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What is Post Traumatic Stress Disorder?
PTSD is a psychological response to the experience of intense traumatic events, particularly those that threaten life. The characteristic set of symptoms experienced has to be present for at least one month before a diagnosis of PTSD is made. It can affect people of any age, culture or gender. This condition has existed for many years under different names, but since 1980, the term PTSD has been used.
Between 5 and 10% of Australians will suffer from PTSD at some point in their lives.
PTSD symptoms can be grouped under 4 main headings:
1) Re-experiencing of the traumatic event by
- Distressing memories or images of the event
- Nightmares of the event of other frightening themes
- Flashbacks (feeling as if the event were recurring while awake)
- Exaggerated emotional and physical reactions to triggers that remind the person of the event
2) Avoidance of reminders of the event by
- Trying to avoid thoughts and feelings that bring back memories of the trauma
- Trying to avoid conversations, people, places or situations that bring back memories of the trauma
3) Negative thoughts and feelings
- Gaps in memory - forgetting parts of the experience
- Feeling afraid, angry, guilty, flat or numb a lot of the time
- Difficulty experiencing positive emotions
- Losing interest in day to day activities
- Feeling cut-off or detached from loved ones
4) Increased arousal by
- Sleep disturbances
- Concentration problems
- Feeling angry or irritable
- Hypervigilance (constantly on the lookout for danger)
- Jumpy, easily startled ( exaggerated startle response)
- Increased risk taking or self destructive behaviour
Associated Problems
It is very common for people with PTSD to experience other problems in addition to the symptoms described above. The most common of these associated problems are anxiety, depression, and alcohol and drug use.
The use of alcohol may have initially been to help you fall asleep or numb the intensity of the feelings and may have developed into its own issue.
Feeling depressed can be the by-product of constant intrusive thoughts with limited resources in knowing how to manage them effectively, or the result of avoiding contact with others.
Family/ marital conflicts are also a commonly experienced problem associated with PTSD. The effects of PTSD symptoms tend to filter into all aspects of your life. Family / friends and even the person with PTSD, may have initially thought that this was simply part of the person’s personality rather than a set of responses to the impact of this disorder.
Some Frequently Used Terms
It may be useful to have an understanding of the basic terms that are used when treating PTSD.
DESENSITISATION
A therapeutic process of reducing the level of emotion that is associated with the traumatic memories.
COGNITIVE RESTRUCTURING
A technique to help modify unrealistic assumptions, beliefs and automatic thoughts that may have initially developed in the context of trauma and are perpetuated in destructive/ unhelpful thinking styles, which then impact on the way we feel and behave.
ASSERTIVE COMMUNICATION
Clearly stating your feelings, the reasons for those feelings and the needs/ wants you wish to express are essential to minimise blame and hostility.
S.U.D.S - Subjective Units of Distress Scale
This scale is a personal rating, out of ten, of how you are feeling in relation to your distress level at a given time. Ten is explosion point, or out of control, while one is calm and quiet. People with PTSD often have a higher idling SUDS level due to their re-experiencing symptoms but may mask this from people around them. When everything is going well their SUDS level may still be at a 6. A SUDS level of 7 or higher gives you less time to think and respond appropriately/ effectively when faced with a situation that is stressful.
AROUSAL REDUCTION
Strategies and techniques that you can use while your level of arousal is high (that is, your feelings of agitation, distress or simply a high SUDS score), Once practiced and integrated into your lifestyle, these skills can help to feel in control and lower SUDS levels. These skills give a person with PTSD increased confidence in their ability to cope and greater flexibility in dealing with the unexpected.
Why do some people have more trouble coming to terms with bad stuff than others?
Some people survive dreadful events and are able to pick themselves up and keep going quite well. Other people will go through the same event and find that their life comes to a complete stop. They find themselves unable to stop thinking about what happened, their emotions turn upside down and they feel physically tense and uptight all the time.
So why? Why do distressing events traumatise some people and not others?
There are a variety of answers to this question. How we respond to serious life threatening events depends upon several factors. Please note that some or none of these factors may relate to you
Type of stressor:
1) Magnitude of the stressor (more severe often means more problems)
- Intensity (dangerousness of event or threat to life)
- Duration of the exposure (how long you were exposed to the threat, prolonged threat or repeated threat)
- Extent of physical injury (whether you were injured or not)
2) Preparation for the event (having some time to prepare for the event often means people recover faster)
- Degree of control available (how much you felt you could influence the outcome of the event)
- Time for preparation before the event happened
- Training for the event
- Resilience training is being researched and implemented in a n umber of manners in jobs where exposure to threats is necessitated these days
Pre - trauma vulnerability
1) Personality and genetics
- There is some evidence that some of us are biologically more vulnerable to developing certain illnesses, including anxiety disorders and depression. If we have someone else in our family who has suffered from similar problems, it can increase the risk for some people
2) Life events
- If we have survived more than one traumatising event in our lives, we may be more vulnerable to experiencing difficulty coping.
- Repeated exposure to distressing events as an adult can also have a cumulative effect, and while we might cope with the first few experiences well, there is a greater risk of problems developing with subsequent events, particularly if a maladaptive coping style is utilised.
3) Parenting/ rearing environment
- Some studies have shown that negative parenting behaviour, emotional neglect or early separation from parents may make us more vulnerable to developing emotional difficulties after distressing events
Immediate/ short term response during event
- Distressing emotional or cognitive experiences ( eg: feelings of panic or extreme confusion at the time of the event)
- Strong dissociation at the time of the event. Dissociation is a way of mentally and emotionally disconnecting from an event typically when overwhelmed. The event does not feel real. Time becomes distorted during the event and there may be large parts of the experience that are forgotten
- Coping strategies during the event (ie: how you tried to cope at the time, or how you had to cope in the circumstances)
Post - Trauma Responses:
1) Amount of distress after the event:
- Almost everyone gets distressed after a highly stressful negative event. When your distress won’t go down, even after a few weeks, it's usually best to get some qualified help.
2) Stinking thinking:
- Negative thoughts often make a traumatic response continue. For eg: when you feel excessively guilty about an event, feel like you should or shouldn’t have done something which may have changed the outcome, if you feel you were singled out, feel you were let down, feel as though you can never be safe again - these beliefs all make it much harder to get over the event. You will need to work on that style or pattern of thinking to fully recover.
3) Avoidance
- This is the key behaviour that leads to the development and maintenance of PTSD. Most people, following a traumatic event, develop Acute Stress Reaction, which tends to subside within a few days, or weeks following the trauma. However, it is avoidance that prolongs the recovery rate. This includes behaviours such as withdrawing from friends and family, avoiding places, people or events, resisting unpleasant feelings, thoughts and sensations.
Effects of PTSD on family
PTSD can make somebody hard to live with. Living with someone who is easily startled, has nightmares, often avoids social situations can take a toll on the most caring family. Early research has shown the harmful impact of PTSD on families and relationships with increased stress on relationships.
How does PTSD have such a negative effect?
It is because those suffering with PTSD have a hard time feeling emotions. They may feel detached from others. This can cause relationship problems and even lead to behavioural problems in children. The numbing and avoidance that occurs with PTSD is linked with lower satisfaction in parenting.
Strategies to take care of yourself:
1) Time out for you and self -care
- This can be different for different people, but it primarily means giving yourself permission to pursue your own interests/ hobbies in an effort to recharge yourself and restore some balance. To be effective this needs to happen on a regular basis
- Being kind to yourself. Not listening to the inner judgemental voice.
- Do things that make you feel good
2) Exercise/ Relaxation
- Exercise is a good means for managing your internal stress level as well as having a positive impact on your physical health. Often we experience stress yet we are not very good at recognising it and managing it in a healthy way. Some ideas are breathing exercises, podcasts, relaxation apps.
3) Learn about PTSD
- Having a good understanding of PTSD and its treatment can help you understand behaviour that might otherwise seem frustrating or difficult to deal with. It may also be beneficial to learn more about depression, anxiety and drug or alcohol addiction if these are having an impact
4) Develop a support network
- Everyone needs support and it is helpful to have someone to talk to
5) Counselling
- Ongoing support from a professional psychologist/ psychiatrist is helpful
Essential Resource List for Ongoing Support
It is important that you feel supported and connected in the community.
My Psychiatrist is __________________________________
My GP is _________________________________________
My Psychologist/ Therapist is _________________________
Available treatment courses / centres
St John of God - Richmond Campus www.stjohnofgod.org.au - specialised occupational PTSD Xavier Unit. Inpatient and outpatient programs
The Hills Clinic - www.thehillslcinic.com.au - inpatient and outpatient programs in addiction, mood disorders, PTSD
Northside - www.northsidegroup.com.au - inpatient and outpatient programs
DBT- Dialectal Behavioural Therapy
SJORG.ORG.AU | 04.07.2018 - Professor Zachary Steel - Psychiatrist
Five reasons we should be talking about first responders and PTSD
A recently released Australian report is putting the spotlight on the emotional wellbeing of our police, paramedics, firefighters and other emergency officers.Trauma and mental health expert Professor Zachary Steel explains the top five reasons we should be paying attention.
1. PTSD doesn’t just affect soldiers PTSD is widely recognised as a risk of military service, but did you know people who work as first responders – police, ambulance officers, firefighters, emergency personnel – are also at higher risk?
First responders who are first at the scene of an accident, natural disasters or other incidents often put their own safety at risk to help others.
Like military personnel, first responders see and experience situations that are shocking and can be hard to process.
This can lead to a higher risk of them acquiring a mental health injury such as PTSD.
2. But there are similarities between armed forces and first respondersThe experiences of first responders and their military comrades - who both run towards disasters while everyone else runs away – are similar and people working in both areas are at an increased risk of PTSD.
Similarly, just as those who work in the armed forces are often characterised as stoic with unending reserves of endurance, so too are those who work as first responders.
Unfortunately, as people serving in the military and first responders see more and more incidents their risk of acquiring PTSD increases over time and their characteristics that empower them to do such a great job of protecting and caring for us, can get in the way of them seeking help for their own emotional wellbeing.
This can lead to their symptoms getting worse.
3. PTSD isn’t inevitableThere is a myth developing that all first responders will get a mental health injury and it is just a matter of time.
This is not the case. The majority of people do get through their careers without acquiring an injury.
Yet there is no doubt there is an increased risk. The one solid research finding that has emerged across multiple settings is that the more critical incidents attended, the greater the risk of acquiring a mental health injury.
The nature of the work first responders do is to be exposed to such events and the resulting risk from this has to be taken seriously.
4. Growing role of first responders makes a differenceOver time, the great work done by our first responder organisations has been getting more professional and more efficient.
The report documents how the operational tempo for first responders has increased over time. The automated systems which help ensure rapid response times and the ability to get more responders to the scene of an incident means that their level of exposure has also increased.
We also need to aware of the role downtime can play in maintaining good emotional wellbeing, and when the demands on our first responders grows giving them the downtime they need diminishes.
5. Help is availableThe When helping hurts: PTSD in first responders report puts a bit of a highlight on some well-established evidenced-based treatments that, unfortunately, a lot of people aren’t accessing.
The one thing that we know is that recovery and improvement is possible, but often it is a long journey and people do sometimes experience setbacks.
There is a network of agencies around Australia that have a lot of experience working with first responders and other people with PTSD.
Even if you experience some early setbacks it is good to keep trying to find people you trust and people you can work with.
If you need urgent mental health help, call Lifeline on 13 11 14.
PTSD is a psychological response to the experience of intense traumatic events, particularly those that threaten life. The characteristic set of symptoms experienced has to be present for at least one month before a diagnosis of PTSD is made. It can affect people of any age, culture or gender. This condition has existed for many years under different names, but since 1980, the term PTSD has been used.
Between 5 and 10% of Australians will suffer from PTSD at some point in their lives.
PTSD symptoms can be grouped under 4 main headings:
1) Re-experiencing of the traumatic event by
- Distressing memories or images of the event
- Nightmares of the event of other frightening themes
- Flashbacks (feeling as if the event were recurring while awake)
- Exaggerated emotional and physical reactions to triggers that remind the person of the event
2) Avoidance of reminders of the event by
- Trying to avoid thoughts and feelings that bring back memories of the trauma
- Trying to avoid conversations, people, places or situations that bring back memories of the trauma
3) Negative thoughts and feelings
- Gaps in memory - forgetting parts of the experience
- Feeling afraid, angry, guilty, flat or numb a lot of the time
- Difficulty experiencing positive emotions
- Losing interest in day to day activities
- Feeling cut-off or detached from loved ones
4) Increased arousal by
- Sleep disturbances
- Concentration problems
- Feeling angry or irritable
- Hypervigilance (constantly on the lookout for danger)
- Jumpy, easily startled ( exaggerated startle response)
- Increased risk taking or self destructive behaviour
Associated Problems
It is very common for people with PTSD to experience other problems in addition to the symptoms described above. The most common of these associated problems are anxiety, depression, and alcohol and drug use.
The use of alcohol may have initially been to help you fall asleep or numb the intensity of the feelings and may have developed into its own issue.
Feeling depressed can be the by-product of constant intrusive thoughts with limited resources in knowing how to manage them effectively, or the result of avoiding contact with others.
Family/ marital conflicts are also a commonly experienced problem associated with PTSD. The effects of PTSD symptoms tend to filter into all aspects of your life. Family / friends and even the person with PTSD, may have initially thought that this was simply part of the person’s personality rather than a set of responses to the impact of this disorder.
Some Frequently Used Terms
It may be useful to have an understanding of the basic terms that are used when treating PTSD.
DESENSITISATION
A therapeutic process of reducing the level of emotion that is associated with the traumatic memories.
COGNITIVE RESTRUCTURING
A technique to help modify unrealistic assumptions, beliefs and automatic thoughts that may have initially developed in the context of trauma and are perpetuated in destructive/ unhelpful thinking styles, which then impact on the way we feel and behave.
ASSERTIVE COMMUNICATION
Clearly stating your feelings, the reasons for those feelings and the needs/ wants you wish to express are essential to minimise blame and hostility.
S.U.D.S - Subjective Units of Distress Scale
This scale is a personal rating, out of ten, of how you are feeling in relation to your distress level at a given time. Ten is explosion point, or out of control, while one is calm and quiet. People with PTSD often have a higher idling SUDS level due to their re-experiencing symptoms but may mask this from people around them. When everything is going well their SUDS level may still be at a 6. A SUDS level of 7 or higher gives you less time to think and respond appropriately/ effectively when faced with a situation that is stressful.
AROUSAL REDUCTION
Strategies and techniques that you can use while your level of arousal is high (that is, your feelings of agitation, distress or simply a high SUDS score), Once practiced and integrated into your lifestyle, these skills can help to feel in control and lower SUDS levels. These skills give a person with PTSD increased confidence in their ability to cope and greater flexibility in dealing with the unexpected.
Why do some people have more trouble coming to terms with bad stuff than others?
Some people survive dreadful events and are able to pick themselves up and keep going quite well. Other people will go through the same event and find that their life comes to a complete stop. They find themselves unable to stop thinking about what happened, their emotions turn upside down and they feel physically tense and uptight all the time.
So why? Why do distressing events traumatise some people and not others?
There are a variety of answers to this question. How we respond to serious life threatening events depends upon several factors. Please note that some or none of these factors may relate to you
Type of stressor:
1) Magnitude of the stressor (more severe often means more problems)
- Intensity (dangerousness of event or threat to life)
- Duration of the exposure (how long you were exposed to the threat, prolonged threat or repeated threat)
- Extent of physical injury (whether you were injured or not)
2) Preparation for the event (having some time to prepare for the event often means people recover faster)
- Degree of control available (how much you felt you could influence the outcome of the event)
- Time for preparation before the event happened
- Training for the event
- Resilience training is being researched and implemented in a n umber of manners in jobs where exposure to threats is necessitated these days
Pre - trauma vulnerability
1) Personality and genetics
- There is some evidence that some of us are biologically more vulnerable to developing certain illnesses, including anxiety disorders and depression. If we have someone else in our family who has suffered from similar problems, it can increase the risk for some people
2) Life events
- If we have survived more than one traumatising event in our lives, we may be more vulnerable to experiencing difficulty coping.
- Repeated exposure to distressing events as an adult can also have a cumulative effect, and while we might cope with the first few experiences well, there is a greater risk of problems developing with subsequent events, particularly if a maladaptive coping style is utilised.
3) Parenting/ rearing environment
- Some studies have shown that negative parenting behaviour, emotional neglect or early separation from parents may make us more vulnerable to developing emotional difficulties after distressing events
Immediate/ short term response during event
- Distressing emotional or cognitive experiences ( eg: feelings of panic or extreme confusion at the time of the event)
- Strong dissociation at the time of the event. Dissociation is a way of mentally and emotionally disconnecting from an event typically when overwhelmed. The event does not feel real. Time becomes distorted during the event and there may be large parts of the experience that are forgotten
- Coping strategies during the event (ie: how you tried to cope at the time, or how you had to cope in the circumstances)
Post - Trauma Responses:
1) Amount of distress after the event:
- Almost everyone gets distressed after a highly stressful negative event. When your distress won’t go down, even after a few weeks, it's usually best to get some qualified help.
2) Stinking thinking:
- Negative thoughts often make a traumatic response continue. For eg: when you feel excessively guilty about an event, feel like you should or shouldn’t have done something which may have changed the outcome, if you feel you were singled out, feel you were let down, feel as though you can never be safe again - these beliefs all make it much harder to get over the event. You will need to work on that style or pattern of thinking to fully recover.
3) Avoidance
- This is the key behaviour that leads to the development and maintenance of PTSD. Most people, following a traumatic event, develop Acute Stress Reaction, which tends to subside within a few days, or weeks following the trauma. However, it is avoidance that prolongs the recovery rate. This includes behaviours such as withdrawing from friends and family, avoiding places, people or events, resisting unpleasant feelings, thoughts and sensations.
Effects of PTSD on family
PTSD can make somebody hard to live with. Living with someone who is easily startled, has nightmares, often avoids social situations can take a toll on the most caring family. Early research has shown the harmful impact of PTSD on families and relationships with increased stress on relationships.
How does PTSD have such a negative effect?
It is because those suffering with PTSD have a hard time feeling emotions. They may feel detached from others. This can cause relationship problems and even lead to behavioural problems in children. The numbing and avoidance that occurs with PTSD is linked with lower satisfaction in parenting.
Strategies to take care of yourself:
1) Time out for you and self -care
- This can be different for different people, but it primarily means giving yourself permission to pursue your own interests/ hobbies in an effort to recharge yourself and restore some balance. To be effective this needs to happen on a regular basis
- Being kind to yourself. Not listening to the inner judgemental voice.
- Do things that make you feel good
2) Exercise/ Relaxation
- Exercise is a good means for managing your internal stress level as well as having a positive impact on your physical health. Often we experience stress yet we are not very good at recognising it and managing it in a healthy way. Some ideas are breathing exercises, podcasts, relaxation apps.
3) Learn about PTSD
- Having a good understanding of PTSD and its treatment can help you understand behaviour that might otherwise seem frustrating or difficult to deal with. It may also be beneficial to learn more about depression, anxiety and drug or alcohol addiction if these are having an impact
4) Develop a support network
- Everyone needs support and it is helpful to have someone to talk to
5) Counselling
- Ongoing support from a professional psychologist/ psychiatrist is helpful
Essential Resource List for Ongoing Support
It is important that you feel supported and connected in the community.
My Psychiatrist is __________________________________
My GP is _________________________________________
My Psychologist/ Therapist is _________________________
Available treatment courses / centres
St John of God - Richmond Campus www.stjohnofgod.org.au - specialised occupational PTSD Xavier Unit. Inpatient and outpatient programs
The Hills Clinic - www.thehillslcinic.com.au - inpatient and outpatient programs in addiction, mood disorders, PTSD
Northside - www.northsidegroup.com.au - inpatient and outpatient programs
DBT- Dialectal Behavioural Therapy
SJORG.ORG.AU | 04.07.2018 - Professor Zachary Steel - Psychiatrist
Five reasons we should be talking about first responders and PTSD
A recently released Australian report is putting the spotlight on the emotional wellbeing of our police, paramedics, firefighters and other emergency officers.Trauma and mental health expert Professor Zachary Steel explains the top five reasons we should be paying attention.
1. PTSD doesn’t just affect soldiers PTSD is widely recognised as a risk of military service, but did you know people who work as first responders – police, ambulance officers, firefighters, emergency personnel – are also at higher risk?
First responders who are first at the scene of an accident, natural disasters or other incidents often put their own safety at risk to help others.
Like military personnel, first responders see and experience situations that are shocking and can be hard to process.
This can lead to a higher risk of them acquiring a mental health injury such as PTSD.
2. But there are similarities between armed forces and first respondersThe experiences of first responders and their military comrades - who both run towards disasters while everyone else runs away – are similar and people working in both areas are at an increased risk of PTSD.
Similarly, just as those who work in the armed forces are often characterised as stoic with unending reserves of endurance, so too are those who work as first responders.
Unfortunately, as people serving in the military and first responders see more and more incidents their risk of acquiring PTSD increases over time and their characteristics that empower them to do such a great job of protecting and caring for us, can get in the way of them seeking help for their own emotional wellbeing.
This can lead to their symptoms getting worse.
3. PTSD isn’t inevitableThere is a myth developing that all first responders will get a mental health injury and it is just a matter of time.
This is not the case. The majority of people do get through their careers without acquiring an injury.
Yet there is no doubt there is an increased risk. The one solid research finding that has emerged across multiple settings is that the more critical incidents attended, the greater the risk of acquiring a mental health injury.
The nature of the work first responders do is to be exposed to such events and the resulting risk from this has to be taken seriously.
4. Growing role of first responders makes a differenceOver time, the great work done by our first responder organisations has been getting more professional and more efficient.
The report documents how the operational tempo for first responders has increased over time. The automated systems which help ensure rapid response times and the ability to get more responders to the scene of an incident means that their level of exposure has also increased.
We also need to aware of the role downtime can play in maintaining good emotional wellbeing, and when the demands on our first responders grows giving them the downtime they need diminishes.
5. Help is availableThe When helping hurts: PTSD in first responders report puts a bit of a highlight on some well-established evidenced-based treatments that, unfortunately, a lot of people aren’t accessing.
The one thing that we know is that recovery and improvement is possible, but often it is a long journey and people do sometimes experience setbacks.
There is a network of agencies around Australia that have a lot of experience working with first responders and other people with PTSD.
Even if you experience some early setbacks it is good to keep trying to find people you trust and people you can work with.
If you need urgent mental health help, call Lifeline on 13 11 14.
SJORG.ORG.AU | 04.07.2018 - Professor Zachary Steel - Psychiatrist
Helping first responders at risk of PTSD
There is growing awareness that people working as first responders such as ambulance officers, police officers and firefighters are at risk of acquiring a mental health injury such as PTSD.
Trauma and mental health expert Professor Zachary Steel explains why.
Why are first responders more at risk?
First responders are those people who provide the initial response in any kind of emergency situation – police, fire, ambulance, rescue and other emergency workers spend their working days helping people in urgent need and often put their own safety at risk by doing so.
Their risks of PTSD and other mental health injuries are larger than the general population because of the work they do involving repeated exposure to traumatic incidents.
What characteristics make it harder for people to seek help?
People who do this kind of work are pretty hardy, they are often stoic and have high levels of endurance, which make them well suited to their roles as first responders.
Unfortunately, it is exactly these character traits which can get in the way of identifying injury and seeking help – they just want to serve and push on so don’t take stock of their own emotional wellbeing.
It is often the very thing that empowers first responders to do such amazing work, that also makes them vulnerable when they do acquire a mental health injury.
What are the signs of PTSD?
A large body of research has clarified the key signs and symptoms of PTSD but they can be difficult for sufferers and health professionals to identify and they may appear to vary from person to person, as do the triggers.
For first responders the signs of PTSD are not that dissimilar to their work which makes its especially hard to recognise they have become injured – both involve high levels of hyper-vigilance, attention to sources of threat, reactivity and high emotion.
his means there is often a long delay in identifying those who need help and often when a first responder is recognised as unwell, they are really unwell.
Many first responders carry these injuries for a long time. By the time of diagnosis it is not uncommon that they have depleted their personal and family resource, which means by the time that they are unfit for work their support networks are fragile or gone.
Why is this report significant?
The critical thing about this report is that such a wide range of organisations were involved in the discussion that led to the report.
It is very encouraging to see so many peak organisations brought together, at both Federal and State levels, to discuss this growing issue.
What does it suggest for organisations and individuals?
Many organisations are taking positive steps to make change and some are further along this journey than others.
It also highlights the importance of organisations having a healthy management structure which builds respect among colleagues and management and includes human resources to help first responders with their mental health needs.
For individuals who are working as first responders, it is about increasing awareness of their heightened risk and how to get help, not leaving this for so long.
Helping first responders at risk of PTSD
There is growing awareness that people working as first responders such as ambulance officers, police officers and firefighters are at risk of acquiring a mental health injury such as PTSD.
Trauma and mental health expert Professor Zachary Steel explains why.
Why are first responders more at risk?
First responders are those people who provide the initial response in any kind of emergency situation – police, fire, ambulance, rescue and other emergency workers spend their working days helping people in urgent need and often put their own safety at risk by doing so.
Their risks of PTSD and other mental health injuries are larger than the general population because of the work they do involving repeated exposure to traumatic incidents.
What characteristics make it harder for people to seek help?
People who do this kind of work are pretty hardy, they are often stoic and have high levels of endurance, which make them well suited to their roles as first responders.
Unfortunately, it is exactly these character traits which can get in the way of identifying injury and seeking help – they just want to serve and push on so don’t take stock of their own emotional wellbeing.
It is often the very thing that empowers first responders to do such amazing work, that also makes them vulnerable when they do acquire a mental health injury.
What are the signs of PTSD?
A large body of research has clarified the key signs and symptoms of PTSD but they can be difficult for sufferers and health professionals to identify and they may appear to vary from person to person, as do the triggers.
For first responders the signs of PTSD are not that dissimilar to their work which makes its especially hard to recognise they have become injured – both involve high levels of hyper-vigilance, attention to sources of threat, reactivity and high emotion.
his means there is often a long delay in identifying those who need help and often when a first responder is recognised as unwell, they are really unwell.
Many first responders carry these injuries for a long time. By the time of diagnosis it is not uncommon that they have depleted their personal and family resource, which means by the time that they are unfit for work their support networks are fragile or gone.
Why is this report significant?
The critical thing about this report is that such a wide range of organisations were involved in the discussion that led to the report.
It is very encouraging to see so many peak organisations brought together, at both Federal and State levels, to discuss this growing issue.
What does it suggest for organisations and individuals?
Many organisations are taking positive steps to make change and some are further along this journey than others.
It also highlights the importance of organisations having a healthy management structure which builds respect among colleagues and management and includes human resources to help first responders with their mental health needs.
For individuals who are working as first responders, it is about increasing awareness of their heightened risk and how to get help, not leaving this for so long.
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Accordingly, before taking any actions based upon such information, we encourage you to consult with the appropriate professionals. We do not provide any kind of medical and/or legal advice. The use or reliance of any information contained herein, or on our website, is solely at your own risk.
