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Mental health of emergency ambulance workers

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Dealing with acutely ill people is undoubtedly stressful. Some patients will inevitably have a bad outcome and there is the possibility of self recrimination among emergency staff. Studies have suggested a prevalence of post-traumatic stress disorder (PTSD) among emergency ambulance staff of around 20% and some degree of psychiatric morbidity in about one in three. Researchers in south Wales and the west of England, UK have performed the largest study yet reported.

Questionnaires were sent to all 1029 emergency medical technicians (EMTs) and paramedics working for one ambulance service covering a population of three million people. To preserve anonymity no record was kept of the names corresponding to questionnaire numbers. Six hundred and seventeen questionnaires (60%) were returned by 513 men, 91 women and 13 respondents who did not declare their sex. There were 380 paramedics, 194 EMTs, and 43 respondents who did not declare their grade.

Two yes/no items on the questionnaire asked about intrusive work related memories. Respondents who had had such memories for a month or more completed a validated diagnostic scale (the Posttraumatic Diagnostic Scale (PDS)) that has shown an 82% concordance with psychiatric interview. All respondents completed the Hospital Anxiety and Depression Scale (HADS). Around 45% of respondents reported current troubling memories and another 15% reported having had them in the past. Twenty two per cent of respondents had a PDS score indicative of PTSD. The rate of PTSD was similar in paramedics and EMTs but higher in men (23%) than in women (15%). The rates of clinically significant anxiety (23%) or depression (9%) were similar in paramedics and EMTs and in men and women.

Among emergency ambulance workers who responded, 22% had evidence of PTSD and a similar proportion had evidence of anxiety. Almost 10% had probable clinical depression. No rates are quoted for comparison groups.