Wellbeing and Mental Health for Paramedics

Concern rose when it was bought to attention that mental health was a growing global issue (1) in this modern era, with a significant rise in patients calling emergency services to attend to mental health concerns. But what hasn't gained mass media attention is the mental health state of those providing the frontline emergency care. Emergency workers will often deal traumatic incidents as part of their daily routine, while the general public will only witness 1-2 incidents. This places paramedics at a high risk of developing mental health issues due to the prolific and distressing nature of their work.

Prevelance and Why They Are at Risk?

There is a growing concern regarding the psychological welfare of frontline workers. Paramedic’s, often being the first to arrive to major accidents, will face some of the most gruesome and horrific scenes.

From cutting open mangled vehicles, breaking ribs to provide effective CPR and dealing with distraught and often violent patients, these are some of the things that paramedics deal with on a daily basis.

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However, not all of these will cause a paramedic to develop mental health issues. Its largely dependent on a multitude of factors, like how they perceive the incident, the coping mechanisms they chose to utilise and whether the incident resonates on a personal level.

While paramedics are equipped with an array of skills to help them cope and deal with traumatic incidents, the nature of their profession means they are exposed to these incidents repeatedly. The cumulative affect is what can leave paramedics with adverse mental health complications.

While most individuals are able to return to a sense of normality and cope with their reactions to a traumatic event approximately 4 week after witnessing it, according to B. Papiernik, Paramedics have a harder time doing this as they, again, exposed to another traumatic event, known as the “does effect”. As a result of their increased exposure, paramedics have a much higher risk of developing PTSD and experiencing severer symptoms.

Adverse Affects of Ptsd Why Its Bad

A report conducted by illustrates the high prevalence of mental health conditions within the ambulance community finding “rates of 11% for PTSD, 15% for depression, 15% for anxiety, and 27% for general psychological distress amongst ambulance personnel”. While these figures may first appear to be low, when compared to the PTSD rates of “7.3% among firefighters and 4.7% for police” they show that paramedics have the highest rate of PTSD amongst other emergency services workers.

Chronic Stress

However, it also the demanding nature of their work that can take a toll on the mental health. According to the AMBULANCE SERVICES ACT 1986, paramedics are legally obligated to “respond rapidly” to “medical emergencies” and to use “specialised medical skills to maintain life and to reduce injuries”. These legal obligations place an incredulous amount of pressure on paramedics as their daily duties make them responsible for maintaining human life through their work.

Responding to life threatening cases quickly and having the fate of someones life in their hands 
can prove to be an emotionally taxing job, especially when having to make critical decisions under time pressures. Combine this with strenuous shift work dealing with negative patient attitudes and the overall unpredictability and uncertainty of their profession, it becomes apparent why the mental health of paramedics is of such high concern.

In most cases, paramedics demonstrate the resilience needed to combat acute stress and have the appropriate social framework to support them. However, when emotional resources are depleted, and energy reserves are low, paramedics become vulnerable to developing chronic stress due to the daily work demands and difficulties they face.

While stress is a natural human emotion and in small quantities can be part of a healthy lifestyle if managed appropriately, the cumulative exposure to stress that paramedics face as part of their occupation can have dire consequences and this is when chronic stress can pose a problem. In a study conducted by … researches investigated the effect of stress on paramedic’s ability to provide care to patients. Their findings show that paramedics, when exposed to a stimulated critical event, experienced elevated levels of anxiety and salivary cortisol levels. These results were considerably higher than the global rating scores. Their research suggests that the clinical performance and documentation appear vulnerable to the impact of acute stress. This study reiterates how imperative it is for paramedics to maintain a healthy emotional and mental state so that they can continue to make good decisions that have positive impacts on patient wellbeing.