RRU capstone sheds light on paramedic dispatching and mental health

Learn more about the Master of Arts in Leadership, and about the Health Specialization. 

Contrary to the stories popular TV series tell us, paramedics are not constantly racing from one extreme call to another. For every serious injury, there’s someone suffering from a twisted ankle.  

While the severity of their calls varies widely from extreme to mundane, the combined effect creates busy shifts for paramedics. Minimal opportunity to decompress between calls – no matter the severity – can compound existing mental health challenges associated with a high-stress job, according to Jonathan Hesler, a Métis scholar in the Master of Arts in Leadership with Health Specialization at Royal Roads University. 

For his capstone project at RRU, Hesler conducted research examining the effects of how ambulance crews are dispatched and the subsequent impacts on their mental well-being. With funding from a Social Sciences and Humanities Research Council Canada Graduate Scholarship and the Indigenous Scholars Supplement, he conducted a focus group and a survey to examine the issues around dispatching and resource utilization in a mid-sized paramedic service located in eastern Ontario. 

“The dispatching is kind of that silent system behind the scenes that a 911 caller doesn’t think about,” he explains. “You call 911, and the public expects that paramedics will arrive very quickly.” 

Because of how ambulance systems work and what's expected of paramedics, they might have to go straight from a traumatic call, like a fatal car crash, to subsequent calls without time to recover. If they need that time, they are often required to call a supervisor and request permission to be kept out of service temporarily. 

“It’s not just the traumatic calls that impact their psychological well-being,” says Hesler. “It’s also the accumulation of the lower acuity calls that add up. The research reaffirmed that the additional workload is cumulatively adding to their stress.” 

The answer, he says, is “about balancing the workload between the paramedics,” adding that, for a paramedic, “It’s that expectation of when I go to work, I’ll have a manageable amount of work on my shift.” 

What that could mean, in practice, is that the closest crew might not be automatically dispatched to less urgent calls if its members need a break, or that some non-emergency assignments go to paramedics experiencing lighter workloads on a given day.  

Consistently maintaining a manageable workload for paramedics requires systemic change, but not necessarily additional public funding. There are already costs associated with sick time and short-term disability for paramedics experiencing mental health injuries and other ailments which have the potential to be reduced with the new approach. “It’s more of a governance and a culture piece,” explains Hesler. 

Hesler works as a Superintendent for Peel Regional Paramedic Services in Ontario and has more than a dozen years’ experience in paramedic services and pre-hospital care. Aided by the MAL program’s focus on systems transformation, he is hopeful they can improve service delivery to benefit more people, including paramedics and their psychological well-being.  

 Learn more about the Master of Arts in Leadership program.