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Great news! Tasmania will become the first state in Australia to legislate that PTSD is a presumptive work-related illness for all first responders. This is a big breakthrough.

Tasmanian Premier Will Hodgman with paramedics – Facebook

It means Tasmanian first responders — including paramedics, firefighters and police — will no longer have to prove to insurers that they developed PTSD from their work to access compensation.

The state government’s acknowledgment of the impact that work-related trauma can have on first responders sends a message to employers that telling staff who are struggling to just “suck it up” is no longer acceptable. Hopefully it will also increase awareness that post-traumatic stress is the brain reacting normally to highly confronting events, giving more people confidence to put their hand up and say “I need help”.

mproved access to workers compensation was one of 31 recommendations in the 2018 Australia21/FearLess report, When Helping Hurts: PTSD in First Responders. So we congratulate Premier Will Hodgman, his government and the Opposition for their bipartisan support of the change. We urge all of Australia’s other states and territories to follow Tasmania’s lead.

“The public has an expectation that first responders will run towards danger while others are running away from it — indeed, we need them to do this if we are to continue to enjoy the levels of safety and security that we generally take for granted,” says Australia21’s report co-author Mick Palmer, who’s a former Commissioner of the Australian Federal Police and NT Police, Fire & Rescue.

“Governments as well as organisational leaders need to recognise and understand the risks associated with the reality of dealing with hugely confronting situations, so first responders and their families don’t continue to pay a heavy price for protecting the community.”

Senate submission

While compensation is vitally important, managing the work environment to prevent or deal with PTSD before it becomes bad enough to stop first responders being able to perform their jobs should always be the aim.

Yet that has not been the practice among many employers.

“There is no question that all agencies are aware of the problem and are focused on improving their capacity to prevent and manage the impacts of trauma related stress in the workplace, most agencies in my experience believe they are better prepared – and in a better place – than in fact they actually are,” says Mick Palmer.

Australia21 has been invited to give evidence at the Senate inquiry into the high rates of mental health conditions experienced by first responders, emergency service workers and volunteers.

In our submission, we have advised the Inquiry that When Helping Hurts identified major obstacles to improving conditions:

  • Significant knowledge gaps in managing exposure to risks and understanding workplace issues that can worsen the effects of PTSD.

  • A range of challenges faced by first responder organisations aiming to improve their response, including adequate resourcing, effective training of operational managers, and overcoming reluctance to seek help by staff who fear it will adversely impact on their careers.

  • Framework issues around cultural change, legal processes, information sharing, data collection, education and training, research, development of a national policy and putting in the issue on the national political agenda.

iCare about trauma related stress

Recognising PTSD as an occupational hazard instead of a personal failing is the first step towards improving outcomes.

“We must remember that the strength of first responders – their resilience, determination, commitment and courage – can also, in PTSD terms, be their ‘weakness’,” says Mick.

“They won’t give up, they won’t admit defeat, and they are unlikely to complain. Leaders must recognise and manage both.”

Mick and report co-author, Lyn Stephens, recently discussed the Recommendations made in When Helping Hurts with NSW first responder organisations, at a meeting hosted by iCare.

They acknowledged there are significant challenges to minimising trauma related stress, particularly as managing exposure rates and levels can impact on an organisation’s operational capacity and budget.

Lyn shared the example of one agency that has a coordinated whole-of-system approach, the Queensland Ambulance Service, which has 4000 staff and 290 response locations covering 1.77 million square kilometres.

Its Priority One Staff Support Service has been operating for more than 20 years, providing dedicated Trauma Counselling, Mental Health Education and a Peer Support Program specifically tailored to the needs of ambulance personnel.

“You could do all these things but if they are not coordinated, and well managed they become mere lip service and a box ticking exercise,” said Lyn.

She told the iCare meeting that QAS is up front about the risk of traumatic stress and normalises accessing a counsellor from the start, for staff and their managers.

Top response

When Helping Hurts was launched in the Northern Territory at the official opening of a wellness centre designed to provide a sense of community and mutual support among first responders.

The Police, Fire & Emergency Service Minister Nicole Manison and Commissioner Reece Kershaw both welcomed the report.

“If you were shot or burnt you’d seek treatment. Psychological injuries should be seen the same way,” Commissioner Kershaw said.

“What we see and do as first responders affects us, and we are all working to normalise seeking support.”

The NT Police Association later flew Mick Palmer to Darwin to address its AGM, attended by representatives of all other Australian and NZ police Associations.

He pointed out that most trauma related stress is caused by repeated exposure to smaller incidents.

“Probably nowhere is this more evident than in the Northern Territory, a jurisdiction in which small, often remote communities, vast distances, limited back-up and relief capacity, and high personal violence crime rates combine to create an environment of particularly serious challenge.

“With homicide rates of between 8 times and, in some communities, 30 times the national average, and personal violence and domestic violence incidents and traffic fatalities frequently running at many times the national average, the exposure of first responders to potentially traumatic situations is consistently high and essentially unavoidable.

“This environment demands that, as far as humanly possible, the risks of PTSD must be understood, effectively mitigated and managed.”

The reality is that trauma takes many forms and impacts in many different ways. The challenge is to recognise the dangers in all their forms and have in place the best possible early warning, awareness and preventive initiatives, a range of adaptable and consistently reviewed management arrangements and efficient and effective treatment and rehabilitative options.

If you or anyone you know needs help, you can contact one of the services below:

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