to should be seen as a healthy thing. It is worse to keep things inside because of the fear that one will be seen as weak or unfit. They may end up unfit to do the job if they DON'T  talk about it. If something affects one of us, it doesn't automatically qualify us as unfit for the profession. That is the bottom line. I think what DEMedic (correct me if I'm wrong) was saying is that we should feel "safe"  talking to someone without getting a stigma attached to us. Being affected by a call or by calls does not mean we are mentally ill or weak. We are human. Keeping it inside could cause mental illness. We need to stop judging and start supporting one another.


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## sack jears (Jul 24, 2016)

I'm bipolar and the funny thing is I've been on the other end of that psych hold and I've also been on zyprexa. I wouldn't want what happened to me to happen to anyone else, and I definitely wouldn't want it to happen to me again. I don't have a problem with speaking out and already having a psychologist is helpful. I don't know what it's gonna look like when I start applying to agencies and they start looking into my past regarding my mental health. I hope it doesn't screw me over in the long run. It's sad to be persecuted over something that's happening internally that isn't your fault at all.


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## ViolynEMT (Jul 24, 2016)

I'm just going to put this out there. I'm here if anyone needs to talk. No judgement. I'm a good listener and I like to think that I'm compassionate.


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## zzyzx (Jul 25, 2016)

"There were medics who came forward in Canada and had their licenses pulled."

Huh, what? This idea that seeking treatment for depression or anxiety related to your EMS job will get you fired is nonsense. Your employer does not have a right to monitor your medical records. Nor would an employer be able to fire you simply because he overheard that you were under treatment for depression. This would make for a great lawsuit if they did.

That said, if your disability was preventing you from doing your job, then your employer could have legal standing to fire you, though even that would be a complicated situation that an employer would have to handle with care.


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## TransportJockey (Jul 25, 2016)

zzyzx said:


> "There were medics who came forward in Canada and had their licenses pulled."
> 
> Huh, what? This idea that seeking treatment for depression or anxiety related to your EMS job will get you fired is nonsense. Your employer does not have a right to monitor your medical records. Nor would an employer be able to fire you simply because he overheard that you were under treatment for depression. This would make for a great lawsuit if they did.
> 
> That said, if your disability was preventing you from doing your job, then your employer could have legal standing to fire you, though even that would be a complicated situation that an employer would have to handle with care.


The college of paramedics in their province pulled their tickets. I'll have to look wgeb im not drink


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## Drax (Jul 25, 2016)

Just talk, talk about things before they build up. Obviously not with your partner if they're a douche. Talk with your spouse, your best friend, a seasoned co-worker, mom or dad, instructors, strangers, strangers on a forum. Even if the call was just weird and not bad, even if the call was just bad and not weird. It is critical to speak up and to do so immediately, like debriefing immediately following whatever call, via phone, via anyone you can get a hold of if it is that bad.

Why talk even if it isn't bothering you? Well, it may be preemptive medicine, it might be practice before the big game.

If you are able to talk to your partner, you might be speaking up when they think they can't.

The scenario where the EMT was making fun of the patient you just dropped off...maybe they're coping with it the way that they know and maybe you could show them another way.

It might be rather obvious if the conversation randomly turns someone off, but I think you'll still get something out of it.


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## johnrsemt (Jul 26, 2016)

I really miss working places with people that have 'been there, done that'.
Used to be that we could sit and talk about bad runs, bad patients etc  and that would lessen a lot of stress.
Now I work with people that don't have a lot of experience, and if you try to talk then some of them take the info and try to get you in trouble with it


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## DrParasite (Jul 27, 2016)

Tigger said:


> This to me is the root of the issue. You can be roughed up by bad calls but still be able to run them. There is no correlation between the two but we assume there must be.
> 
> I had a partner that did, there were no issues. She got the treatment she needed and was a fine paramedic and easy to work with. But might as well just assume that she'd be damaged goods right?
> 
> So many make assumptions about mental illness and the ways people cope. Not everyone copes the same way and to suggest that someone is a weaker provider for the way sought help would be unfortunate.


I think I was a little unclear, and I will apologize if my post insinuated something other than my intent.  What I tried to say (and now see how it wasn't made clear) was the perception of speaking about rough calls is that you can't handle the next one.  It's an assumption in EMS, one often based more on rumors and speculation instead of reality and facts (but I know many EMS agency's rumor mills which spread inaccurate information faster than the local junior high school).

And for the record, one of my favorite people to work with suffered from depression, so much so that he jumped off one of our local bridges when he was younger.  15 or so years later, he's on the right medication, he's earned his masters degree, and he's one of the few people who I used to look forward to working with, because he was both a competent provided and a fun partner.

I will agree with you, many people will dismiss someone with a history of mental illness without getting to know them, or in a job interview, or if you are assigned to them and the rumor mill has already tarnished the guys reputation.


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## Tigger (Jul 29, 2016)

DrParasite said:


> I think I was a little unclear, and I will apologize if my post insinuated something other than my intent.  What I tried to say (and now see how it wasn't made clear) was the perception of speaking about rough calls is that you can't handle the next one.  It's an assumption in EMS, one often based more on rumors and speculation instead of reality and facts (but I know many EMS agency's rumor mills which spread inaccurate information faster than the local junior high school).
> 
> And for the record, one of my favorite people to work with suffered from depression, so much so that he jumped off one of our local bridges when he was younger.  15 or so years later, he's on the right medication, he's earned his masters degree, and he's one of the few people who I used to look forward to working with, because he was both a competent provided and a fun partner.
> 
> I will agree with you, many people will dismiss someone with a history of mental illness without getting to know them, or in a job interview, or if you are assigned to them and the rumor mill has already tarnished the guys reputation.



I think we're on the same page. Just a tough place to be. I'm happy my partner and I can talk about stuff, but the rest of my shift just can't or won't listen in a meaningful way.


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## Handsome Robb (Jul 29, 2016)

RocketMedic said:


> I would never admit to weakness or a need for treatment. It would be career suicide.



That's so far from the truth. 

You're perpetuating a myth that needs to die. If you truly are an EMS supervisor you need to lose that attitude. If you're a day laborer then lose it too. 

That's the attitude that ends with us in class A uniforms at funerals. 


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## RocketMedic (Jul 30, 2016)

Handsome Robb said:


> That's so far from the truth.
> 
> You're perpetuating a myth that needs to die. If you truly are an EMS supervisor you need to lose that attitude. If you're a day laborer then lose it too.
> 
> ...



I disagree with you. I don't think my plant would hire a laborer who claimed that work stress was a problem, and I really don't see most of EMS any differently. The myth is firmly rooted in reality.


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## SandpitMedic (Jul 30, 2016)

He has a point. 
They'll pull you off the line, and you'll lose your job. 
Somethings are better left unsaid to the man behind the desk. 

If you have problems, seek help outside of the work circle, or you'll be labeled... Don't think you won't be.


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## Handsome Robb (Jul 31, 2016)

SandpitMedic said:


> He has a point.
> They'll pull you off the line, and you'll lose your job.
> Somethings are better left unsaid to the man behind the desk.
> 
> If you have problems, seek help outside of the work circle, or you'll be labeled... Don't think you won't be.



Y'all work for some terrible services. No offense but that's the truth. 

If your employer isn't providing resources to you or making them available for those who need them and so they can be accessed anonymously, for those who are worried about "being labeled", something needs to change. 


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## RocketMedic (Jul 31, 2016)

Handsome Robb said:


> Y'all work for some terrible services. No offense but that's the truth.
> 
> If your employer isn't providing resources to you or making them available for those who need them and so they can be accessed anonymously, for those who are worried about "being labeled", something needs to change.
> 
> ...



So if you walked into your administration right now, with a mental health issue so big that it justified telling them that you needed a break from field work and treatment, that you would keep getting paid and have a job? I doubt it


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## Handsome Robb (Jul 31, 2016)

RocketMedic said:


> So if you walked into your administration right now, with a mental health issue so big that it justified telling them that you needed a break from field work and treatment, that you would keep getting paid and have a job? I doubt it



Yes, I would. 100%

Also, see the Family and Medical Leave Act of 1993. 

They don't have a choice than to keep your job for a minimum of 90 days, by federal law. That's not just my employer, that's any employer. As far as getting paid, that's going to depend on if you have enough sick time banked or if you have short term disability. 


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## SandpitMedic (Jul 31, 2016)

We have an Employee Assistance Program. 

You do not need to tell anyone in the office you are using it.


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## RocketMedic (Aug 1, 2016)

SandpitMedic said:


> We have an Employee Assistance Program.
> 
> You do not need to tell anyone in the office you are using it.



I think there's a world of difference between an employee assistance program and coming off the truck because you can't handle it.


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## res1551cue (Aug 1, 2016)

SandpitMedic said:


> We have an Employee Assistance Program.
> 
> You do not need to tell anyone in the office you are using it.



This is something that is slowly making its way throughout all job fields. It is nice to have someone to talk to about things that are unbiased and non-judgemental that also have a confidentiality clause. The military has something similar. Mainly we can use unbiased third parties such as a chaplain or First Sergeant without having it affect our career. In these cases you do not need to be religious to talk to a chaplain. In my line of work I have one of the highest security clearances in the military and although would not really be a problem right now talking to a mental health provider could be a career ending move. Which makes it nice to have these lines of communication available where there is no record filed. 

I think there are good and bad things that can happen when talking to a mental health professional. I mean that is why they are called professionals right? Sometimes going to them should not necessarily mean that you should get canned and this shows bad judgement on the employers part. In these jobs one can not expect everyone to work like robots without feeling or emotions and not provide them someone to talk to. I deal with depression, stress, and PTSD and recently had a fear of talking to a medical professional because I thought it was going to end my career because there have been horror stories of people with certain levels of security clearances, such as mine, loosing their clearance and job because they sought medical help. This is true in some cases but it was mainly in jobs that dealt with nuclear missiles. These jobs require their personnel to carry weapons on them at all times and having a mentally/psychologically unstable person with a gun probably is not the best idea. Both for the protection of themselves and others. Sometimes thing happen that trigger something in someone causing them to pop a screw loose. This does not necessarily mean that they are unfit for duty. It just means that they have taken on a little too much, have no one to vent to about it without having negative repercussions. There are times where people do not to come off a truck, not necessarily to be fired but to let them take a step back, seek professional help and let the medical professionals decide the unfitness of the individual. If an employer fires you just because you go seek professional help means that the company does not care. I would much rather have someone seek help than have someone come back from a bad scene/call and end their life in the back of my rig.

I think that when it comes to these types of issues the lack of information on how to get help is the reason for people loosing control.

I can also understand why sometimes people do not talk to their shift partners. Unlike most fire/ems related jobs I do not work with the same people everyday and I do not necessarily get a long with everyone that I do work with on a personal level. Professionally I tolerate them but personally they get on my nerves. Sometimes this is the case and not being able to vent to them about certain topics is understandable. I do however know who I can and cannot talk to on both a personal and professional level at work which makes it easier sometimes to vent about the issues I deal with.


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## RocketMedic (Aug 1, 2016)

That's the thing though....after FMLA is exhausted, an employer is going to be very gunshy about keeping around someone who can't do the job they were hired for because of mental health and will likely find a reason to terminate.


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## TransportJockey (Aug 1, 2016)

My company put one of our medics doing office and.logistics when she went to admin and said why she needed off a truck. My agency tries to help our people and keep them


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## Summit (Aug 1, 2016)

RocketMedic said:


> That's the thing though....after FMLA is exhausted, an employer is going to be very gunshy about keeping around someone who can't do the job they were hired for because of mental health and will likely find a reason to terminate.


Yes if you qualify for FMLA, and your illness prevents you from returning to full duty for longer than FMLA limits, you can be terminated unless they like you and can find an alternate duty for you.

But work induced psychopathology is Workers Comp, so if pursued as such, unless you reach MMI and are still unable to work, they cannot terminate. Employers that are not ****s tend to try and find alternate duty for good employees who MMI without capability to return to original duty.

But retaliatory or creative termination for valid use of FMLA or WC in either instance is grounds for huuuuuge lawsuits, and also a sign that your employer is a raging ****.


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## res1551cue (Aug 1, 2016)

TransportJockey said:


> My company put one of our medics doing office and.logistics when she went to admin and said why she needed off a truck. My agency tries to help our people and keep them



It is nice to see employers taking an active approach to realizing the issues involved with responder's.


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## ViolynEMT (Aug 1, 2016)

This job has actually "taught me" to keep things inside. Unfortunately.


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## res1551cue (Aug 1, 2016)

ViolynEMT said:


> This job has actually "taught me" to keep things inside. Unfortunately.



It is very unfortunate that people have to go through life like that because they fear for their jobs. I too have learned to keep things bottled up because I am not the greatest at opening up about my feelings but I have realized that when I start to take my anger or frustration out on whoever happens to be there at the time that I need to take a step back and figure out what it causing an issue and then try to resolve it. It has been difficult and has cost me some valuable relationship but I have a great network of friends that I know I can trust and talk too that are struggling with the same issues.


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## ViolynEMT (Aug 1, 2016)

ViolynEMT said:


> This job has actually "taught me" to keep things inside. Unfortunately.



This is not just because of employers. There are those,  those that you thought you could trust and would be helpful,  that label you as weak if you even show that something has affected you. I have perfected a really good poker face and have learned to stuff it down and build really strong,  tall walls.


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## res1551cue (Aug 1, 2016)

I am the same way. It sucks that there are people out there that treat people like that. 

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## Carlos Danger (Aug 1, 2016)

Are we talking about why we don't talk to our peers, or our employers?

Are we talking about being afraid to seek help when we really need it, or complaining that everyone we work with doesn't want us crying on their shoulder every time we feel a little blue?


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## RocketMedic (Aug 1, 2016)

I think the pro-talking crowd has made it both. Apparently everything's supposed to bother you and give you ptsd


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## ViolynEMT (Aug 1, 2016)

Guess I'm done.


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## ViolynEMT (Aug 1, 2016)

RocketMedic said:


> I think the pro-talking crowd has made it both. Apparently everything's supposed to bother you and give you ptsd



Wow. That's a ridiculous comment.


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## Handsome Robb (Aug 2, 2016)

RocketMedic said:


> I think the pro-talking crowd has made it both. Apparently everything's supposed to bother you and give you ptsd



Where has that been said in this thread? It hasn't. 




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## ViolynEMT (Aug 2, 2016)

Remi said:


> Are we talking about why we don't talk to our peers, or our employers?
> 
> Are we talking about being afraid to seek help when we really need it, or complaining that everyone we work with doesn't want us crying on their shoulder every time we feel a little blue?




OP started this whole about being afraid to seek help, but worrying about a stigma that may get attached. It's not about whiny babies crying on shoulders every time something isn't perfect. It morphed into the employer thing. And then it got stupid.


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## SandpitMedic (Aug 2, 2016)

What if dead babies don't bother you?
Does that mean you need help?
Or do different people have different thresholds  or different tolerance levels?

I think EAP is a good way to go about seeking confidential professional mental health counseling. I don't believe in spreading your feels out there in public on a regular basis.

(To the security clearance issue, it isn't one in EMS- but if you throw out some shrinks name on your SF86 then the men in black are going to get your records... HIPPA or no HIPPA... And could very well get you **** canned).


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## QRScomplex (Aug 2, 2016)

Summit said:


> Yes if you qualify for FMLA, and your illness prevents you from returning to full duty for longer than FMLA limits, you can be terminated unless they like you and can find an alternate duty for you.
> 
> But work induced psychopathology is Workers Comp, so if pursued as such, unless you reach MMI and are still unable to work, they cannot terminate. Employers that are not ****s tend to try and find alternate duty for good employees who MMI without capability to return to original duty.
> 
> But retaliatory or creative termination for valid use of FMLA or WC in either instance is grounds for huuuuuge lawsuits, and also a sign that your employer is a raging ****.



The way interpret this topic it has less to do with legislation to support mental health and all about how we treat each other in support of good mental health. 

I've seen some disturbing comments about "pro-talking crowd" assuming that all incidents lead to PTSD. Let me ask this question, for those who say that they would be career suicide to come and discuss things with your fellow EMS members, what kind of response/feedback would I get if I PM'ed you directly asking for help? I think the spirit of this topic is to generally accept that what we do and what we see is not just traumatic to the the patient but we all need to open ourselves to the notion that we should be willing and able to help each other without bias, without judgement, and to aid in whatever capacity we can. 

Just like in EMT-B we had verbal diarrhea, in EMS we shouldn't keep things in and allow ourselves to talk freely and openly about our problems.  


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## RocketMedic (Aug 2, 2016)

QRScomplex said:


> The way interpret this topic it has less to do with legislation to support mental health and all about how we treat each other in support of good mental health.
> 
> I've seen some disturbing comments about "pro-talking crowd" assuming that all incidents lead to PTSD. Let me ask this question, for those who say that they would be career suicide to come and discuss things with your fellow EMS members, what kind of response/feedback would I get if I PM'ed you directly asking for help? I think the spirit of this topic is to generally accept that what we do and what we see is not just traumatic to the the patient but we all need to open ourselves to the notion that we should be willing and able to help each other without bias, without judgement, and to aid in whatever capacity we can.
> 
> ...



Honestly? Depending on the cause and content of your gripe, it could negatively affect my opinion of you. 

Were you to ask me for my opinion on a truly distressing call and if we had a prior friendship or association, that's one thing. If you're just an acquaintance complaining about a generic call, how you're being treated, etc then I might not have the same sympathy.


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## QRScomplex (Aug 2, 2016)

RocketMedic said:


> Honestly? Depending on the cause and content of your gripe, it could negatively affect my opinion of you.
> 
> Were you to ask me for my opinion on a truly distressing call and if we had a prior friendship or association, that's one thing. If you're just an acquaintance complaining about a generic call, how you're being treated, etc then I might not have the same sympathy.



I appreciate your honesty. What you said affirms the messaging that I see in EMS, that if you aren't in an existing group of people who have built professional friendships over years and who rely only on each other, that the new guys have to find their own way to cope. It's more of an exclusionary model than an inclusionary one. In my business I don't care if you are the lowest paid or highest paid person when I say I have an open door to listen and help--even if it's to grip about something--my door is always open. I may coach you on ways of dealing with those annoying non-critical issues that inexperience can bring but that's also part of the learning process that could lead to longer term professional relationships. But to dismiss the issue as irrelevant and not in my interest of time creates an environment where people are closed up about things in fear that they will be labeled as weak and ineffective. *****ing about things doesn't win points but if I can take that and turn it introspectively so that person can understand what is at the root of their discomfort or anger or frustration or fear than those are building blocks that will both help them cope but also give them tools to pay it forward. Just because we haven't done this before or just because you may not have had it when you were new doesn't mean that it's the right way--especially if there is another way that may be worth trying. It goes beyond EMS--physicians who during their residency work endless shifts for no other reason than the current staff had to do that when they were residents. 

As far as I see it we have a choice. We can choose to accept things as they are and worry about what will happen when I need help or we can collectively try and make each other's needs more of a priority and to work to build up those relationships that will ultimately provide the system of care for those who may reach their emotional limits. Better to have something now than when you actually may need it don't you think?  


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## Carlos Danger (Aug 2, 2016)

ViolynEMT said:


> OP started this whole about being afraid to seek help, but worrying about a stigma that may get attached. It's not about whiny babies crying on shoulders every time something isn't perfect. It morphed into the employer thing. And then it got stupid.



My comment wasn't directed towards anything specific that you or any one else wrote. 

The thing is, being able to expect support from your employer when you have a legitimate mental health need and expecting everyone to listen constructively to when something is just "bothering" you are very different things. And it seems that they have gotten lumped together as the same thing in this thread.

Hence my question.


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## ViolynEMT (Aug 2, 2016)

Remi said:


> My comment wasn't directed towards anything specific that you or any one else wrote.
> 
> The thing is, being able to expect support from your employer when you have a legitimate mental health need and expecting everyone to listen constructively to when something is just "bothering" you are very different things. And it seems that they have gotten lumped together as the same thing in this thread.
> 
> Hence my question.




No worries. I didn't take it personally. I was just clarifying.


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