Emergency Assistance

I've just read a couple of police blogs, most recently Totallyunpc http://totallyun-pc.blogspot.com/ which have been thoughtful and insightful pieces about the stresses and strains of police work. They include gripping and moving accounts of life-threatening events in which they were involved. Totallyunpc also had a think about whether or not counselling helps in the aftermath of such distressing circumstances. So I thought I would post today about some of my experiences of working with emergency service staff.

In my time (I used to be a nurse back in the day) I have been involved in emergencies - cutting down someone who had hung himself and walking in to a ward bathroom to find blood up the walls and a dying patient in the bath - slashed wrists. Amazingly we saved both of them but I still dream about them from time-to-time. So I'm not completely ignorant of the horrors that staff in 'extreme' occupations see. However, I have also seen a number of emergency service personnel in my current guise - working in the drugs and alcohol treatment field.

Usually they are self-referrals because naturally they're concerned about confidentiality and I have seen police officers mired in cocaine or alcohol, ambulance bods the same. In almost every case the person can link their drinking or drug taking to a specific and awful incident or series of incidents. Usually they have a history of social drinking or drug use which begins to escalate after attendances at incidents. Often they have also experienced feelings of desperation when unable to help a victim or a colleague who is in dire straits. What confuses people though is that often they don't begin to feel depressed or upset until quite some time after the event(s), by which time they're drinking too much or gobbling down tranquillisers or sometimes street drugs. This usually gets noticed by wives/husbands/girlfriends/boyfriends and they start to feel they are losing it. What also makes it doubly difficult for emergency staff to seek help are complicating factors such as:

• Pride - 'it's me that helps people not the other way round'.
• Fear: Of losing a job.
• Loss of face in front of other colleagues, especially in the stiff upper lip, make a joke of it culture of some services.

and so on. But in fact what is often the case is that they are suffering from post-traumatic stress disorder, what used to be called shell-shock by the armed services. PTSD usually appears some months after the event(s) and is often a complete surprise to the victim who had thought they were ok thankyou. By the time they end up with me though they have probably been to the GP and been misdiagnosed or just given pills or wrongly diagnosed as having a drink or drug problem. Where the good work comes in by experienced and thoughtful drug treatment staff is to help the worker understand what has happened to them and why and to give practical help with the drink and drug use. This coupled with quality counselling which helps the worker talk through their distress and upset and maybe some anti-depressants can solve the problem most of the time. Sometimes the person returns to active duty and is fine or sometimes they recognise that time's up and to save their sanity they should do something else.

And sometimes it helps just to write it all down.