EAP

Employee assistance: What are we assisting? Employee Assistance Programs provided by employers are typically programs designed to deal with psychiatric disease, addicton, and social problems. These are hugely important problems, that employees should absolutely use the resources of an EAP to handle, if they realize they have them. How many colleagues do you know, though, who have these kind of conditions and leave them untreated? How many of them do you think just don't notice their condition, or don't want to, or are too embarassed or ashamed to admit that they need help? How many of us actually know what to look for, or what to do to help our colleagues? Behavior patterns can give a huge insight into someone's psychological health and psychiatric condition, if we take the time to notice and to help.

Many might say that people with such disorders should not work in EMS. These same dissenters may not realize that EMS may have caused the condition in the first place. Fatigue, shift work, irregular sleep patterns, and adrenal stimuli are all known triggers for psychiatric conditions including bipolar disorder ^1,2. The running joke in my local EMS community is "Everyone working in EMS is either on psych meds or should be". It's true, to a extent. Many people in EMS do suffer from diseases ranging from stress and anxiety to bipolar disorder. Some people find their own coping mechanisms that help mitigate the work stresses, exercise being the most effective it seems, but some don't know what to do.

So what about other work-related diseases? EAP dosn't cover chiropractic, fitness and exercise, massage, accupuncture, or any of the things we know to prevent workplace injury. Worker's compensation programs only cover workplace injuries. I've heard some great podcasts about the topic like episode 50 of the EMS Educast and episode 28 of the EMS Garage, but I don't see employers spending any extra money on those kind of benefits in the near future, especially not in the corporate EMS world. Many ambulance personnel don't even have good enough health insurance (or any) to provide themselves these service that are really a necessity in an EMS career.

My point is that employers would be better to just take good care of their employees in the first place than to simply react to the injuries that develop. EMS leaders: bear this in mind. All you have to do is care. Care about your employee's health and well-being, and do something with that caring. Perhaps develop a program to pay your employee's copays for a semimonthly chiropractor visit, or reimburse. Perhaps take the time to chat regularly with your employees and make sure that their lives and minds are healthy, and help them notice the need for help. Maybe even make a semiannual psychiatric and/or psychological assessment (the two are related, but very different) another recommended, or even mandatory thing, like CPR cards, physicals, piss tests, etc.. The long-term cost of maintaining a heatlhy employee is far less than that of trying to fix an ill or injured one. Being medical professionals, you think we'd all get this idea. The problem though comes down to money, I think, and making good decisions with it. When an manager or executive only sees line-item spending, but not the forest through the trees, they end up spending far more money in the long-term.

I'm not a manger. I'm not a CEO. I'm not a board member. Some of you might be. Just care.

1. Umlauf, MG, Shattell, M. (2005). The Ecology of Bipolar Disorder: The Importance of Sleep. Issues in Mental Health Nursing, 26, 699-721.

2. Mendlewicz, J. (2009). Disruption of The Circadian Timing Systems. CNS Drugs, 23, 15-27.