The latest reports show that one in four paramedics in Canada will develop PTSD in the course of their careers, and the suicide rates amongst paramedics are five times the national average. But despite increased public awareness around PTSD, there is still surprisingly little support for these civilian workers. While understanding and support of the disorder has improved over the past two decades for other occupations, the old stigma still holds sway for paramedics. This has left them desperate for solutions that keep their struggles in the dark, and lead them to some dangerous methods of coping.

Clive Derbyshire is a paramedic working in Vancouver’s Downtown Eastside, an area overwhelmed by drug addiction and hard-hit by the opioid epidemic. His personal history of addiction makes him a relatable figure to the drug user who has just overdosed in an alley. Tragically, it’s this job — one that allows him to help the addict on the street — that lead to his own PTSD. A single traumatic event was his undoing — one call to a scene. To cope with the trauma, he began self-medicating with alcohol, hoping to lessen its effect so that he could function on the job. When that no longer worked, he turned to meth, escalating his use until he was injecting by needle. Working on his sobriety, Clive is still plagued by addiction and PTSD.

Training and experience make injury, blood, and death routine occurrences, but it’s one violent or traumatic event that can drastically change how the mind works. Like Clive, it was one call that changed the life trajectory of Ontario paramedic, Natalie Harris. Being witness to first responders treat her mother’s seizures, Natalie grew up believing paramedics were heroes. Becoming one herself, she spent years fulfilled by the role of saving lives. However, her strong sense of morality — a common trait in paramedics — could not hold up when called to the gruesome scene of two murdered women. What she had to do in that room caused a “moral injury” to her mind that plagued her for years, until she could no longer control her thoughts.

Don Devine, a retired BC paramedic, suffered a life-changing “operational stress injury” in 1996 when he responded to a call where eight people had been shot — one of the largest mass shootings in Canadian history. Over his next 20 years, he responded to several other tragic calls, each one reinjuring the brain. Each trauma piled up on the next until Don broke down completely.

As he describes it, “As caregivers, we suck up a lot of fear for the patient, and we take it away. We don’t know what to do with it.”

The general view of PTSD is still based on a limited understanding of what causes trauma. And what many paramedics encounter when seeking help is skepticism and stigma. By sharing stories of paramedics, After the Sirens hopes to shine a light on the problem and provoke a conversation that leads to real change.