Post-Traumatic Stress Disorder (PTSD) in Alberta's Healthcare Workers: A Guide to Understanding and Support

Post-Traumatic Stress Disorder (PTSD), once mainly linked to soldiers returning from war, is now a growing concern for healthcare workers, especially right here in Alberta. This guide offers a comprehensive overview of this issue.

PTSD: A Historical Perspective

PTSD was formally recognized in 1980, appearing in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III). This was largely due to the experiences of Vietnam War veterans. Before this, similar conditions had different names, like “shell shock” in World War I. See History of PTSD.

More recently, events have highlighted PTSD in those who care for our health. The 2003 SARS outbreak in Hong Kong showed the mental health toll on healthcare professionals working on the front lines. Learn more at History of Post-Traumatic Stress Disorder (PTSD).

The COVID-19 pandemic pushed this issue further, with healthcare facing major challenges. High patient numbers, limited resources, fear of getting sick, and seeing widespread suffering caused many healthcare workers to experience significant trauma. This increased discussion and the need for better mental health support. For more information, refer to PMC article on COVID-19 and PTSD.

Effective PTSD Treatments for Healthcare Workers

Several treatment options are available for PTSD in healthcare workers. Two are known for their effectiveness.

Cognitive Behavioral Therapy (CBT) is a type of therapy that helps people change negative thought patterns and behaviors. It’s proven to be beneficial for PTSD. More details can be found at EMDRIA - Is EMDR effective?. CBT helps process traumatic memories and develop coping strategies for symptoms like anxiety and flashbacks.

Eye Movement Desensitization and Reprocessing (EMDR) is another effective treatment designed specifically for PTSD. Evaluating effectiveness of TF-CBT and EMDR. This involves guided eye movements while recalling distressing memories, helping the brain reprocess them and reduce their emotional impact.

Other approaches include group therapy and mindfulness. While evidence exists for effectiveness, large studies focused specifically on healthcare workers aren’t as common.

Barriers to Care: Roadblocks to Getting Help

Even with effective treatments, many healthcare workers in Alberta struggle to get the help they need.

• Stigma: A major barrier is the stigma around mental illness, which is even stronger within the healthcare profession itself. SAGE Journals article on stigma. Healthcare workers, often seen as strong caregivers, may feel pressure to appear invulnerable. Admitting to a mental health struggle can be seen as weakness or affecting one’s career, leading to shame and fear of judgment.

• Workplace Culture: Healthcare settings often have cultures that, unintentionally or not, encourage silence around mental health. Psychology Today article on healthcare worker mental health. There can be an unspoken expectation to “tough it out”.

• Lack of Resources: Practical barriers also exist. The availability of mental health support programs, especially those with culturally sensitive treatments is a factor.

• Other Issues: Financial constraints, location, and other systemic issues also create challenges.

• Solutions: Organizations and healthcare leaders can help by creating supportive environments, implementing peer support programs, and using telehealth to improve access.

Adapting Therapies: The Need for Customization

While therapies like CBT and EMDR are effective, they might not fully address the unique challenges faced by healthcare workers with PTSD. Adaptations are often needed.

• Trauma-Informed Care: Given the high chance of trauma exposure in healthcare, using a trauma-informed approach to mental health therapy is very important. PMC article on Trauma-Informed Care. This approach recognizes trauma’s impact and emphasizes creating a safe and supportive environment.

• Moral Injury and Burnout: Healthcare workers’ experiences often go beyond traditional PTSD. Moral injury, related to PTSD, is the distress from events that violate one’s moral code. Chaplaincy Innovation Lab - Trauma and Moral Injury. For example, making tough decisions under pressure or feeling unable to provide proper care can contribute to moral injury. This needs to be addressed alongside burnout.

• Self-Care: Training and prioritizing self-care are crucial, focusing on prevention. Healthcare workers need tools to manage stress and build resilience.

Prevention: Stopping PTSD Before It Starts

Prevention is always better than cure. The goal is to reduce the likelihood of healthcare workers developing PTSD.

• Early Intervention: Early intervention is key. Cognivia Psychiatry - Prevention and Early Intervention. Providing support and resources immediately after a potentially traumatic event can reduce long-term problems. This might include debriefing sessions or counseling.

• Building Resilience: Resilience training equips healthcare workers with coping mechanisms to handle stress. This might include stress management techniques, mindfulness, and problem-solving.

• “Huddles”: Brief, on-site training sessions, or “huddles,” can provide immediate coping mechanisms and support. PubMed article on huddles. These short interventions can be integrated into the daily workflow.

Ethical Considerations

Treating PTSD in healthcare workers raises important ethical issues.

• Confidentiality: Confidentiality is essential in any therapeutic relationship. Healthcare workers need assurance that their personal information will be protected, especially given the stigma around mental health.Ausmed article on confidentiality.

• Duty to Care vs. Retraumatization: Healthcare professionals have a duty to care for patients, but this must be balanced with the risk of retraumatization. The Clinics - Duty to Care and Retraumatization. Forcing someone to relive trauma can be harmful.

• Informed Consent: Before treatment, healthcare workers must receive full information about risks, benefits, and alternatives. PMC article on informed consent. This ensures their autonomy and allows informed choices.

Resources in Canada and Alberta

Addressing PTSD requires a multi-pronged approach, and both national and provincial initiatives are crucial.

• Canada’s Federal Efforts: The Canadian government supports high-risk populations, including healthcare workers, vulnerable to PTSD. Government of Canada news release. Specific funding and programs aim to improve access to care.

• Canadian Clinical Practice Guidelines: The Canadian Clinical Practice Guidelines for the Management of Anxiety, Post-Traumatic Stress, and Obsessive-Compulsive Disorders provide recommendations for healthcare professionals across Canada. Canadian CPG for Anxiety, PTSD, and OCD. These guidelines offer a framework for assessment, diagnosis, and treatment.

• Alberta’s Support System: Alberta Health Services (AHS) provides a 24/7 Mental Health Help Line. AHS Mental Health Help Line. This offers immediate support and referrals for mental health crises, including those related to PTSD. It’s staffed by a diverse team, including nurses, social workers, and psychologists.

Statistics and Correlations: Understanding the Numbers

Understanding PTSD prevalence is crucial for effective intervention.

• Prevalence: Studies show variation in reported PTSD prevalence among healthcare workers, ranging from 3.5% to 48.8%. PMC article on PTSD prevalence. This highlights the need for consistent assessments.

• Specific Study Findings: One study found a 9.3% prevalence among healthcare providers. PubMed article on PTSD prevalence.

• Correlations: Research shows PTSD is negatively correlated with self-efficacy and positively correlated with anxiety and depression. PubMed article on PTSD prevalence. Healthcare workers with PTSD tend to have lower self-efficacy and higher anxiety and depression.

• COVID-19 Impact: The pandemic significantly impacted healthcare workers’ mental health, with a high prevalence of subthreshold PTSD symptoms. PMC article on subthreshold PTSD.

The work of a healthcare worker can be rewarding but challenging. As a result, PTSD and first responders in Alberta is an increasingly important issue.

If you are a healthcare worker in Alberta struggling with PTSD, or if you are concerned you might be, remember you aren’t alone, and help is available. Reach out to the AHS Mental Health Help Line or explore the resources mentioned above. Take the first step towards prioritizing your mental well-being. Contact Responders First for additional support and resources tailored to your needs.

Don Davis

15+ years of emergency response experience. Passionate about connecting our first responder communities with critical resources. Author of hundreds of articles and guides on First Responders mental health care. When not responding to emergencies, you can find me playing with my dogs, hiking, or enjoying a good book.