BONNYVILLE – To support first responders and emergency health-care workers living with or at risk of developing Post-Traumatic Stress Injuries (PTSI), the Alberta government announced on Feb. 2 that they are providing four non-profit organizations and seven researchers a total of $1.48 million worth of grant funding.
The province’s relatively new Supporting Psychological Health in First Responders grant program is just the tip of the iceberg says Regional Fire Chief Dan Heney, of the Bonnyville Regional Fire Authority (BRFA).
“There is no problem out there right now that is more important to start dealing with, and to learn more about, than post-traumatic stress injuries in first responders,” said Heney.
“There are so many mental health problems as a result of the types of things that first responders deal with that the average person doesn't see... Now it's a category called occupational stress injuries.”
From 2015 to 2019, there were 685 Workers’ Compensation Board (WCB) claims for first responders related to PTSI, totaling $104 million worth of related treatment and compensation, according to the province.
In Alberta there are more than 14,000 full-time, part-time, casual and volunteer firefighters, of which roughly 80 per cent are volunteers. There are more than 7,500 police officers, at least 9,400 paramedics, 770 sheriffs and 1,500 corrections officers. Not included in the province’s list of first responders are Alberta’s 911 operators.
Recognizing the costs
Heney says politicians are finally waking up to the high costs paid by Public Safety Personnel.
“They are finally starting to see research projects that have hard data. Politicians finally started to hear it, and the numbers are staggering,” he said.
According to information gathered by the Centre for Suicide Prevention, where two per cent of Canadians will experience PTSD in their lifetime, first responders experience PTSD two times the rate of the average population.
An estimated 22 per cent of all paramedics will develop PTSD, reports the Centre for Suicide Prevention website.
According to Heney, mental health issues are the third most common reason for time loss claims for Canadian firefighters. In the country, Alberta firefighters have the second highest rates of time loss claims due to mental health.
Speaking of the cause of occupational stress injuries for firefighters, he says they can be triggered by nearly any event members respond to, including fire calls, rescues, motor vehicle collisions, medical assistance calls, or even prolonged levels of high stress.
“The more we learn about stress, the more we learn that it may not necessarily just be one incident. It may be just the high levels of stress over an entire career,” he explained.
For Heney, the purpose of creating a trauma-informed workplace and acknowledging the reality of occupational stress injuries is to hopefully contribute to a reduction in PTSI and suicides of first responders, which he says continues to climb.
"Eventually, they pay the price for the things that we do. Being a first responder – whether that's law enforcement, military, ambulance, fire – there's a price to be paid,” expressed Heney.
Between April and December of 2014, 27 first responders died by suicide, according to the Centre for Suicide Prevention.
Bringing awareness to the psychological toll placed on public safety workers is the first step, but more research and more services are needed, he says.
“If we can have people pay the ‘price’ early, then they are not paying with interest later on," said Heney, acknowledging that he has undergone therapy himself to deal with his own work-related traumas.
Not an ‘if,’ but a ‘when’
In 2019, Heney was diagnosed with Post-Traumatic Stress Disorder (PTSD) after reaching out for help following a presentation by psychologist Dr. Megan McElheran. At the time, McElheran was presenting on trauma informed leadership to managerial members of the Calgary Fire Department.
“She flashed a PowerPoint presentation up on the screen that showed the six things that need to be in place before one of her patients would be accepted by WCB as a post-traumatic stress injury patient. When she flashed that that list up on the screen and I moved from point to point, my inner monologue was going ‘Check, check, double check. Oh, my goodness Yahtzee I’ve got all six – I reached out the next morning,” he recalled.
Heney says that as he moved to different first responder positions higher up on the chain of command the stress level of the job only got greater.
During a particularly stressful time, a call that he had responded to in the 90s involving a fatality in an industrial accident began to haunt him once again.
Heney says he can't remember exactly when the event happened or even the year, but he can remember almost every detail of that one call.
“I had been reasonably dealing with the aftereffects of a number of calls, but then I just got to a point in the job where – I don't even know exactly what happened – but something happened in the job that my stress level reached a point where I stopped being able to cope,” he recalls. “My normal coping mechanism stopped being effective and I just hit a point where I was melting down and it was 20-plus years later.”
Heney started displaying all the core symptoms that make up post-traumatic stress.
“I wasn't sleeping because I had nightmares all night, every night. Then the nightmares came into my daytime where I could be working at my desk on my computer, writing a report and then all of a sudden, I was back on that call in the middle of a nightmare in the middle of a day when I'm supposed to be awake and working.”
A greater shift in culture is needed to address mental health issues because it is not a matter of ‘if’ but ‘when’ first responders will be affected by work-related stress.
“This isn't stuff that just happens to ‘the weak links’... This is every responder at some point. We know enough now to work under the assumption that it’s not going to be if you suffer from an occupational stress injury, it is when you suffer from an occupational stress injury.”
‘You always know’
Even before Heney saw McElheran’s presentation, he already suspected he was suffering from PTSD.
“I pretty much always knew, and most of us do, unless you are brand new to the industry... But like every other responder, part of our training and being first responders is learning how to compartmentalize things. I am not able to help in a situation if I'm not focused on the task at hand,” he said.
“I'd be lying if I said that there weren’t times that I cried myself into a puddle. So, you always kind of know, it's just how much are you willing to try to convince yourself that it's really not an issue.”
Heney says going through therapy and treatment for PTSD “felt like coming out of the fog. All of a sudden, things were a lot clearer.”
Through his own experiences, it has led the regional fire chief and other members of the BRFA to reform how the organization and its corresponding divisions deal with mental health and work-related trauma.
The three divisions that fall under the BRFA include the region’s 911 operators, fire and EMS.
“It becomes incumbent on the organizations... to start stepping up and taking a little more responsibility. It's easy to talk about all how we care about our people and that we want our people to be safe and well – it's very different to back it up with action.”
Leading by example
When Heney joined the BRFA as a deputy fire chief in 2019, he brought with him a framework for a project to increase the comprehensiveness of the organization’s mental health program.
Currently, Heney and another fire chief from Iron River, Gordon Graves, sit on the steering committee of a research project based on a paper created by Dr. McElheran called Prevention of PTSI Work Disability.
The organization has also gone so far as to make it mandatory to do Post-Call Defusing to discuss the emotional toll a call may have had, separate from an operational debriefing.
One of the goals of the BRFA’s mental health program is to continually keep members informed about occupational stress.
“The insidious part of this type of injury, operational stress injury, is that you slowly start to remove yourself from the people around you. You start to pull back. You start to create walls. And eventually, those walls get pretty thick... This is not a problem we can ignore anymore.”
He says the numbers have proven that this is an issue and that leaders must understand how imperative it is to have resources available.
The roughly 160 volunteer members within the BRFA are also covered by a health policy, which is not the case for all volunteer firefighters across the province.
Only time will tell whether the BRFA’s actions will do good, says Heney, adding, he’s going to continue to drive the program forward.
With the additional grant funding being allocated to first responders’ psychological health in Alberta, Heney hopes the culture begins to change and people continue to recognize that “this is a real deal.”
“This funding is just the tip of the iceberg – there are high cost for psychological care and there aren't enough supports out there for everybody.”
2020-21 Grant recipients
The group of 11 researchers and service providers are the first recipients of the province’s first responders mental health grant program, which is intended to commit up to $1.5 million per year starting in 2020-21.
“We will have a new list of recipients for 2021 in the next few weeks at another news conference opportunity for the Minister (Tyler Shandro),” Press Secretary Joseph Dow, for the Ministry of Labour and Immigration, told Lakeland This Week.
Vincent Agyapong, University of Alberta - $150,000
Suzette Brémault-Phillips, University of Alberta - $206,137
Doug Gross, University of Alberta - $49,494.50
Bonnie Laskewicz, University of Calgary - $209,525
Linda Duffett-Leger, University of Calgary - $201,614
Rose Ricciardelli, Memorial University of Newfoundland - $187,966
Dwayne Van Eerd, Institute for Work & Health - $172,820
Alberta Critical Incident Provincial Network - $99,875
Alberta Fire Fighters’ Association -$134,662.50
Edmonton Fire Rescue Services – $40,000
Wellness Works Canada - $31,600