9-1-1: The Dispatcher Is in Distress
Every 9-1-1 call begins exactly the same. The dispatcher answers the call and calmly asks what the emergency is. The response from the caller is usually a frantic, distraught voice of someone who needs help right away. For the length of the call, the emergency dispatcher is the voice of calm that assists the caller in managing the crisis until help arrives. Behind the soothing voice, adrenalin is pumping full force, as the dispatcher struggles to find the balance between hope and fear.
A 2014 report by the Office of the Auditor in the city and county of Denver showed that the average response time for a priority 9-1-1 call was just under 13 minutes. When emergency responders arrive on the scene, the caller gets immediate help in resolving the crisis. By the time the scene has cleared, emergency dispatchers may have taken a dozen more crisis calls with no time in between to decompress their adrenalin and emotions. The stress encompasses sharing the caller’s trauma, compounding that stress with repeated calls, and suffering the after effects of secondary trauma. Emergency dispatchers have the disadvantage of an on-the-job hazard with a triple threat of stress.
One Call: Three Kinds of Stress
Nearly every occupation involves some degree of stress. To better understand the impact of stress on the emergency dispatcher, consider the types of stress that comes with this type of work.
Patricia Smith, founder of The Compassion Fatigue Awareness Project, says that caring too much can hurt. Compassion fatigue is vicarious traumatization—the emotional strain of those that help others going through a traumatic event. Smith defines compassion fatigue as “symptoms of normal displays of chronic stress resulting from the care giving work we choose to do.” Dispatching emergency teams to crisis callers certainly falls into that definition. Smith adds that destructive behaviors such as apathy, isolation, and substance abuse come to the surface when caregivers fail to practice self-care.
When stress is increased in quantity and degree, it grows accumulatively and causes a type of stress called cumulative stress. Emergency dispatchers take so many calls in quick succession that they take the stress home with them, go to bed with it, and wake up with it the next morning. Chronic stress exacerbates the dispatcher’s physiological reactions. DanTest, a company that manufactures products that measure physiological responses, says that untreated chronic stress “has been linked to the onset and development of a multitude of physical, behavioral, and mental ailments including diabetes, depression, migraines, hypertension, oncological formations, gastric ulcers, heart pathology, and more.”
The National Traumatic Stress Network (NTSN) defines secondary stress as the emotional duress that occurs as a result of one individual that hears about the traumatic experiences of another individual firsthand. The symptoms of secondary trauma closely mimic the symptoms of post-traumatic stress disorder (PTSD). Individuals that experience secondary stress may re-experience the trauma or become triggered by other experiences that make them re-experience the trauma. NTSN notes that secondary stress causes changes in memory and perception, alterations in the sense of self-efficacy, depletion of personal resources, and disruption in their perceptions of safety, trust, and independence.
Signs and Symptoms of Stress
Emergency dispatching agencies are becoming increasingly aware of the impact of stress on the job for their frontline dispatchers, especially for dispatchers that take the most distressing calls. Some agencies are starting to incorporate education about stress as an integral part of their training programs. A proactive approach can help reduce the incidences of secondary trauma for emergency dispatchers.
Stress affects emergency dispatchers even when they don’t realize it. Physical symptoms can sneak up on an individual. When a person has a job that is inherently stressful, as in the case of all first responders, it can be difficult to separate normal health concerns from those that are caused by on-the-job stress.
Mayo Clinic recognizes that stress affects not only the physical body. Stress affects the mood to an extreme that causes negative changes in behavior. Mayo Clinic breaks down the signs and symptoms into categories of changes that are noticeable in the body, mood, and behavior.
Signs of Stress that Affect Your Body
- Muscle tension or pain
- Chest ain
- Change in sex drive
- Stomach upset
- Sleep problems
Signs of Stress that Affect Your Mood
- Lack of motivation or focus
- Feeling overwhelmed
- Irritability or anger
- Sadness or depression
Signs of Stress that Affect Your Behavior
- Overeating or undereating
- Angry outbursts
- Drug or alcohol abuse
- Tobacco use
- Social withdrawal
- Exercising less often
Emergency Dispatchers Are Affected by Indirect Stress
As 9-1-1 emergency dispatchers vicariously live the emergency call along with the caller, the call ends abruptly when police and fire departments arrive on the scene. This leaves the dispatcher wondering whether the parties that were involved lived or died. There is often no way for the dispatcher to fully process the traumatic event, because there is no way to get closure.
NIU researchers, Heather Pierce and Michelle Lilly, conducted the first study on emergency dispatchers, with the goal of better understanding the effects of indirect stress. The study was published in the Journal of Traumatic Stress and included 171 emergency dispatchers from 24 states. The study revealed that the unexpected injury or death of a child was the most traumatic type of emergency call. Other types of calls that impacted the dispatcher’s stress levels included suicide calls, police officer shootings, and the unexpected death of an adult.
Emergency dispatchers have the responsibility for making lightning fast decisions that hold the potential to affect the outcome of life and death.
Where Can Emergency Dispatchers Go to Get Help?
The best therapists to help emergency dispatchers get treatment for PTSD and stress-related disorders are the therapists that have first-hand experience working in the field of first responders.
First responders feel a greater comfort level when being treated and supported by a team of their peers that will support them without the fear of stigmatizing their disorders in relation to the field.
Frontline Responder Services is staffed by active and retired first responders that have backgrounds in peer support, peer counseling, employee assistance, and crisis intervention. The clinical therapists at Frontline have extensive years of training and experience working with clients that have exposure to PTSD and severe stress that is related to being a first responder.
Frontline also offers training to emergency dispatcher agencies and other first responder departments to help agencies take a proactive approach to dealing with job-related stress related to trauma. Peer-led trainings include:
- An overview of the causes and effect of single and cumulative events
- Signs and symptoms of trauma
- Reliance on alcohol and other substances as a default method of treatment
- Evidence-based treatment options
Without exception, all first responders are susceptible to trauma-based stressors. Emergency dispatchers need to be proactive about addressing their stress as it occurs on the job. To effectively deal with job-related stress, they also need regular encouragement to incorporate stress-reducing activities into their everyday lifestyles. Most importantly, first responding employers can help their employees by adding training about the effects of stress into their orientation processes and give their employees access to treatment for health conditions caused by stress.
Mark W Lamplugh
Mark Lamplugh is a fourth-generation firefighter and former captain with the Lower Chichester (PA) Fire Company. He was the Chief Executive Officer with 360 Wellness Inc. (www.360wellness.org) and currently the Vice President of Business Development of the Frontline Program (www.frontlinerehab.com) at Sprout Health Group. Lamplugh is also nationally recognized in Crisis Stress Intervention through the American Academy of Experts in Traumatic Stress. Lamplugh hosts his own talk show called "Firefighter Wellness Radio" (http://www.blogtalkradio.com/fireengineeringtalkradio) with Fire Engineering. He has helped hundreds of firefighters, police officers, veterans, EMS personnel, and civilians nationwide find help for addiction, alcoholism, PTSD, and mental health support. He can be reached for comment at firstname.lastname@example.org.