Work Disability Management of PTSI in Paramedic Service Organizations: A Needs Assessment
Objective
The objective of this needs assessment was to determine gaps and challenges between the current and desired conditions for addressing post-traumatic stress injuries (PTSI) in paramedic service organizations. Specifically, this study aimed to:
- Identify what paramedics need from paramedic service organizations to address PTSI;
- Understand how paramedic service organizations are currently addressing PTSI;
- Identify challenges to preventing and managing PTSI at the organizational level; and
- Provide recommendations that would address the identified needs and challenges while improving performance
Methods
We conducted semi-structured interviews with 11 key informants representing three stakeholder groups: 4 frontline paramedics, 5 supervisors and 2 union representatives. Interviewees represented services from British Columbia, Al - berta, Yukon, Ontario, Prince Edward Island, and New Brunswick.
The duration of the interviews ranged between 68 and 148 minutes, with an average of 95 minutes. The interview questions were designed to understand the existing organizational initiatives and processes, the preferred situation for addressing mental health needs, and the challenges to addressing PTSI in the workplace. The interview guides were tailored to each stakeholder group.
General Findings and Discussion
Significant strides have been made over the past decade to avoid and reduce the impact of PTSI amongst paramedics; there has been a noticeable shift in culture and the availability of resources. Our semi-structured interviews with key informants in the Canadian paramedic community revealed seven core elements for an effective and accessible work disability management system for addressing PTSI:
- recognizing non-traumatic and chronic stressors as precursors to PTSI;
- building and maintaining resilience;
- stigma reduction;
- supervisor support;
- programs, policies and practices for managing PTSI;
- additional time for recovery; and
- early and gradual return to work with modified duties.
Each identified element is necessary but insufficient by itself to create an effective disability management system for the prevention and management of PTSI. Recommendations from this study will be embedded within the Canadian Work Disability Management System Standards for the Prevention and Management of PTSI in Paramedic Organizations to ensure synergistic application of the core elements.