City of Cleveland denying PTSD support for EMS workers

The union says paramedics, EMTs and dispatchers don’t have protocol in place to deal with PTSD after a call.

City of Cleveland denying PTSD support for EMS workers
Paul Melhuish is president of the Cleveland Association of Rescue Employees, CARE/ILA Local 1975. (Source: devin lamb)

CLEVELAND, OH (WOIO) - Cleveland paramedics, EMTs and dispatchers are fighting the city for post-traumatic stress disorder support in their new contract.

But those negotiations are now on hold.

PTSD in Cleveland EMS

The city of Cleveland just sent the union a letter asking to throw out an arbitrator ruling, that would have provided them that support.

Cleveland 19 found police and fire have protocol in place for PTSD, but Cleveland EMS personnel do not.

They’re there when you need them the most—dispatchers answer your 911 calls in emergencies, and paramedics and EMTs rush to the scene to save lives.

It's part of their job, but they're people too. And sometimes, they suffer from PTSD.

Paul Melhuish is president of the Cleveland Association of Rescue Employees, CARE/ILA Local 1975.

They represent about 300 dispatchers, paramedics and EMTs.

He's also a paramedic himself.

Cleveland EMS personnel are asking for PTSD support to be covered by the city.
Cleveland EMS personnel are asking for PTSD support to be covered by the city. (Source: WOIO)

Melhuish says paramedics, EMTs and dispatchers with Cleveland EMS don't have protocol in place to deal with PTSD after a call.

“Our other safety forces, police and fire, both have PTSD. They have a process of trying to get people into PTSD,” Melhuish said.

He gave us one example when a paramedic really needed it.

“This crew has had two newborn full arrests, which is cardiac arrest. The one paramedic really had issues this morning. He just got off shift and we had to refer him immediately to EAP services,” Melhuish said.

He said paramedics, EMTs and dispatchers can get help from Cleveland firefighters and police through the Employee Assistance Unit.

However, Melhuish said it’s not the same because they don’t have the same job.

“Fire and police have their specific people that they go to. EMS, we don't have anyone to go to. We don't know what fire go through, we don't know what police goes through,” he said.

Sometimes after traumatic calls, police officers and firefighters hold debriefings.

EMS does not.

“If police and fire are not involved in the city, we do not get debriefings. It's basically, 'hey, we know you had a bad call, go ahead hurry up and take the next call,’” Melhuish said.

A study by the University of Phoenix last year found 10 percent of EMS personnel have been diagnosed with PTSD.

A 2012 study by the Journal of Traumatic Stress found 3.5 percent of dispatchers reported PTSD symptoms.

Melhuish said you can’t help going over what happened again and again after a traumatic call.

“You really question yourself, did you do everything you could do, is there anything you could've done better? Were there circumstances that would have had this outcome be better?” he said.

CARE's union contract ends next April.

They want PTSD addressed in their new contract, falling under Hazardous Duty Injury, or HDI.

That way if a doctor diagnoses mental trauma, paramedics, EMTs and dispatchers could take paid leave.

Right now, they can qualify for HDI for assault, patient transport and care issues, and other physical injuries.

In arbitration documents between CARE and the city of Cleveland, the arbitrator notes the city says resources are already available to EMS personnel.

It also says the city worries this would "open the door" to claims of emotional distress from EMS personnel "exponentially" increasing.

But the arbitrator, who is neutral, ruled in the union's favor on this.

“The city, a lot of their responses were 'hey, if you don't like it, quit. And that's just not appropriate. People came into this career, they know what they're doing, they do, they know what they're getting into. But no one ever tells you how you're going to react to what you're going to see. Everyone processes things differently. It's difficult, it is difficult,” Melhuish said.

CARE wants to use a doctor who already works with Cleveland Police officers for PTSD evaluation.

They're also asking for one employee already on staff to act part-time as a PTSD counselor.

I asked Melhuish whether your services could be affected if the contract dispute drags on.

“We are not a striking union, we'd never do that. Our job is to care for citizens, not sit there and delay care to them,” he said.

Under the contract negotiations, CARE says paramedics, EMTs and dispatchers got the same raise police and firefighters recently got from the city.

Those raises are now on hold.

CARE said there are other issues with the contract, but PTSD protocol is the main sticking point.

They say they were willing to give up some things just to get PTSD addressed.

CARE started a peer support group to recognize signs of trauma, but they say that's not enough.

According to the city of Cleveland’s Motion to Vacate Arbitration Award paperwork, they argue the arbitrator ruled incorrectly, and they’re asking for a new arbitrator.

The city says the arbitrator’s award “contained inexplicable redundancies, oversights, inconsistencies and irrational analyses.”

They said CARE asked for fully paid leave for mental trauma for eight or more months, and that “would add millions” to the cost of the city’s division of EMS, while “stripping the commissioner of many of her management rights.”

The city says EMS personnel already have resources available for mental trauma, including EAP representatives and a doctor with the Cleveland Police Department.

The city of Cleveland says it opposes paid leave for mental trauma “due to the difficulties associated with verifying such claims, potential for abuse, and due to the fact that virtually no other union contracts in the city, Northeast Ohio or among Ohio’s major cities, provided such an extreme benefit,” it says in the documents.

“The City of Cleveland takes the health, safety and welfare of our employees very seriously. The employees within the Division of EMS have access and routinely take advantage of the same resources as other employees in the Divisions of Police and Fire,” said Director of Media Relations, Dan Williams, in a prepared statement.

It took the city two days to respond to Cleveland 19.

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