APBC POSITION STATEMENT ON MENTAL HEALTH CONSIDERATIONS OF PARAMEDICS
Dear members;
APBC POSITION STATEMENT ON MENTAL HEALTH CONSIDERATIONS OF PARAMEDICS DURING
COVID-19
In March 2020, the World Health Organization (WHO) declared the outbreak of a new coronavirus disease,
Covid-19, a global pandemic.1 As countries, governmental agencies, and health authorities act to contain the
virus, this time of crisis is generating widespread psychological concerns. At particular psychological risk
during this pandemic are our healthcare professionals, including our paramedic practitioners. We are issuing
this position statement to highlight what the existing literature tells us about the mental health effects of
previous pandemics on frontline healthcare staff. It is also critical to acknowledge how Covid-19 has already,
at this relatively early stage, impacted the working environment for healthcare professionals, our members
included. And perhaps most importantly, we want to advocate for the psychological support of the
profession.
According to previous studies from SARS, H1N1, MERS, and Ebola epidemics, the psychological burden that
healthcare professionals experience during these crises is significant.2 Both their physical and mental wellbeing
has been shown to be compromised by a myriad of factors including increased workload, physical
exhaustion, insufficient personal protective equipment, and the potential distress of making ethically difficult
decisions regarding the rationing of care.3 Furthermore, the resiliency of these healthcare professionals can
be further compromised by isolation and loss of support, risk of or infections of family and friends, as well as
often unsettling changes in medical protocols and workplace procedures.3
Studies have indicated that healthcare professionals are vulnerable to specific mental health concerns both
during and after pandemics. In a study of 1800 hospital practitioners in Hong Kong after the 2015 MERS
outbreak, it was found that medical staff who performed MERS-related tasks showed the highest risk for
posttraumatic stress disorder symptoms.4 Surveys from over 10,000 healthcare workers in Singapore after
SARS found that staff in daily contact with SARS or staff from SARS-affected institutions expressed
significantly higher levels of an anxiety.5 In addition, more than half reported increased work stress and
workload. And here in Canada, the Impact of SARS Study found that one to two years after the outbreak,
professional burnout and symptoms of traumatic stress, anxiety, and depression remained elevated among
Toronto hospital workers compared with colleagues in settings that did not treat SARS patients.6
Research has already started to emerge regarding the psychological implications of Covid-19 on front-line
healthcare providers. Systematic reviews conducted of these studies indicated that healthcare workers are
encountering a considerable degree of stress, anxiety, depression, and insomnia.3,7 For example, a survey of
1257 healthcare workers in China found that a considerable portion reported symptoms of general distress
(71.5%), anxiety (44.6%), depression (50.4%), and insomnia (34%).8 Another observational study of 180
healthcare workers found substantial levels of anxiety and stress that negatively impacted sleep quality and
feelings of self-efficacy.9
Our position is that the Covid-19 pandemic will impact the psychological health of paramedics and
dispatchers. The workload and burden has already increased, as the BCEHS CISM team was activated on
232 occasions in April 2020 as opposed to 130 activations in April 2019.
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It is imperative that we learn from previous pandemics and the aforementioned research. It should help us
predict future mental health needs, and act and prepare accordingly. We are also aware that in the absence
of a pandemic, our profession is already at higher risk for stress disorders than most other occupations.10
Therefore, we feel strongly that the profession should be psychologically supported both during this time and
on an ongoing basis. It is true that healthcare providers who feel well supported and trained experience better
mental health over the long term.11 Organizational provision of psychological services, support for staff in
isolation/quarantine, peer support, as well as communication, empowerment, and humanity from leaders
have been identified as considerations for supporting healthcare providers during this pandemic.12 We feel
strongly that paramedics and dispatchers deserve to have access to these kinds of supports for their mental
health.
(Writing and recommendations by Dr. Kathy Keating, Registered Psychologist (CPBC #2169), Commissioned by the Ambulance
Paramedics & Emergency Dispatchers of BC)
Provincial Executive Board
Ambulance Paramedics
CUPE Local 873
Please click HERE to view Statement with footnotes.
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