To prevent burnout in a stressful work environment, agencies must take steps to ensure that providers are protected from mental illness.
In an EMS1 webinar sponsored by ZollA panel of EMS leaders shared their experiences with how their agencies’ mental health support programs can create psychologically healthy workplaces. This included EAPs that understand providers’ needs, peer support teams, and EMS chaplaincy.[At the end of this article, download a copy of Richmond Ambulance Authoritys Peer Support team Ethics Contract and privacy considerations]
The panel also included:
- Nicole Holm MA, BCC, chaplain for Allina Health EMS
- Xavier De La Rosa BS, LP NRP, FP, Chief Clinical Officer for Harris County ESD 11 Mobile Healthcare
- Sean Simmonds, safety and emergency preparedness manager for the Montgomery County Hospital district
- Rebecca Szeles is a nationally registered paramedic, and communications supervisor at Richmond Ambulance Authority.
You can watch it now:
View on-demand – How to create a mental wellness-friendly environment at your company
Learn how mental support programs can reduce stress in the workplace
Here are some takeaways from the live conversation on the relationship between mental and spiritual burnout.
1. Peer support can be helpful in everyday stress management, not just during crisis situations.
Rebecca Szeles, Paramedic, shared her experience as part of Richmond Ambulance Authority’s Critical Incident Stress Management Team & Peer Support Program.
Peer support providers are able to identify warning signs that indicate that a call that was missed by CISM may be affecting a provider. Szeles pointed out that not every call will affect everyone in the same way. She illustrated this with a personal story she shares during training.
Szeles’ first call was a 12-year old pediatric arrest. But that call is not what stuck with her. The triple A call she received just weeks after the death of her grandfather was what really hit her.
It’s not surprising that CISM and peer support programs can be extremely helpful in helping providers after a serious incident. However, Szeles explained that peer help can also help providers process calls they receive each day as well as daily stressors. Peers can relate to stress at home, including financial concerns and elder care problems due to schedules.
These providers are able to identify signs and offer help to those who have worked with them every day. Szeles stated that if we catch the signs early, it is possible to start the healing process before the situation gets worse.
Szeles added that a peer support program has another benefit: your most motivated employees will be your peers. These employees can act as cheerleaders for the company during difficult times or calls. You can also motivate your employees to create a better work environment.
These are the key tips Szeles shared for a successful EMS peer-support program:
- A culture of trust is essential to build a strong peer support group.
- Only a peer is able to be a friend: Field supervisors shouldn’t be in a position where they have to report an employee.
2. Chaplaincy can be a misunderstood asset that is often underutilized
Allina Health EMS Chaplain Nicole Holm, MA (BCC), chaplain with Allina Health EMS encouraged the group to approach chaplaincy with a beginner’s mindset. Holm dispelled some of the most common misconceptions people have about chaplaincy.
- Myth: Chaplains offer spiritual support. Holm observed, “What I really enjoy to tell people is my particular belief system, and my particular history is really irrelevant.” I am here for you in any way that is beneficial and life-giving. The hope is that an EMS chaplain won’t be here to preach, to pray, to read scripture, or any other purpose you might have in mind when you think about a chaplain. It is there to help you in whatever way you find life-giving. The counsel you receive can be different. It can be poetry, nature, or prayer. It has nothing to do spirituality or religion. You may have your own deep sense and purpose and meaning. She said that we’re here to help all people in all their ways.
- Myth: Chaplains intervene in order to maintain calm. Holm shared an anecdote in Chaplain Kate Braestrups’ book. A family member said, Oh! You’re here for me, keep you from freaking me out. Braestrup said, “I’m not here for you to freak out.” I’m here to support you as you grieve, laugh, suffer, or sing. It’s a ministry of presence. It is showing up with a loving spirit. Holm stated that this is the essence of EMS chaplaincy. It’s an added benefit to EAP and peer support. It’s people who are designated to be there for their providers when they cry, grieve, laugh, suffer or sing to show love.
- Myth: Chaplains are available for difficult calls. Holm explained that we’re here to help in subjectively difficult calls as well as in difficult calls generally. Recognizing that one medic’s trigger may not be the same for another, and vice versa, is important. Calls that aren’t difficult for someone else may be for someone else depending on their family history, their backgrounds, and the circumstances of our lives. So, we are responsible for providing coverage when needed.
3. Without a culture and a plan to make it effective, an EAP is not enough
Sean Simmonds (MCHD emergency preparedness safety manager), noted that healthcare providers are better for patients with poor health. We are givers. We try to alleviate suffering and pain for others. It’s difficult for us to be the patient and turn around.
Simmonds stated that while most healthcare agencies recognize mental health as a serious concern they have very poor coverage. We put so much emphasis on making sure our line of work gets recognized, is aggressive, and does the best for our service areas that we sometimes forget about including our providers in our preparation.
Simmonds said that once we’ve acknowledged this fact, it’s time to take action. He said that we may have an EAP that provides counseling services, home coaching, and support for work-life balance. But do we have a culture that allows people to say, Hey, this was really hard for me? It didn’t hurt me physically, but it hurt my soul. I began having nightmares after I got home. On the way to work I had panic attacks. I was just not motivated to get up this morning.
How do we act on that culture?
A one-size-fits all approach won’t work. However, it is important that you have a plan and have identified ways to support your employees. Simmonds stated, “We need to be confident in our actions so that employees we are providing services to are confident in what we’re going for them to do.”
Simmonds stressed that a mental illness is a catastrophe, just like a hurricane or a huge freeze, or even a tornado. It can totally ruin a person’s life, financial background, family life, or work life. It is a disaster that should be prepared just like we prepare to deal with fires and hurricanes.
Simmonds stressed that a mental illness is a disaster just like a hurricane or a huge freeze or tornado. “It can absolutely derail a person’s life … destroy financial backgrounds, family life, work life. So, it absolutely is a disaster and should be prepared for just like we prepare for fires and hurricanes and everything else.” (Photo/Getty Images)
4. Be ready to assist providers during a mental illness crisis
Even with all the best programs in place for members mental health support, agencies still need to be prepared for a serious mental health crisis.
Chief Clinical Officer Xavier De La Rosa shared information about the unique partnership Harris County ESD 11 Mobile Healthcare has formed with a local hospital for behavioral health to support members.
The Honor Strong program at Cypress Creek Hospital addresses the unique symptoms of law enforcement, firefighters and frontline healthcare workers. Named after the Houston Strong motto, the Honor Strong program helps first responders weather a mental storm.
The program offers a 24/7 private, dedicated referral line as well as a voluntary mental health inpatient service for military personnel and first responders. This is staffed with certified first responder counselors, who are also first responders.
The program offers tiered support. This includes a telehealth mental assessment, mobilizing the counselor to meet the provider, and VIP admission to the hospital. Providers have their own entrance with their own unit or wing to avoid being mixed with patients they may have brought.
De La Rosa pointed out that the effects of these experiences can be more devastating than most people realize on those who serve in emergency positions. We are so excited about the Honor Strong Program. We are looking forward to seeing this program grow in the country and throughout the region.
Your agency has mental health needs that are real and present
Simmonds stressed that you must be prepared for mental health crisis and needs. Your agencies have people going through mental health crises right now. He said that they are in my agency and in yours. It’s important to recognize that and prepare for them when they decide to speak up. It’s okay if they don’t want to. It is possible for someone to reach that point. Kudos to them when it happens. We need to be ready for them when they get there.
Simmonds recommended that the first step in preparing for mental health support is to protect privacy. If a member gives out information about their private life, it must be understood that it will not go further than it has to. If someone is threatening themselves or others, they will need to expand their support to ensure that the right level of support is available. But only on a strictly need-to-know basis.
