Read a PTSD discussion in another thread. Will reply here.
These changes came after I retired. But, better late than never.
Our department handles Mental Health and Wellness this way. Other 9-1-1 services may vary.
I think the first thing for Paramedic applicants to understand is what they are getting into.
Emergency call volume can have an impact on mental health and wellness.
Dedicated in-house Staff Psychologist/Psychological Associate in place since 1986 who provides 24/7 confidential consultation, and a Peer Resource Team established in the late 1980s to provide confidential peer-to-peer support.
• Peer-led training (2016-2018) for all staff, encompassing Psychological First Aid, suicide prevention/intervention, and anti-stigma training.
• Greater opportunities for time off and to reduce the need to work additional hours.
• Psychological Health and Wellness Plan for all staff (launched in February 2017).
Implementation of more compassionate administration of existing Collective Agreement provisions (February 2018), meant to increase support for
Paramedics involved in difficult emergency calls.
• Introduction of increased psychological benefits entitlement in 2018 for Paramedics and their eligible family members.
• City-sponsored TCEU Local 416 representative assigned to assist Paramedics in a safe and early return to work from injuries and illnesses (assigned in January 2019).
• City-approved provision of psychological services for Paramedics through the City's benefits provider, Green Shield Canada.
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• Expansion of the Telehealth program since March 2020 to reduce the number of Paramedic responses to 9-1-1 calls.
In February 2017, Toronto Paramedic Services launched a comprehensive Psychological Health and Wellness Plan for Paramedics, focused on prevention, reduction of stigma, timely intervention, post-incident support and increasing available resources. The Plan was developed in consultation with Union Local 416, the City’s Employee Assistance Program staff, City of Toronto Ombudsman, and People & Equity's Disability Management section.
The Plan includes the following:
o Enhancement of the in-house, volunteer Peer Resource Team (PRT) established in the late 1980s to provide 24/7 confidential, peer-to-peer
support to Toronto Paramedics. Selection and training of the team has been enriched and the team was doubled in size to 30 members to ensure greater accessibility for staff and sustainability of PRT members.
o Dedicated in-house Staff Psychologist/Psychological Associate position in place since 1986 who provides 24/7 confidential consultation; short-term, evidence-based, clinical interventions; information and referral to community-based services; assistance with navigation of mental health
systems, including WSIB; crisis intervention; and staff education.
o An extensive list of online resources for Toronto Paramedics, including access to self-help/monitoring tools as well as listings of
mental health resources in employees' own communities.
From August 2019 to August 2020, out of six available self-help tools, the highest and most consistently used tool was for Stress
Reduction.
Other available self-help tools to help identify mental health issues early and take immediate action (e.g., FeelingBetterNow®)
Protocols implemented for pre-emptive notifications to PRT and Staff Psychologist/Psychological Associate based on category of calls
responded to by Paramedics and in-person follow-up support by frontline Superintendents; notification of Local 416 also provided with consent of frontline staff.
o Peer-led training (2016-2018) for Paramedics, encompassing Psychological First Aid, suicide prevention/intervention, and anti-stigma training.
• City-approved provision of psychological servics for Paramedics through the City's benefits provider, Green Shield Canada.
o For Paramedics, $3,500 is available per person, per calendar year and for eligible family members.
o Psychological services for Paramedics is provided through the online, therapist-assisted BEACON program (launched spring 2020).
o From 2019 to 2020, there was a 19.7% increase in fees for psychological services paid to Paramedics.
• The City's Employee Assistance Program (EAP) is available to assist staff and their families. Family Services EAP (FSEAP) is also available exclusively to TCEU Local 416 members.
• Toronto Paramedic Services' senior staff meets on a quarterly basis, or as feasible, with the executive of the TCEU, Local 416 Paramedic Unit to address concerns of Paramedics and the Division. In 2020, the parties met twice (March, September).
• Toronto Paramedic Services' cross-divisional Commander staff meet monthly with the shop stewards and executive of the TCEU Local 416 Paramedic Unit to discuss new and upcoming matters and to resolve issues of mutual concern, with the objective of avoiding disputes. In 2020, all but one of these meetings were cancelled by mutual agreement due to the pandemic.
• Since March 17, 2020, Toronto Paramedic Services has operated a Staff Support Centre (SSC) that serves as a centralized information resource for all Toronto Paramedics and tracks COVID-19-related absences. In addition, the SSC:
o Provides guidance on workplace exposure/self-isolation/quarantine and wellness checks;
o Completes prompt referrals for COVID-19 testing and workplace contact tracing to identify at-risk Paramedics, thereby mitigating spread within the workplace;
o Ensures pre-shift screening is completed and follows up in real time for failed screening;
o Tracks and reports divisional Paramedics failed screening, self-isolation, quarantine and cleared-to-return-to-work metrics daily.
• Group psycho-educational sessions are offered to Paramedics following mass casualty events and significant events where multiple Paramedics are called upon to respond to a stressful incident. (e.g., Yonge St. van attack, Danforth shooting, Raptors' parade, etc.).
• Implementation of a re-integration program in spring 2018 to provide tailored support for Paramedics returning to the workplace following an operational stress injury.
• Toronto Paramedic Services is continuing to pay normal wages to Paramedics, who are asymptomatic and have been exposed to a probable case
of COVID-19 – or who are showing symptoms consistent with COVID-19 and are on self-isolation – for the duration of the self-isolation period, without impact to their sick banks or other paid leave banks.
• Toronto Paramedic Services is continuing to pay Paramedics for pre-scheduled shifts during the period of self-isolation.
• In 2020, Toronto Paramedic Services held three virtual Town Hall Meetings for staff (April, June, October) to provide Paramedics with the opportunity to ask questions (in advance or live) of senior divisional staff.
• Under a specific Collective Agreement provision, Paramedics are afforded paid time out of service on Medical Stress Leave (MSL) from 1 hour up to two additional, consecutive 12-hour shifts following exposure to difficult or critical calls.
o From 2019 to 2020, there was a 49% increase in MSL usage among Paramedics.
In addition, on April 6, 2016, the Ontario Government passed the Supporting Ontario's First Responders Act. This legislation created a presumption that post-traumatic stress disorder (PTSD) diagnosed in first responders, is work-related. The Act requires the development of PTSD prevention plans by employers of workers who are covered by the presumption (see Psychological Health and Wellness Program above). From 2019
to 2020, there was a 22% increase in WSIB hours related to occupational stress among Toronto Paramedics.
New Supports to Address Paramedic Mental Health, Wellness and Workloads
Following consultation with both TCEU Local 416 (CUPE) and People and Equity, Toronto Paramedic Services will be undertaking various further measures to support the mental health and wellness of Paramedics.
• Continue to operate the Staff Support Centre implemented in March 2020 in order to ensure continued support for Paramedics with concerns about COVID-19 related symptoms and absences.
• Continue to advocate for frontline Paramedics to receive the COVID-19 vaccination as a priority healthcare group.
• Provide additional consideration for doffing personal protective equipment (PPE) and for cleaning and disinfecting their ambulance after completion of an emergency call, as requested by the Paramedic, thereby helping to reduce workload stresses.
Conduct discussions with TCEU Local 416 regarding feedback obtained by the TCEU Local 416 Rehab Representative to enhance existing return-to-work programming for Paramedics.
• Continue to expand training for frontline Superintendents to enhance relationships with frontline staff.
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• Subject to approval through the 2021 budget process, Toronto Paramedic Services recently received Provincial funding confirmation for expanded
Community Paramedicine programming to support both the Home and Community Care sector and the Long-Term Care sector. Community
Paramedicine Expansion to Support Home and Community Care (includes COVID-19 testing and vaccinations, support for clients returning home from scheduled hospital procedures) and the Community Paramedicine Expansion to Support those awaiting Long-Term Care placement are both programs that can help in mitigating emergency calls through the 9-1-1 system and reduce paramedic workload.due to the advancement of the vaccine roll-out for the general public. Specifically, this "normal" activity means more emergency calls due to the expected relaxing of public health measures, increased movement of people and vehicular traffic, re-opening of bars/restaurants, as well as the resumption of special events and large-scale gatherings in the fall of 2021.
• Toronto Paramedic Services will continue to meet on a quarterly basis, or as feasible, with the executive of the TCEU Local 416 Paramedic Unit to address the ongoing mental health, wellness and workload concerns of Paramedics.
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