In recent years you may have noticed the increased prevalence mental health issues have in our daily lives and in the news. Whether it’s ensuring our returning Afghanistan military veterans are getting the care they need, or understanding the difficulties of front line responders here at home, there seems to be more public awareness on the subject than ever before.
This makes the results of our survey on healthcare providers’ traumatic experiences and PTSD in the Ontario healthcare system all the more surprising. Common themes in our interviews were workplaces’ lack of awareness and appreciation for the traumatic experiences healthcare professionals face. While lack of funding for employee mental health was a perennial concern, most frontline workers cited an apathetic organizational culture as the primary obstacle to improvement. In many cases nurses could cite existing internal resources, such as employee assistance programs and peer mentoring, being underutilized or misapplied due to a lack of organizational focus and communication. Nurses cited past traumatic experiences where they desired additional support, but did not use or could not describe the limited programs in their workplace due to a lack of awareness from supervisors.
So the question stands: why does Ontario healthcare, especially those specializing in traumatic cases (burn victims, sexual assaults) not have an adequate organizational focus on the mental health of their employees? The answer may lie in the budget conscious and public service ethos of the organizations. While Ontario’s 14 Local Health Integration Networks (LHINs), regional organizations that formulate and implement the strategic direction of Ontario healthcare policy, have a focus on mental health, they are externally facing programs meant to deal with the general population, not internal stakeholders such as employees.
We see this trend in other public services such as police, with recent innovations like the Hamilton Mobile Crisis Rapid Response Team (RRT) brought in to deal with high-risk situations involving mental health. First piloted in 2014, the RRT involved a mental health professional from St. Josephs Healthcare Hamilton accompanying a police officer as part of the primary response to an emergency call. Previously, mental health professionals had only gone on site as part of secondary, follow-up calls. The Canadian Mental Health Association estimated during this pilot project the RRT had “shown a 43 per cent reduction in the number of apprehensions being made, due to individuals being referred to the appropriate services and care”, thus reducing repeat calls. Other favourable outcomes involved up to “580 hours of saved police officer time per year”. As a result, Hamilton Police Services and St. Joseph’s Healthcare Hamilton made the arrangement permanent, and the Mobile Crisis Rapid Response Team has continued with expansion to Halton taking place in December 2015. But what does the external policy success of one police department have to do with the PTSD concerns of a health professional in Ontario?
Ask anyone in the Ontario healthcare system, and it’s clear that budget considerations are a big impediment to any employee-focused initiative, mental health or otherwise. In Hamilton police saw huge benefits in integrating mental health concerns into its external policy, resulting in both improved service to the general public and reduced personnel costs. Mental health advocates need to show the same organizational benefits for internal policies. If new systemic policies on employee trauma are going to be pushed, it will have a better chance if the organization believes that it will not only help a valued employee when they hit rock bottom, but also its own bottom line.
In order to do so, we need to answer some basic questions. How much is a healthcare professional’s effectiveness reduced by untreated psychological trauma? What is the percentage of people professionally treated for job-related trauma, which are then able to return to the same “high stress” line of work? What are the odds of those that receive professional treatment for trauma developing PTSD versus those that do not seek treatment? All these are important questions to answer when making the case that many mental health experts believe; that left untreated, widespread mental trauma inflicted on a workforce in high-stress occupations may actually increase personnel costs and exacerbate key metrics like experienced employee turnover.
Dr. Jane Storrie was president of the Ontario Psychological Association from 2013 to 2015, and frequently consults with first responder organizations in areas like the treatment of occupational PTSD. “Unfortunately I don’t have specific statistics because there have been very limited studies of mental health in policing, particularly in Canada,” she says. “When there are stats available, they tend to result from surveys carried out by individual police services.” Her focus is on police services, but the experiences and data speak to the same issue: a lack of data on occupational trauma and its effects on the organization.
The truth is we don’t know how much untreated traumatic experiences are costing the Ontario healthcare system, both in human anguish and real dollars. How many nurses or paramedics have left their jobs after years of building up skills and experience? And how many could have been avoided with proper resiliency training or trauma treatment by a mental health professional? For those who believe this should be a priority, the solution is to demand proper statistics and data be collected throughout the entire Ontario healthcare system. Asking these questions may take longer, and we may not always get the answers we like, but it has a better chance of bringing wholesale change on a province wide level, as opposed to a fragmented and piecemeal approach.
Reference: Canadian Mental Health Association: http://ontario.cmha.ca/news/mobile-crisis-rapid-response-team-first-ontario/#.V5Zseo-cHSE
