Controlled exposure and downtime to reduce PTSD: report

Controlled exposure and downtime to reduce PTSD: report

Controlled exposure and downtime could be the key to reducing mental health issues among Australia’s first responders, a new report says.

However, the report author warned the approach would require more funding for the nation’s frontline emergency services.

The When Helping Hurts: PTSD in First Responders report - authored by Australia21 - was released in Canberra on Thursday afternoon.

The report made 31 recommendations, which included calls to develop a national approach to information sharing and raising awareness, best treatment and care for personnel, and managing the health risks of trauma-related stress in first responders.

Australia21 chair Paul Barratt said three to four million Australians live with, or have family affected by post-traumatic stress disorder.


"PTSD has far reaching impacts across the entire community and it will take a whole-of-community approach to achieve better outcomes for those living with PTSD," Mr Barratt said.

"This report shows the need for cultural change across the community, along with legislative change and improvements at a managerial and medical level."

The approach to PTSD for staff working in the nation's frontline services has come under increased scrutiny recently.


Earlier this year, an AFP review found one-quarter of officers suffered from psychological distress, while almost one in 10 has had suicidal thoughts.

Fourteen per cent show symptoms of clinical depression and 9 per cent exhibit signs of post-traumatic stress disorder.

The latest report - which drew on research and discussions with federal, state and territory first responders – called for arrangements for front-line personnel to have regular scheduled "down time" built into their rosters.

The report said first responders felt the toll of being on call virtually all the time, which meant they could not enjoy everyday life without fear of being called in.

It also found the need for a base level of operational tempo.

The report examined the cumulative effects of high operational tempo, which made it hard for personnel to sleep or meet nutritional requirements.

"The cumulative effects of too high an operational tempo [is that] that front-line personnel are constantly sleep deprived, a problem compounded by the fact that the shocking situations they deal with mean they get poor quality sleep," the report said.

The report also called for the establishment of a national database to further research and knowledge into the issue.

"There is no overall system for collecting even basic epidemiological data such as how many people are affected by PTSD, who they are, where they are, and how they are affected," the report said.

"Such data are fundamental to scoping the true extent of the problem, for developing policy responses, and for monitoring progress."

Mr Barratt warned that tackling the issue would cost money, however, he said the public would foot the bill for PTSD either way.

"Politicians and treasuries and finance departments can say whatever they like about efficiency, this kind of work requires a certain number of people to put out a fire or investigate a crime scene," he said.

"Efficiency dividends have no meaning in that kind of context, you have just got to match the number of people to the amount of work, there’s no way around that.

"The brutal way to put it, is the Australian public will only get as much as they pay for.

"You can substitute that expense by demanding more and more from a limited number of people but it can’t last."

He said the public paid either way as "you’ve also got the wrecked lives, that effects everyone in their immediate circle, their partners, children and friends".

If you require assistance contact Lifeline 13 11 14; beyondblue 1300 22 46 36; or Suicide Call Back Service 1300 659 467.

Michael Inman is a courts reporter for The Canberra Times

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