There are no textbooks or educational syllabi for coping with the situations first responders see every day. When they witness sick and vulnerable patients constantly, how do our personnel take care of themselves after calls? What measures do they take? Most just continue with their day and run the next call.
This approach doesn’t always work. Many first responders experience mental health issues related to traumatic events. Suicides and mental health disorders are elevated among EMS and other first responders, with large numbers diagnosed with PTSD and/or depression and an alarming number who abuse alcohol and other drugs.
Thirty-four percent of EMS personnel report being diagnosed with PTSD, a rate 10 times that of the general population.1 Surveys have found traumatic events on the job have caused 84% of first responders to experience mental health issues and that 55% of first responders feared managers would treat them differently if they voiced mental health concerns.2
The mental health stigma and corresponding culture must change. First responders need healthier ways to cope with the stress of their jobs.
A Four-Legged Solution
I work as a paramedic for Gaston County EMS in North Carolina. I have experienced many horrendous events that could lead to mental disorders if left untreated.
I became interested in mental wellness when we lost several coworkers to suicide. I also noticed several of my cohorts involved in alcohol or substance abuse. It takes a toll on you emotionally and physically to see traumatic events befall people you call family, so I decided to learn more about mental wellness among first responders and how to cope with the stresses of the profession.
I learned our workforce has a mental wellness stigma. When I first entered EMS, I was told to “suck it up,” and that “nice people don’t make it in EMS.” We cannot say these things to our partners. We must know the warning signs of mental illness and help our colleagues get the treatment they need and deserve.
That challenge had me searching for ways to help my colleagues cope. One outside-the-box possibility was incorporating therapy dogs at our agency. We introduced three during a biannual recertification academy in 2019.
The academy brings 10–15 employees in for training at headquarters. We had the dogs’ handlers explain about mental illness and therapy dogs. If employees wanted to participate, we introduced them to the dogs. Only one declined, due to fear. We didn’t collect any feedback during the academy; it was just a time for the employees and dogs to meet. The employees petted and interacted with the dogs, and some got on the floor with them. After the academy the employees asked when the dogs were returning. Shortly thereafter a crew had a pediatric traumatic call and requested the dogs during the debriefing.
Knox, Bijou, and Macy Mae are our certified therapy dogs. Knox is a 7-year-old Great Dane that weighs 198 lbs. He is a gentle giant and great with everyone. Bijou is Knox’s mother and very sassy in her old age. Macy Mae is a 3-year-old Great Dane who is great at pressure therapy (using her weight as a calming mechanism) and will be certified soon.
The goal of the dogs is to provide emotional support to the first responders of Gaston County EMS. They will be brought in during shift changes and professional developments and after critical calls. They will not remain at the station all day but will attend morning sessions and then go home until the afternoon. The therapy sessions will be 30–60 minutes, depending on group size, and the dogs will receive frequent breaks throughout each session.
Value to Personnel
To determine if the dogs are valuable to our employees, we performed a survey. First we circulated a mental health presurvey that included a needs assessment to every employee at Gaston County EMS. The two-week therapy dog sessions began shortly thereafter. The dogs and their handlers came to Gaston County’s headquarters during shift changes and professional developments. Each employee had the opportunity to interact with them.
After the therapy sessions we sent follow-up surveys. All data remained anonymous. The results supported that the dogs are valuable for our responders. Eighty percent of those who participated reported high stress that was reduced in the therapy dog session. Most responders said they would like to see the dogs daily or weekly.
Since the study we have continued to employ the therapy dogs. The stressors facing EMS are even greater today than when we started the program. We face a pandemic, increased death rates, complex interventions and policies, an upsurge of complex patients, hospitals being on redistribution, changes to personal protective equipment, alternative living arrangements, and increased workload. I anticipate more agencies using therapy dogs as a healthy way to help cope with the stresses of the profession.
1. Barber E, Newland C, Young A, Rose M. Survey reveals alarming rates of EMS provider stress and thoughts of suicide. J Emerg Med Serv, 2015 Sep 28; www.jems.com/special-topics/survey-reveals-alarming-rates-of-ems-provider-stress-and-thoughts-of-suicide/.
2. EMS1. Survey: Majority of responders face workplace mental health challenges. EMS1, 2017 Apr 22; www.ems1.com/fire-ems/articles/survey-majority-of-responders-face-workplace-mental-health-challenges-VVzNZefxPvsq4gSp/.
Jessica Ross, MHS, NRP, is a training major at Gaston County EMS in North Carolina.
Elizabeth Tait, PhD, is an associate professor of health sciences at Western Carolina University in Cullowhee, N.C.