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Leadership/Management

Canadian Agency Tackles PTSD Head On With Peer Support Program

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Even for the battle-toughened members of Canada’s York Region Paramedic Services (YRPS), the carnage was unspeakable. (York Region is located north of Toronto.) Three children from the Neville-Lake family and their grandfather were fatally injured when their Grand Caravan mini van was broadsided by a Jeep Cherokee SUV driven by a drunk driver.                   

“Harrison (Harry), 5, died in hospital about midnight, holding his two-year-old sister Milly’s hand, after doctors placed them together, knowing nothing could save them,” reported the National Post newspaper. “Their parents made it to hospital in time to say a final goodbye, but they were too late for Daniel, 9, who died three hours earlier.”

Drunk driver Marco Muzzo, who blew three times the legal alcohol limit at the accident location, was sentenced to 10 years in jail after pleading guilty. Still, the verdict did nothing to erase the traumatic impact of this loss on the Neville-Lake family, and the York Region paramedics who attended the grisly scene.

In response to its paramedics’ emotional trauma, the YRPS launched a Peer Support Team. Comprised of 20 York Region paramedics trained in psychological first aid, these paramedics provide traumatized EMS practitioners with someone they can reach out to for help, right after something like the Neville-Lake fatality has occurred.

“The idea is to give our 493 full- and part-time paramedics immediate access to frontline emotional support; from people they know, trust and have existing relationships with,” says YRPS Deputy Chief Iain Park.

“At the same time, our peer support people are not counselors, although they are able to refer staff to professional help as requested and as needed,” says YRPS Superintendant John Anderson. “Instead, they are meant to give traumatized EMS providers the ability to start processing tragedy as soon as possible; a proactive approach that can reduce the incidence of depression, PTSD and suicide by paramedics.”

York Region is no stranger in offering mental support to its staff members. For the past 20 years the regional government’s Critical Incident Stress Management (CISM) team has been providing such services to the area’s first responders. However, this is a very much an office-based approach, whereas the Peer Support Team is designed to bring mental support directly into the workplace.

“Coincidentally, we had been planning to roll out the Peer Support team before the Neville-Lake crash occurred,” says Park. “It proved to be the triggering event to get the program launched.”

In order to provide its Peer Support team with the most relevant training, the YPRS has worked closely with the Tema Conter Memorial Trust (Tema), a Canadian agency that provides peer support, family assistance, and training for public safety/military personnel coping with operational stress and PTSD.

How York Region Program Works

The whole concept of peer support is for paramedics to seek help from fellow workers. This is why the YRPS started building the Peer Support Team by asking its 493 staff members to anonymously nominate colleagues for the team; including providing reasons as to why these nominees were suited for this role.

“From these recommendations, we selected a number of potential candidates who were referred to TEMA for written psychological evaluations,” says Anderson.

To ensure that all four YRPS platoon shifts would always have access to a Peer Support team member 24/7, “our final selection of 20 was guided to make sure we selected people from each shift,” notes Park.

Once the Peer Support team members were selected, training began. Specifically, they were trained using three Tema two-day programs. The first was the MANERS Psychological First Aid approach developed by Australia’s Victorian Ambulance Services, which “is specifically designed for those individuals who assist those who have been involved in traumatic or crisis situations, says the Tema website.

“After our Peer Support team members went through this program, we gave them a month to use it on the job, so that they could become familiar with it in practice,” says Anderson. “They then came in for a second two-day course on Applied Anti-Suicide Intervention Skills followed by a second month of usage. Next, the team went through the third module on Mental Health First Aid, which is more knowledge-based than the first two practical courses.”

Having started the process in September 2015, York Region’s Peer Support teams were fully trained by spring 2016. Meanwhile, all of the region’s paramedics are going through a four-hour training course called "Road to Mental Health" to give them access to quick coping skills when confronted with stressful situations. The training process will be completed in June 2016.

“The Navy Seals, who invented this four-step approach, call it the Big Four,” says Anderson. “The four steps are Goal Setting (figuring out what you want to achieve), Visualization (imagining how you can achieve it), Positive Self-Talk (‘I can do this!’) and Tactical Breathing (taking deep slow breaths to calm yourself).”

Today all York Region paramedics have access to Peer Support services so that they can proactively cope with the sometimes horrific consequences of trying to save lives.

“It’s too early to say how well the program is working,” says Park, “but if just one paramedic’s life can be saved from PTSD or suicide as a result of this work, it will be well worth it.”

James Careless is a freelance writer with extensive experience covering computer technologies.

                                                                                               

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