Many CUPE members, including paramedics and emergency dispatchers, work as first responders. These ESS occupations frequently require workers to put their lives at risk to protect others. They often experience a variety of traumatic or critical incidents which put them at higher risk of critical stress injuries. When these stress reactions are left untreated, they can lead to post-traumatic stress injuries (PTSIs), including post-traumatic stress disorder, depression and anxiety disorders.
PTSIs can be disabling and lead to substance abuse and even suicide. Sadly, the number of PTSIs, suicidal ideation, and death by suicide are higher among workers in these occupations than in the general population. About 45 per cent of ESS workers show clinical symptoms of PTSIs.
Although frequent exposure to potentially traumatic events is part of the job, this does not mean that workers and unions can’t respond. Unions can address the effects of these hazards through information, training and organizational procedures that ensure early intervention after traumatic exposures. And they can bargain better peer support programs, professional care, and follow-ups. Beyond training and employer policies, appropriate supports can and should be bargained into benefit packages and employee assistance programs (EAPs).
Many workplaces offer programs to help first responders manage the critical stressors they experience. Some of those are crisis-focused, and others try to build resiliency through training before, during, and after critical incidents. Experts have highlighted the need to evaluate the effectiveness of these programs and expand their use. From our experience, some programs and supports are managed only by the employer, while others - such as professional counselling - can be included in EAPs.
CUPE’s position is that exposure to trauma should be recognized as an occupational hazard by ESS organizations. Protocols, including special training and ongoing measures to protect workers’ mental health as they cope with work related trauma, should be required by law and/or included in collective agreements. These should be designed and evaluated based on scientific evidence, and unions should be included in their implementation and monitoring.
Here’s an example of contract language from CUPE’s airline sector:
“Critical incident is a term used to describe an abnormal, shocking, or traumatic event. The company shall, in consultation with the Health and Safety policy committee, develop a critical incident stress policy that states “critical incidents and critical incident stress are health and safety hazards, and that all steps reasonable should be taken to prevent further injury from their occurrence.” This policy shall include a procedure to prevent critical incident stress and related mental injuries that follows the principles described in APPENDIX X.”
“Committee members who regularly perform defusing and debriefing shall be provided with resources to prevent mental injuries from this type of work, they shall be provided with all required EAP services. The cap for such services may be exten ded if required. External expert resources will be provided through the existing Employee Assistance Program.”