December 17, 2018

PTSD expert guidelines: a clinician’s summary

At any point in time, around 10% of first responders working in emergency services like police, fire, and ambulance, are likely to be experiencing symptoms consistent with post-traumatic stress disorder (PTSD)[1].

Diagnosing and treating psychological injury amongst emergency service workers can be complicated. EML partnered with nine of Australia’s leading PTSD experts to deliver Expert Guidelines: Diagnosis and Treatment of Post-Traumatic Stress Disorder in Emergency Service workers, a set of evidence-based guidelines on how PTSD should be diagnosed and treated amongst first responders.

To help embed the recommendations made in the PTSD Expert Guidelines and support clinicians with their day-to-day management of emergency service workers with a psychological injury, EML funded the development of a Clinician’s Summary of the PTSD Guidelines, written by Associate Professor Samuel Harvey from the Black Dog Institute; Professor Richard Bryant, UNSW; and Professor David Forbes, Phoenix Australia Centre for Posttraumatic Mental Health.

Around one in 10 emergency service workers have symptoms consistent with post-traumatic stress disorder (PTSD), with similar high rates of depression and generalised anxiety symptoms.

PTSD and emergency services

There is increasing awareness that there may be mental health consequences of the cumulative trauma exposure and organisational stress experienced by many emergency service workers.

Symptoms of PTSD include:

  • Severe and persistent stress reaction to a traumatic event
  • Persistent arousal
  • Re-experiencing symptoms
  • Avoidance
  • Negative cognitions and mood

The PTSD Guidelines highlighted that an emergency worker may present with typical PTSD symptoms however they are also more likely than the general public to present with other related problems, such as anger, relationship problems, sleep difficulty, substance abuse or a more general mental health crisis.

While our emergency agencies are making progress in promoting early identification and intervention there are still some issues around self-stigma, workplace stigma, negative perceptions of the compensation process and concerns for the future of their career [2].

First responders are more likely than most other professionals to experience potentially traumatic incidents and have a higher likelihood of this happening repeatedly. This has implications for return to work and recovery discussions and feedback received from the medical industry highlighted the need for the PTSD Guidelines and Clinician’s Summary to provide clear and practical steps to approach these discussions.

PTSD clinical guidelines

As experts in workers compensation claims management for emergency services, we are acutely aware of the toll PTSD can have on the mental health of Emergency Service Workers, their family, support network and community.

The Australian Guidelines for the Treatment of Acute Stress Disorder and Posttraumatic Stress Disorder provide information about the most effective treatments for PTSD in the general population and are an important resource.

But in cases of work-related trauma exposure such as in emergency services there are specific issues that require a more specialised approach, and more than symptomatic improvement alone.

To deliver outstanding outcomes for emergency service workers experiencing PTSD, EML approached A/Prof Sam Harvey from Black Dog Institute and University of NSW.

A/Prof Harvey brought together eight of Australia’s leading PTSD experts to conduct a review of all of the available literature on PTSD to develop a series of recommendations on the diagnosis and treatment of PTSD within emergency service workers. The resulting PTSD Guidelines are a world first.

“As a claims manager for thousands of Australian emergency service workers, the new Guidelines provide us with greater confidence that the treatment will be more effective and hopefully enable even more people to get back on with their lives sooner,” said Mr Mark Coyne Chief Executive of EML.

The guidelines have been endorsed as gold standard by the Royal Australian and NZ College of Psychiatrists.

A clinician’s summary 

There are a range of effective treatments for PTSD that mean with an accurate and timely diagnosis and evidence-based care, many emergency service workers can recover and manage their symptoms effectively ensuring they can return to life and work.

Clinicians are at the front-line of diagnosing PTSD and facilitating access to effective treatment. An important part of getting the best treatment for first responders is ensuring their clinicians have industry-leading guidance.

The PTSD: A clinician’s summary is designed to provide clinicians with a brief overview of these expert guidelines to help with their management of psychologically injured emergency service workers.

They aim to make it easier for GPs and primary health providers to provide gold-standard treatment for emergency service workers who may have PTSD or have been impacted by work-related trauma.

We have also delivered training in new, leading treatment approaches for PTSD to more than 70 icare-accredited psychologists across NSW. If you need assistance referring to a local, accredited practitioner with specialist training in PTSD therapies, you can talk to your First Responder’s Case Manager.

Further resources

AT-Ease - DVA

Learn about the signs and symptoms on this Australian Government health and wellbeing portal for veterans and their families.

Case Study - Post-Traumatic Stress Disorder

Flashbacks and an increasingly short temper made 20-year infantry veteran Mick think he might have an issue with post-traumatic stress.

Sources:

[1] and [2]: Beyond Blue (2018). Answering the call national survey, National Mental Health and Wellbeing Study of Police and Emergency Services – Final report.

Emergency Services Injury Support Mental Health PTSD