Prevention & Management of PTSI in Paramedic Service Organizations: An Environmental Scan of Recommended Programs and Practices

April 29, 2022


The objective of this environmental scan is to synthesize existing guidelines and recommended practices to prevent and manage work disability related to post-traumatic stress injuries (PTSI) in paramedic service organizations. Findings will contribute to informing the new Canadian Work Disability Management System Standard for Paramedics with a focus on the prevention and management of PTSI and mental illnesses.


We systematically searched Canadian agency websites for guidelines and resources pertaining to the prevention and management of PTSI in paramedic service organizations. A sample of the websites included in the search are, but not limited to the Paramedic Chiefs of Canada, Paramedic Associations of Canada, provincial paramedic associations, provincial workers’ compensation boards, and health and safety associations. We also supplemented the search results with international resources and resources beyond the scope of paramedic work. From each retrieved resource, we identified programs and practices that could be applied to a work disability management system. The description, rationale, recommended practices, potential barriers to implementation, and any additional relevant information of each program were extracted for synthesis.


A total of 23 guidelines/resources were identified. Six were specific to paramedics, ten were intended for first responders (i.e. police officers, firefighters, and paramedics), and seven were general resources intended for all types of organizations. Our synthesis of these guidelines/resources identifies core programs appropriate for a comprehensive work disability management system for paramedic service organizations with a focus on PTSI, along with their associated recommended practices and potential barriers. The programs are grouped into one of three domains: prevention, early detection and intervention, and disability management.


Organizational programs for the prevention of PTSI included stigma reduction initiatives, mental health education and training, and pre-employment screening. Stigma reduction initiatives and mental health education and training play a crucial role in creating the foundation to a psychologically safe and healthy workplace. They help to de-mystify the invisible injury and empower paramedics, supervisors, and friends and family with the appropriate knowledge, skills, and abilities to address PTSI. Further, they reduce paramedics’ fear of being ostracized for seeking help. Paramedic service organizations have also been considering the use of pre-employment screening to identify individuals who are predisposed to developing PTSI. However, there are ethical concerns with pre-employment screening. Rather, more specific and sensitive assessment tools are needed to support paramedic mental health needs.

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