Today’s guest blog comes to us from Dr. Ben Bobrow, Medical Director – ADHS, Bureau of EMS & Trauma System. Dr. Bobrow shares his thoughts on the potential mental health issues facing those who respond to health crises every day…..emergency medical providers. Once you’ve had a chance to read it, we’d love to hear your thoughts. Generating meaningful conversations around the health issues making headlines is another way we are working toward our long-term goal of one day making Arizona the Healthiest State in the Nation!
While not a new public health problem, with several recent celebrities tragically taking their own lives, suicide has dominated much of the lay news. Alarmingly, in 2016, nearly 45,000 deaths in the United States were attributed to suicide making suicide the 10th leading reported cause of death for all ages. In an attempt to combat this widespread problem (which is intertwined with our opioid epidemic), suicide and mental health programs have received significant federal funding to implement effective prevention strategies. Despite these large scale efforts, national rates of suicide have increased 34%, from 10.4 per 100,000 in 2000 to 13.92 per 100,000 in 2016. Arizona is in the top tier of states for suicide.
Research has shown the risk of suicide is not equal across geographies or occupational fields with notable increased risk among law enforcement professionals, firefighters, veterans, physicians, and EMTs. The increased suicidality observed in these occupations may be related to inherent stressors and occupational hazards found in their workplaces such as repeatedly being witness to all varieties of adult and pediatric trauma, shift work, and even physical abuse suffered by providers. New data from Arizona presented at the 2018 National Association of EMS Physicians conference suggested between 2009-2015 there, was a 39% relatively higher risk of dying by suicide for EMTs in Arizona compared to the general public.
In addition to its link to suicide, chronic stress is also linked to significantly higher rates of post-traumatic stress, substance abuse, depression, anxiety, poor work performance, divorce, and burnout. We all recognize it is nearly impossible to help others when the provider is struggling. And while easy to recognize in the patients they care for every day, it is often difficult for emergency medical providers (both inside and outside the hospital) to recognize these clinical entities in ourselves.
Last year, in response to these findings, the Arizona Department of Health Services (ADHS), Bureau of EMS and Trauma System commissioned a broad group of dedicated EMS and behavioral health experts to develop an effective strategy to bring about awareness and help mitigate the impact of these natural human responses to challenging situations.
Since its inception, the EMS Resilience, Wellness, and Safety Workgroup have met regularly and held a successful Summit in conjunction with the ADHS Public Health Emergency Preparedness in September, 2017. One of the outputs of that Summit was a public health website with easily accessible resources designed for all emergency medical providers. The Workgroup recognized the reality that these major stressors impact in-hospital and prehospital providers equally. The overarching goal is to eliminate stigmas, foster more understanding, and provide better access to accurate information and assistance for all providers.
Thank you for sharing these resources widely and please look for information on the upcoming Resilience Summit planned for the fall of 2018. https://www.azdhs.gov/preparedness/emergency-medical-services-trauma-system/index.php#resilience-home