How Stigma Impacts Post-Traumatic Stress Treatment for First Responders

You’re the one who answers the call.

The one who shows up.

The one who offers light through life’s darkest moments.

So how could you possibly be the one feeling lost?

Feeling lost is common for First Responders, even while at work doing what they love.

If you’ve experienced feeling lost, at work or at home, you’re certainly not alone.

First Responders and Post-traumatic Stress

The Canadian Mental Health Association (CMHA) says First Responders (police, firefighters, and paramedics), military personnel, doctors, and nurses all experience higher rates of post-traumatic stress than people in other professions.

For example, twice as many First Responders compared to the average population experience a post-traumatic stress injury. That’s according to The Center for Suicide Prevention.

Dr. Jonathan Wan, MD, FRCP(C), Medical Director at Homewood Ravensview adds that this can look quite different from person to person.

General signs of post-traumatic stress, according to Dr. Wan and the CMHA, include:

  • Anxiety, avoidance, and dread about attending work
  • Insomnia and/or nightmares about traumatic events
  • Feeling “on edge” and full of physical tension
  • Apathy or having reduced interest or pleasure in spending time with others or engaging in usually enjoyable activities
  • Persistent self-blame or guilt related to traumatic experiences
  • Re-experiencing the traumatic event
  • Feeling detached from reality or lost, disengaged, not really present
  • Emotional numbness or having hard time feeling or expressing emotions
  • Concentration issues (ie., brain fog)

Stigma Still Exists. You Can Fight Back.

“Unfortunately, stigma for First Responders reaching out still exists today,” says Steve Farina, City of Coquitlam Fire Captain, Vice President of Lower Mainland North at BC Professional Fire Fighters Association and Vice-Chair of the BCPFFA’s Mental Health Taskforce and Occupational Health & Safety Committee.

Stigma can be internal (ie., self-stigma) or external (ie., from peers or institutions).

Internal stigma

“The biggest barrier for reaching out seems to be self-stigma (that internal conversation where one feels weak, fearful of being judged, etc.),” says Farina.

Dr. Wan further explains that despite greater awareness related to mental health issues, reaching out can still remain difficult.

“Part of the reason is because internalized stigma can present as the negative attitudes and self-judgement we have about our own experiences,” he says.

External stigma

External stigma can come from comments said by colleagues and supervisors, or fears about what they may say or think.

Negative perceptions (ie., judgements) and harmful behaviours such as gossip towards First Responders who have experienced mental health challenges or mental health conditions are examples of external stigma, says Farina.

Dr. Wan adds that external pressures can range from peers looking unfavorably on taking time away for recovery to institutions not acknowledging the impacts of psychological injuries.

“Whatever the source, stigma can compound mental health difficulties and prevent individuals who would benefit from treatment in seeking prompt care,” he says.

Expert Advice for First Responders

Farina says his advice for any new First Responder beginning their career is to connect to a mental health professional right away.

While we understand it’s not always easy to reach out, Farina suggests there’s benefit to seeking support sooner than later.

For First Responders with post-traumatic stress injury diagnoses, the accumulation of psychological injuries in the workplace at the expense of one’s health seems to be a common occurrence, he explains.

It’s vital for First Responders to understand their health and act accordingly, adds Wan.

“The saying of putting your own oxygen mask on in a plane before helping others is a fitting analogy,” says Dr. Wan.

“Don’t wait until your backpack is full of traumatic calls and stress and you’re overwhelmed, burned out, etc.,” he says.

Farina’s suggestions:

  • Find a mental health professional you can trust and relate to
  • Establish a relationship and baseline history early in your career
  • Check-in regularly throughout your career

Leaving symptoms of post-traumatic stress untreated can build up into a traumatic stress injury or diagnosis of PTSD.

“PTSD usually appears within three months of a traumatic event, but sometimes symptoms may not appear for years,” according to the Canadian Mental Health Association.

The benefits of working with someone at any time, according to Farina, include learning tools to:

  • Destress
  • Down-regulate your nervous system
  • Develop the awareness to know when to take a knee and reach out for help or additional support

If you’re already experiencing early signs and symptoms of post-traumatic stress, Farina encourages you to reach out and tell your supervisor, spouse, trusted coworker, or friend.

The Homewood Ravensview Difference

Come home to yourself at Homewood Ravensview.

Since opening in 2019, we’ve helped over 400 First Responders find their path forward from post-traumatic stress injuries.

We’ve made it part of our mission to continue learning and developing programming specific to the unique needs of this critical group. We do this by learning from people who get it because they have experienced something similar and know that while every trauma experience is different, you can heal from this injury, too.

Continual Learning

In partnership with Wounded Warriors Canada, Homewood Ravensview employees were given access to specialized occupational awareness training for the treatment of trauma-exposed professionals such as members of the Canadian Armed Forces (CAF), veterans, and other First Responders (ie., police, fire, emergency service professionals, etc).

The Introduction to Trauma-Exposed Professionals training program, developed by Wounded Warriors Canada’s co-National Clinical Advisor, Dr. Tim Black, has been designed to help increase competencies in the divide that exists between trauma-exposed professionals and the public.

The training program provides culturally-specific clinical approaches to support the complex mental health needs of trauma-exposed professionals and, through our partnership, is available to all Homewood Health employees.

Healing Outside of the Uniform: Guardians Program

The Guardians program at Ravensview supports First Responders in their journey in recovery from mental health difficulties.

Highlights of Treatment

  • Personalized for your unique needs
  • Medication consultation and management
  • Access to group and individual therapy
  • Ongoing assistance from trained professionals
  • Peer support from other First Responders

Treatment starts with a comprehensive and multi-disciplinary assessment to better clarify your individual needs.

You’ll gain access to individual and group talk therapy and educational tools about psychology to support your overall wellness needs.

A diverse team of physicians will then discuss ongoing interventions that can include, but are certainly not limited to, medication management.

You’ll be involved in the process of your own medical care and get the support you, too, deserve.

According to Dr. Wan, every type of treatment occurs in a therapeutic setting with other First Responders. We’ve found this promotes safety and acceptance.

Homewood Ravensview believes in the transformative power of care because we’ve seen it firsthand. If you or someone you love feels lost from trauma or PTSD, take the first step – reach out. The courage to do so could be the beginning of your path forward.

 

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