Breaking wall of silence on PTSD

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This article was published 28/3/2016 (1845 days ago), so information in it may no longer be current.

Some first responders in Winnipeg are paying out-of-pocket for mental-health services to avoid facing a perceived stigma in the workplace — months after provincial legislation was implemented aiming to make it easier to receive treatment for work-related, post-traumatic stress disorder.

Police, paramedics, firefighters and military personnel are still likely to "go underground" when seeking help for mental illness, said clinical psychologist Richard Shore, chairman of the board of directors for the Anxiety Disorders Association of Manitoba.

He says the first responders he treats for symptoms of PTSD will usually exhaust their third-party health coverage, which typically covers a percentage of three to 10 sessions per year, and then pay out-of-pocket rather than accessing treatment available through employee-assistance programs and the Workers Compensation Board of Manitoba because they want to avoid scrutiny from co-workers and supervisors.

"That’s not unusual. What they say is it’s worth it to them to know that it’s confidential," Shore said.

"It’s a shame that they can’t utilize the coverage that they were given but there’s so much paranoia (about) the cost of (employers) finding out."

Unions representing local police, firefighters and paramedics say they know more first responders are suffering with PTSD and other mental-health conditions than are willing to ask for help from their employers.

A 2014 health and wellness survey of 400 Winnipeg Police Service officers found about six per cent of them likely suffered from PTSD, "yet the record of claims before WCB from our membership is very modest," noted a Winnipeg Police Association report last year.

The report said the police service’s in-house mental-health supports could be contributing to the relatively low number of claims filed, but WPA president Maurice Sabourin told the Free Press some officers are concerned about informing the police service that they need treatment.

The WPS declined to comment.

"We do have a psychologist on hand, but the unfortunate thing is some members still see a psychologist as being a stigma and there’s the concern that it’s not as confidential as it should be because the psychologist is an employee of the service. There’s always that concern that, even though there’s patient-client confidentiality, the psychologist is an employee of the service and is anything filtering through?" Sabourin said.

This is in spite of existing Manitoba legislation that officially recognizes post-traumatic stress as a work-related condition.

The legislation, which came into effect at the beginning of the year, was designed so employees in high-risk jobs no longer have to prove their work contributed to their PTSD. It means employees who are diagnosed with PTSD are immediately eligible for treatment and workers’ compensation.

Alex Forrest, president of the United Fire Fighters of Winnipeg, said 10 firefighters have filed workers’ compensation claims for PTSD treatment since the law came into effect.

He said the union wants to see the fire department bring in a full-time mental-health officer to help fire and paramedic staff.

"A lot of firefighters, they are dealing with it themselves. And we are trying to fight that, because these are firefighters that have always wanted to help people and now it’s very difficult for them to ask for help. They don’t want their fellow workers to know that they are having issues," Forrest said.

"But what happens is that many of these (individuals) that deal with it on their own, they come up in the system in other ways.

"We deal with our members that deal with alcohol abuse, drug abuse, anger management, marital breakdowns — so that’s how we know there’s so many more than just the 10 that have come forward and formally put in workers’ compensation claims."

As they continue to advocate for more mental-health resources, both unions say awareness is improving and attitudes are changing within police and fire departments, which are now seeing more retired employees seeking help for mental illnesses.

"They’re changing, but they’re slow. It’s just like any change. Sometimes, it takes time for members to trust the system of confidentiality and to actually feel comfortable with coming forward," Sabourin said.

One of the common first symptoms of post-traumatic stress is rage, which can lead to discipline issues at work, along with dissociation from reality (zoning out), anxiety, depression and panic attacks.

PTSD often manifests itself via drug and alcohol abuse and, if left untreated, leads to an increased risk of suicide, particularly for first responders, who will often play down symptoms because they don’t want to stop working, clinical psychologist Shore said.

"The higher in authority — the higher the better — needs to convey down the line that PTSD should not be stigmatized and that it is the nervous system’s normal reaction to something that it can’t handle," Shore said.

katie.may@freepress.mb.ca