WHEREAS accidents, emergencies, human conflict, natural disasters, and events where there is the potential for illness, injury, or death occur daily in Alberta; and

WHEREAS emergency first responders are typically found at the scene of accidents, emergencies, human conflict, natural disasters, and events where there is the potential for illness, injury, or death which results in emotionally distressing situations; and

WHEREAS research indicates that emergency first responders are at high risk for depression, anxiety, family dysfunction, negative work-site interactions, substance abuse, post-traumatic stress disorder, and toxic stress and over time, ongoing toxic stress leads to increased rates of heart disease, cancer, arthritis, diabetes, and other medical illnesses; and

WHEREAS research indicates that the suicide rates for emergency first responders are much higher than the general population; and

WHEREAS emergency first responders are traditionally viewed by the public as emotionally resilient and are expected to always remain calm under pressure, which often creates difficult emotional challenges for emergency first responders experiencing distress; and

WHEREAS emergency first responders, their respective agencies, and municipalities have various methods for debriefing following serious emergency incidents, debriefing is not necessarily sufficient in assisting individuals with managing the emotional and psychological effects of traumatic experiences; and

WHEREAS not all psychiatrist, psychologist or therapist clinicians are skilled and trained at treating emergency first responders; it is crucial that clinicians treating first responders have extensive experience and expertise in the specialized area of treating emergency first responders; and

WHEREAS many small, remote, and rural municipalities do not have specialized clinicians present in their communities; and

WHEREAS it is currently an additional burden placed on many emergency first responders experiencing distress to have to travel long distances to seek treatment; and

WHEREAS the Government of Alberta has demonstrated its prioritization of mental health initiatives through the Valuing Mental Health Report and other various programs and initiatives;

THEREFORE, BE IT RESOLVED that the Alberta Association of Municipal Districts and Counties strongly encourages the Government of Alberta to create and staff a governmental unit capable of providing specialized clinical counselling and therapy for distressed emergency first responders capable of servicing and travelling to all regions of the Province.

Volunteer fire fighters are a ubiquitous and necessary presence in rural communities; there are over 450 volunteer fire departments in Alberta dedicated to providing fire suppression and emergency first response services. The County of St. Paul boasts four volunteer fire departments within its boundaries supported by over one hundred volunteer fire fighters.

Over the past several years, some volunteer fire fighters within the County have responded to a series of highly traumatic incident scenes including several fatalities. Specifically, the volunteers’ response to motor vehicle collisions has been particularly traumatic. Due to the exposure of these traumatic incidents, several volunteers fire fighters have experienced negative consequences to their mental and psychological health.

The County finds that while the treatment of acute stress can typically be managed with local resources, the treatment of chronic stress in the weeks and months following a traumatic incident is very difficult to manage.

As these volunteer fire fighters sought out treatment, they often are forced to drive long distances to Edmonton to seek appropriate care. This has placed an additional strain on volunteer fire fighters within the County of St. Paul, their families, and their jobs as they are required to travel to seek appropriate care.

RMA has no active resolutions directly related to this issue.

Alberta Health

The Ministry of Health is working to promote and focus on the mental health of health care practitioners, including paramedics, within the publicly funded health system. Alberta Health can only speak to supports provided for paramedics, as supports for police forces and firefighters are outside the purview of the ministry.

Alberta Health Services (AHS) has implemented a Mental Health Task Force made up of frontline paramedics and a Psychological Health and Safety Advisory Committee, with representation from the ministry, the Health Sciences Association of Alberta, ambulance operators (including contracted providers), the Alberta College of Paramedics, and the Workers’ Compensation Board.

Measures implemented by AHS include the rollout of a suicide prevention course to all Emergency Medical Services (EMS) supervisors and peer support team members, and the Road to Mental Readiness (R2MR) program from the Mental Health Commission of Canada to all EMS practitioners in Alberta. AHS has also hired a permanent senior advisor to ensure adequate mental health supports are available to paramedics, and continues to train staff to be trainers of the R2MR resiliency program.

The AHS EMS Psychological Awareness and Wellness Support program provides an accredited facility dog (AFD) to help support EMS providers that have been on challenging calls. AFDs have been shown to have a calming and positive effect on a person’s psychological health.  They are bred, raised, trained and selected for their temperament. AFDs are skilled in supporting a variety of people, whereas a service dog is dedicated to assisting a specific individual.

AHS is also expanding reintegration training across the province to support psychologically injured paramedics through all stages of their injury, with the goal of helping staff return to work in the safest possible way. By implementing new minimum training requirements to improve the quality of peer support available through the Critical Incident Support Management (CISM) program, AHS staff also have access to crisis support, chaplain services, grief counselling and the Mental Health Helpline to help cope with the challenges of the work environment. All services are available 24/7 and are confidential and free to use.

Alberta Municipal Affairs

For many years, Alberta Municipal Affairs (MA), through the Office of the Fire Commissioner (OFC), has supported the operation and training of emergency responders and local health care providers who provide the CISM. The CISM has traditionally been a regional cohort of multi-disciplinary emergency responders, social service professionals, and mental health professionals.

In recent years, the OFC has worked with and provided funding to the Alberta Fire Chiefs Association (AFCA) to provide CISM training, in conjunction with a contracted registered mental health clinician. The AFCA is holding these regionally based training sessions across the province.

In the wake of the Horse River Fire (Regional Municipality of Wood Buffalo) in 2016, the OFC has entered into a further Conditional Grant Agreement with the AFCA, for their clinician to provide CISM Operational Stress Injuries (OSI), and Post-Traumatic Stress Injuries (PTSI) supports to fire and other emergency responders who participated in these events.

To support the OFC, the AFCA CISM training, and to co-ordinate the delivery of OSI/CISM programming within the Government of Alberta (GOA), MA will be posting a competition for a two-year temporary Program Services position. This individual’s role will be to blend and enhance these and other programs from the emergency responder perspective; strengthen existing relationships and build new ones within the GOA and with external stakeholders and service provider groups; and provide guidance on the development of a permanent and sustainable OSI, PTSI, and a Post-Traumatic Stress Disorder prevention and support program for Alberta’s emergency responder community.

Alberta Community and Social Services

Alberta Community and Social Services recognizes the importance of supporting first responders exposed to emotionally distressing situations during emergency events and the need for adequate supports to be available to those requiring services. The ministry supports and will follow the expertise of the responsible agencies for mental health initiatives through their programs.

The overall Government of Alberta response indicates a wide range of existing preventative and post-incident mental health support systems for emergency first responders, as well as ongoing activities to enhance and broaden such services in the wake of first responders’ roles in responding to recent natural disasters in Alberta.

The Alberta Health response indicates a current initiative to deliver regional reintegration training for paramedics suffering psychological injuries with the goal of supporting their return to work. Similarly, the Alberta Municipal Affairs response indicates an effort to improve the coordination and accessibility of multiple separate programs supporting the mental health of first responders. These examples both align with the intent of the resolution, which is to centralize mental health supports for first responders under a single “governmental unit” with the capability to provide such services in all regions of the province. RMA is also pleased by the Government of Alberta’s December 2018 announcement of an emergency medical services (EMS) action plan, which includes one million dollars in funding to support the mental health of EMS workers.

RMA appreciates the efforts of the Government of Alberta in supporting the mental health of first responders. As the government response reflects elements of the centralized, mobile unit requested in the operative clause, this resolution is assigned a status of Accepted in Principle, and RMA will follow up with Alberta Health and Municipal Affairs to determine whether the changes references will meaningfully improve the integration and mobility of first responder mental health support services.

RMA is also pleased by the Government of Canada’s recent announcement of a $29 million plan to address mental health and post-traumatic stress disorder in emergency personnel, including $10 million for an “internet-based cognitive behavioral therapy pilot” to improve access to care for emergency personnel. RMA looks forward to learning more about the details of this program and how it will support emergency first responders operating in rural areas.