Provinces focus on PTSD strategies

Ontario announces new approach for first responders, Manitoba looks at all occupations

Bill Rusk is nudged awake by his service dog every night just before he is about to have a night terror — it’s part of living with post-traumatic stress, said the ex-Toronto police officer who was shot in the face, neck, shoulder and hand while on duty in 1990.  

Rusk recalled the events of that traumatic day this past February, when Ontario labour minister Kevin Flynn announced a new strategy addressing post-traumatic stress disorder (PTSD) in first responders. 

“We owe it to the first responders in this province to ensure that they get the treatment they deserve,” said Flynn. “They’re the people who put their lives, on a daily basis, on the line for us.” 

The strategy would include legislative changes, expected to be announced soon at Queen’s Park. While details are forthcoming, awareness is key to prevention and reducing stigma attached to PTSD, said Flynn. An awareness campaign would include an online resource toolkit for first responders and employers, research grants and an annual leadership summit hosted by the labour minister. 

“What we need to do is ensure that we have protections in place that not only treat those people who have contracted PTSD, but also ensure we have a system in place to make sure that we prevent people from getting PTSD in the first place,” he said.

Living with PTSD
First responders are at least twice as likely as the general population to suffer from PTSD due to the amount of stressful situations they face in the course of their work, according to the Ontario Ministry of Labour.

Rusk, who is currently a police sergeant in Owen Sound, Ont., and executive director at Badge of Life Canada — a resource for police with operational stress injuries — said the accumulation of trauma on the job is a major factor in the increased likelihood of PTSD sufferers. 

“The accumulation of trauma is what is really killing us… police officers arriving at the same traumatic event as the public, that may have been the tenth traumatic event that day that they’ve responded to, and in the course of a 10- to 12-hour shift, working a bunch of days in a row — I can tell you, you can be running from one traumatic incident that is very horrible, to the next — and the next might be worse than the one you were already at,” he said. 

Common symptoms include severe anxiety and depression as well as night terrors, said Rusk, whose wife, a retired police officer, also suffers from PTSD. For police, the stigma attached to operational stress injuries is harsh. 

“In a police culture, especially, you look very weak and you could be ridiculed and looked down upon by your superiors and your co-workers because they feel you’re not cut out for the job,” he said, adding that work is only half the battle.
 
“You have a house that has not just one person that suffers on a daily basis but you have two, and we have to live together and we have to manage that. We have four children — it’s a balancing act to be able to self-care and self-manage your own stuff, and then your children’s stuff.”

Manitoba leads the way
This year, Manitoba became the first province to recognize PTSD for all occupations, effectively allowing all employees to be able to make a claim for PTSD and mental injury under workers’ compensation, as well as presuming the illness to be a work-related illness. 

There were concerns over the presumption provision, said William Gardner, a labour and workers’ compensation lawyer in Winnipeg and chair of the Manitoba Employers Council.

“With PTSD, it has to be a traumatic event which tends to be fairly recognizable — you know, someone gets killed or injured in front of you. Its symptoms must arise in a finite amount of time, so it didn’t seem to make any sense.” 

That differs from the circumstances of a firefighter, he said, who might suffer from a certain form of cancer that would take a long time to manifest, and for which it would be difficult to pinpoint the source or cause but could be the result of hazards faced while on the job. Such cases would be better suited to a presumption provision rather than PTSD, said Gardner, adding legislative changes might have the opposite effect and see doctors relying on that diagnosis. 

“Mental illness is notoriously difficult to diagnose, and incorrect diagnoses are endemic. We were afraid that if you had a presumption in the legislation regarding the workers’ compensation board, it would encourage physicians, who naturally are concerned about the welfare of their patients, to default into a PTSD diagnosis, where such PTSD diagnosis might not be appropriate.”

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