Creating awareness of PTSD and CPTSD for our South African Firefighters/EMTs/Paramedics and Law Enforcement

Wednesday, March 2, 2022

Why is Mental Health Coaching Important?

 It is very important to understand how and why we may or may not react, to various situations. When we were all students, education, and training in our own mental health and its challenges, was glossed over. It is the elephant in the room that no one wants to acknowledge or deal with, and most certainly not your employers. You must be tough, cowboys don't cry. You have chosen to follow this path and if you cannot deal with it, then leave!

First Responder Mental Health Coaching is critical for the longevity of your career and relationships and, it should be presented by a colleague, who has been exposed to your working conditions. How else can someone understand your level of distress, when they have never actually experienced it, for themselves?

We know very well when an outside person comes in to tell us how to do our jobs, we fold our arms in hostility and discuss between ourselves, "what does she/he know"?

Something that has always interested me, is how first responders from the medic on the scene, to the nurses and doctors in the emergency room, treat suicidal patients who have survived a suicide attempt. They are treated with contempt and very little empathy. Amongst ourselves, we often 'joke' about the incident, perhaps it is a coping mechanism. Do we react in this way because we are afraid this is a us, looking at ourselves in the mirror every morning, or our future selves? Does this behavior act as a protective shield around what is really going on inside, day in and day out. Would be very interesting research material. 

First responder mental health coaching is about teaching you about the different mental health issues you will be faced with during your career, how to identify them, and seek help before you end up in a body bag. It is here to educate you on the challenges and strategies, you can use for yourself or your partner. It is about encouraging healthy outdoor physical activities or hobbies to cope with the ghosts and complexities of some of your calls.

Many of the older firefighters will throw their arms up in protest, "they don't make firefighters like they used to", 'this new breed of firefighters are soft". We have all heard them and these words may have even come from our own lips. But are they soft, this new breed, this young blood, or do their working conditions, current call rates, the high crime, and violence they are exposed to, day in and out, very different to the exposure in "the good old days of firefighting" 

If you are one of those old generation firefighters back in the 'good old days' consider this:

People obeyed the rule of law, the bylaws were enforced, the buildings were compliant with safety and building requirements, highrise buildings did not have informal settlements and shacks erected inside them. There were no such dilapidated buildings and inner-city slums we see today, which need to be navigated during a medical call at night, never mind when the building is well alight.  Lifts worked, stairs were not missing, buildings had running water and electricity, were not in such state of disrepair, a fire deathtrap. You did not have to dodge bullets or have bricks raining down on you while carrying out your duties. Deal with such hostile bystanders and communities armed with guns. Just a thought to ponder.

I would also like to ask the old firefighters how has their retirement faired. Did your small retirement businesses fall away or thrive. Did your marriages and relationships survive? Do you have drinking problems? How is your relationship with your children? Remember you too will carry some scars with you. No firefighter ever retires without scars, without the ghosts following you, they never retire, do they? It is time that we are all honest with ourselves. We cannot give the very best of ourselves every day to our calling and communities without some baggage. 

Perhaps we are voicing how badly things are carried out today. Should we not also be voicing and discussing, what has gone wrong? Why do the firefighters not have the tools of the trade,  is it the firefighters or is it the fire department management and structures, that have failed the firefighters and the communities they serve. So many of the firefighters work with very little or no resources and strive to do the very best they can and then go home feeling as though they have failed their communities, feel useless, worthless, dejected. Is it not time the old guard and young blood sit down to share their experiences and knowledge. Both the old firefighters and young blood need to ask themselves these uncomfortable questions so we can move forward together.

As the old guard, you knew if you were killed in the line of duty, it would more than likely be from a motor vehicle accident while responding or inside a structural collapse. Today our firefighters/EMTs are more than likely to die in one of the multiple health traps, due to lack of resources and/or backup/rescue teams, incompetent and inexperienced officers who lead firefighters to their deaths, or to be robbed at gunpoint, shot, stabbed, and raped, and/or murdered while in uniform. The playing fields have changed and just leaving home in a uniform makes us a target. 

Mental health is as important as it was then as it is now. The world we live in has changed and so with it is the need for continuous mental health care so we can retire and thrive.

Sunday, February 20, 2022

Do We Have Adequate Professional Mental Health Programs Available For First Responders in South Africa?


Welcome to my blog Because We R Warriors,

The intention of this blog is to create Mental Health Awareness and awareness of our rights as per the OHS Act 85 of 1993, for all our first responders, and to enforce the implementation of proper Mental Health Programs that actually work, made up of Medical Professionals, such as Clinical psychologists specializing in Post Traumatic Stress Disorder (PTSD) and Complex Post Traumatic Stress Disorder (CPTSD). The umbrella of first responders would include all of us dealing with continuous traumatic situations, multiple times on a shift, from the scene all the way to the receiving doctors and nurses, in the emergency trauma units.

The other intentions of my blog are to discuss how to become a good leader, that can be trusted, understand the difference between a leader and a manager.  Further to this, my blog will be discussing important issues such as Mentorship, Situational Awareness, Debriefing, First Responder Safety, Crew Resource Management (CRW), Conflict Resolution, Mental Health First Aid, and various supporting legislation.

Do we have adequate professional Mental Health Programs available for first responders in South Africa? This question has been a bone of contention for many years. 

In my own personal experiences and from what first responders have shared with me, the answer is a resounding NO!

As human beings, we are not supposed to be in a permanent adrenaline state. To have adrenaline coursing through your body 24/7 is unnatural to the body. In fact, is it harmful both physically and mentally and we will explore this in more detail? 

The question therefore is, why do employers of first responders expect their first responders to work at this pace and exposure, without some form of a proper Mental Health Program? I am not talking of the EAP - Employee Assist Programs, in my opinion, with my own experience and feedback from hundreds of first responders, exists on paper or in the boardroom. The EAP does not actually carry out what it is supposed to, relying on 'counselors' who have never actually worked on the road, nor medically trained to deal with the turbulence of emergency workers' mental state. How do they then understand what we are going through?

I will explore this in more detail in subsequent posts.

Occupational Health and Safety Act 85 of 1993

We also need to ask ourselves why do we not receive adequate mental health support? Why are our Fire Departments, Ambulance Services, Law Enforcement, and Hospitals who employ us, not held to account for the failure of not fully implementing the Occupational Health and Safety Act 85 of 1993 and having their COIDA system operating within the Act?

Let us look at the purpose of this act which is "To provide for the health and safety of persons at work and for the health and safety of persons in connection with the use of plant and machinery; the protection of persons other than persons at work against hazards to health and safety arising out of or in connection with the activities of persons at work; to establish an advisory council for occupational health and safety, and to provide for matters connected therewith". Direct Quote (South Africa 1993: p2).  We will explore the Act in more detail in other posts.

Why are the 4 weeks of post-trauma exposure not taken more seriously, by employers and employees alike, when the scientific evidence clearly shows that if a first responder receives counseling within the first 4 weeks of the incident, the chances of developing Post Traumatic Stress, are drastically minimized?

Why are the officers and/or line managers not professionally trained to understand mental health issues and spot the warning signs in their teams?

Why are we as first responders, not trained to spot the warning signs in ourselves and in our colleagues?

There has been some global research, indicating quite strongly, that when the first responders, who were together on the same incident, share their experiences and talk it out with each other, can assist more than speaking to someone, who has absolutely no idea what actually happened on the call.

Why are there no regular workshops on Mental Health Issues and education carried out at the workplace? Why is there no ongoing support for the first responder and their families?

Why once first responders take that first courageous step to raise their hand for help, are they victimized by their line managers and management, to the point, that the victimization perpetuates PTSD and CPTSD?

Work Situation and home situation: This victimization can lead to the first responders either committing suicide, turning to narcotics, drugs, and alcohol, or being forced to resign, take early retirement or go on disability. How often have we witnessed our peers coming drunk to work, becoming more aggressive and increasing anger outbursts, sometimes rather violent ones, or using narcotics to cope while on duty, gambling problems, to name a few? 

The work stress and demons will eventually follow them home, to the only stability the first responder has. When this breaks down, divorce, affairs, and a family has been ripped apart. They are now all alone without support from the employer or family, what is left? What does management do, charge you, fire you instead of looking at the root cause of the outcome? Therefore reacting to the signs and symptoms rather than treating the root cause of the situation.

Why is there no accountability to the employer when an employee commits suicide? Surely if they work as firefighters, EMTs, and other first responders their suicide MUST be investigated by the Police, OHS, and COIDA officials on whether the employer assisted and supported the deceased in a mental health program. Were they victimized? Did the employer follow the OHS Act 85 of 93, if not then they must be held accountable for the employee's suicide?

The same must be said about a Firefighter/EMT and other first responders who have been boarded off on disability, due to PTSD or CPTSD. If you have had to go on disability before your retirement age, the employer must pay your medical aid and your basic salary for lifel

Employers that employ first responders had gotten away for far too long in South Africa for not following the Basic Conditions of Employment and the Occupational Health and Safety Act 85 of 1993.

Debriefing: Why is there no professional training available, to teach leaders how to debrief correctly, and understand the different types of debriefing and, when and where to use them? Understanding the importance of Critical Incident Debriefing, Critical Incident Stress Debriefing, Follow up Debriefing, and Peer Debriefing Process for Critical Incidents is crucial, for the state of mental health of the teams and to prevent the trauma from progressing into a debilitating disorder.

Why do Medical Aids not cover PTSD and CPTSD and the subsequent medication and treatment?


Resources Consulted

South Africa. 1993. Occupational Health and Safety Act 85 of 1993. Cape Town: Government Printer.

Available:

https://www.gov.za/sites/default/files/gcis_document/201409/act85of1993.pdf

Accessed on 2022/02/20

Why is Mental Health Coaching Important?

 It is very important to understand how and why we may or may not react, to various situations. When we were all students, education, and tr...