Due to the nature of their jobs, public safety personnel may be at increased risk of developing mental health conditions. Minnesota Cities recently spoke with Amanda Schuh, a psychiatric nurse practitioner and city council member for Jordan, about how cities — especially elected leaders — can create an accountable and compassionate work environment that promotes the mental health of public safety employees.
Q. How can a city council member help to normalize the conversation about public safety mental health? What steps do you recommend?
A. As a city council member, you need to be mindful of language you use during meetings and other correspondence. For example, avoid derogatory language, such as “that’s crazy” or “that’s insane,” when discussing certain topics. This language perpetuates the stigma of mental illness.
This stigma is particularly evident among public safety professionals such as police officers, firefighters, emergency medical technicians (EMTs), and other emergency responders. There is a plethora of resources available to combat the stigma. Connecting with local, regional, and national organizations, such as the National Alliance for Mental Illness, is a great place to start.
Q. Post-traumatic stress disorder (PTSD) is common among public safety professionals. Can employees with PTSD get treatment that enables them to return to work?
A. Although most cities and public safety department leaders have equipped their public safety staff to respond to mass casualties, few have prepared their personnel for the psychological impact of such events. The ongoing COVID-19 pandemic has compounded the stressors public safety personnel cope with daily.
Thankfully, treatment works for mental health conditions like PTSD. However, many public safety personnel also believe that by seeking help for these conditions, they will face negative repercussions at work. This makes them reluctant to take advantage of available mental health services.
Untreated PTSD can lead to reduced functioning, increased suffering, and loss of employment for the individual, along with loss of expertise for the organization. That’s why it’s important for city and public safety leaders to recognize the symptoms of PTSD and encourage employees to get the help they need.
There are a variety of PTSD symptoms, including memory problems, lack of concentration, poor interactions with co-workers, and absenteeism. The goal of treatment for PTSD is to reduce the physical and emotional symptoms, improve daily functioning, and help individuals better cope with the traumatic event that triggered the disorder. The main treatments for PTSD include psychotherapy, medications, or a combination of both.
The federal Americans with Disabilities Act requires employers to make reasonable accommodations related to a known disability. PTSD is considered a disability, and accommodations can take many forms. The employee should be able to discuss and plan appropriate accommodations with their supervisor and health care provider as part of a treatment plan. Workplace accommodations can help an employee with PTSD better manage any physical, cognitive, or emotional limitations.
One of the primary symptoms of PTSD is avoidance of places and situations associated with the traumatic event. Employees who experienced or witnessed a traumatic event at work can have difficulty returning to work. On the other hand, research has shown that employees who are unable to return to work also experience more persistent PTSD symptoms.
Without a clear plan for a successful return to work, an employee can remain in a cycle where their PTSD symptoms are preventing them from returning to work, but their absence from work is negatively affecting their ability to overcome the PTSD symptoms. If the employee can work with their organization and health care provider to develop the right workplace accommodations and treatment plan, they have a good chance of avoiding this cycle.
Q. The League of Minnesota Cities Insurance Trust (LMCIT) workers’ compensation premium rates have increased significantly over the past year due primarily to increased PTSD claims among police officers. Should city council members (and health care professionals) be concerned about this?
A. City council members should be concerned about this because these costs affect city budgets and the ability to meet the public safety needs of citizens. These increased rates likewise affect other aspects of the budget, and decisions will need to be made to mitigate these costs.
Health care professionals are certainly concerned about this because there are finite resources to provide care to individuals with PTSD. Without timely identification and initiation of treatment, the individual will likely suffer longer, and it will be more difficult to treat.
Q. Other than cost, what are consequences to the city for not proactively addressing public safety mental health?
A. The human cost. Lost wages, low quality of life, poor job satisfaction, impacts on family, missing work, and increased risk of suicide are a few of the concerns specific to untreated stress and mental illness.
The loss of experienced public safety personnel can impact entire departments and affect the ability to meet the work demands of providing public safety. The organization could also have difficulties recruiting and retaining personnel.
Q. Why is it important for the city council to provide financial support for programs, schedules, and back-to-work strategies that promote mental/physical wellness?
A. If the culture promotes wellness in all forms, this will impact how the entire public safety team is able to function. That’s why it’s worth the investment. Programs that focus on improving overall wellness need to include medical and physical considerations.
Specific programming might include:
- Education on the importance of getting enough sleep.
- Incentives to encourage physical activity.
- Mental health and stress management training specific to public safety personnel.
- Peer support programs.
- Regular mental health check-ins that encourage personnel to discuss how they are engaging in self-care and managing stress.
For employees suffering from mental health conditions, providing adequate leave time allows individuals to recharge and successfully perform their duties. The time it takes to return to work varies, and it depends on several factors, including the work environment, how early the mental illness was identified, and the treatment the person received.
Once the person returns to work, their schedule needs to be carefully considered. For example, 12-hour shifts and overtime are discouraged. It is well-documented that working 12 or more hours in one shift is detrimental to an individual’s functioning.
Q. What do you think is the individual’s responsibility when it comes to staying physically and mentally healthy? What is the department’s responsibility and the city leadership’s responsibility in these efforts?
A. We all exist within different environments and there are only so many things an individual can do to maintain wellness. Placing the responsibility solely on individuals to care for themselves is not always productive or helpful.
Eventually, the mind and body will no longer be able to function with prolonged stress — no matter the effort made to reduce these effects. Peers, families, departments, and communities all have a responsibility to encourage a model of wellness.
Leaders who are more attuned to the needs of their teams can help to foster an open environment and begin to create a more accountable culture that supports seeking help and reducing stigma. City leadership can also model self-care practices, including adequate sleep, regular physical activity, and taking time off.
Q. How can a city council support and promote its police department, while respecting the concerns of citizens that may have been negatively impacted by police behavior?
A. More attention should be given to the day-to-day work of police officers and their role in the community. Poor police practices and wrongdoings need to be properly addressed as part of a culture of accountability. Every community has different needs and expectations of their law enforcement. A social compact needs to be explicitly identified and agreed upon between police and the public they serve.
Along with holding police accountable, city councils need to be willing to invest in emerging evidence-informed programming and resources to help mitigate the effects of trauma on public safety personnel.
As an elected city official, it’s important for you to clearly show you’re aware of these issues and truly care about them. Reach out to public safety personnel and give your public support for the positive work they do. Invite public safety personnel to city council meetings for regular updates regarding the department and how the employees are doing. Continue to reach out and engage the community in meaningful conversations about the experiences of those who may not be normally heard. Transparency is key in these approaches.
Q. What does creating an accountable and compassionate work environment mean to you? How can a city council member influence the city’s work culture?
A. As a city council member, I do not act alone, and my role is to advocate for all residents in my city. As stewards of the city budget and relevant resolutions, we indicate our commitment to a just and compassionate work environment through our actions and decisions as a council. Improving communication and transparency is important when working to build and maintain trust among city leadership, government, departments, and those we serve.
Q. What advice would you give other city council members about understanding and supporting public safety mental health concerns?
A. Reach out to your community leaders, including the fire chief, police chief, and public works director. Look for opportunities, such as ridealongs, with these leaders and front-line staff to increase your awareness of the work these employees do.
Always check in with how their departments are doing and ask how you can better support them. I would also recommend sharing information from the League of Minnesota Cities, including the PTSD and Mental Health Toolkit, pocket guides, training, and other resources available at www.lmc.org/mhtoolkit.