Since when can any EMS provider "heal" anyone? Healing is a long term adjective.
1) Does honest expression of ones feelings and experiences (at appropriate times and places and with the appropriate people, like after, but not too long after an inciting call) mean you can't do the job you're supposed to?
No, but that is a vague question. On just how much expression, and yet what type of experience. A death in a MVA versus a traumatic infant death? There is medium that one is expected to continue and perform their job, and as well as events that can cause problems. Not all medics want to hear other medics problems, many feel that they have enough of their own, as well may not see problems with that particular incident.
#2) Were medics to have access to a regular, face-to-face forum where they could speak openly (and with a built in system of mutual support through peer counseling) about the stresses they're dealing with, would there be less hitting the wall?
See below* There is a forum that has a trained licenesed counselor, Chaplain, that is a medic. Fieldmedics.com, that is discreet. Opening up on a forum, could be potentially dangerous, involving fellow peers erronoeous information and potential HIPPA violations.
#3) Is the assumption that we must turn to licensed, trained professionals for such counseling a way of saying that we're not (whatever, you fill in the blank) enough to take care of our own?
Just how much education and information was given to most EMT's in that 120 hour course? Do most EMT's really know what clinical depression is and the signs of multi disciplinary disorders are, or did they recieve all that education from that one chapter of a whole 12 pages? I already look at the "poor" medical advice that is already being given out on EMS forums, and this is even on "physical" conditions that one should already have knowledge on! Venting or discussing problems, is just one of steps in the process of healing, but what then afterwards?
What if that medic already has some form of mental illness? I know many that have bi-polar, clinical depression, schizophrenia and other forms, are you trained to recognize those pre-existing problems that might not have been diagnosed yet? Peer discussion is not always the best treatment in all cases! You see there are many different mental health problems, that may already exist prior to the incident. Like diseases, each should be properly evaulated by a qualified health provider.
Sure, medics discuss things with each other and they should. I have and still have partners that "open up" to me all the time. Sometimes, it is the usual family crisis, or the "bad" calls that things did not click well, or even a "bad incident". This is what friends and partners do... listen. Do I watch for other potential problems? You bet! Do I sometimes recommend professional help? Damn right! For example, I would never attempt to treat them if they had hypoglycemia by giving D50 and then say.."there ya go!".. your healed!
In this business the events and problems generally.."snow ball" and develop. It is not always that "one incident" that causes most problems in a medic. There may be other factors at home, school, private life, etc. that are adding up and then that "one bad call" is the final straw.
Just like regular routine physical examinations, I believe EMS personal should have mental ones as well. Sorry, the stuff and some of the crap we deal with does or should effect the normal psyche. Seeing people dying in front of you, or intubating through brain matter and seeing abused children, should affect one. If it does not, then again we have a problem. Being able to monitor and developing appropriate coping skills, is the key to lasting.
Remember, not all EMS personal want to bring their personal life, or problems to the table for discussion. Again, when I see anger, excitability and general change in attitude, many times it has nothing to do with the work environment itself, rather an underlying issue. There is still a lot of the B.S. issue of "sucking it up" and deal with it ourselves. Peer pressure does occur within this business. As well as the "we can cure anything" or personally deal with it attitude.
If one really knows anything about mental health, that it is a very complexed disease and usually has to be treated by long term multidisciplinary measures. It is not like most injuries we see and one cannot "fix" it immediately or in a short interval. It may require medication(s) and proper counseling, definitely nothing within the scope of any EMS provider.
Firetender, I have read your programs. I do believe such avenues would be a good adjunct in preventing "burnout". These type of programs would be great as "internal checks" and healing processes before such events occured (before the snowballing effect) or possibly as part of a treatment regime recommended per a mental health professional.
R/r 911
