HORSE BEFORE THE CART
March 16, 2012
By Jim Lanier & Jim Marshall
Have you ever wondered how managing the “worst” calls affects a Public Safety Telecommunicator’s (PST) mental and physical health? And if the PST is affected by these calls (or the accumulated effect of many such calls) will the PST realize it soon enough to prevent personal damage? (Hint: The effects of stress can be purely physical and occur long after the traumatic events that triggered them).
A 2008 study by Roberta Troxellfound a significant number of PSTs showed symptoms consistent with Secondary Traumatic Stress Disorder (STSD). The features of Post Traumatic Stress Disorder (PTSD) and STSD are almost identical. This estimated incidence of STSD is comparable to the rate of PTSD found among our police ranks—and it is drastically higher in PSTs than among the general public.
Troxell found that psychologically PSTs are in fact “on-scene” when they are processing the worst calls. This study should cause us to think very strategically about how to protect our PSTs in the face of current PSAP stressors; the 9-1-1 community as a whole has not yet caught up to these realities in preparing PSTs to work in a safer way mentally within today’s PSAP.
But if it’s true that traditional PST work is already like riding a bareback bronco, we may want to start looking for some saddles and tighten our grip because these health risks may increase drastically in the NG9-1-1 capable PSAP. Specifically, NG9-1-1 will enable real-time video contact from the public and field responders during emergencies, as well as texting, photographs, and other digital data. Undoubtedly, these call features will provide much richer information that can result in heightened response capabilities. But at what cost to the PST?
No one knows what the effects of exposure to callers via real-time video will be—positive or negative. To date, video relay service (VRS) providers are the only call managers with extensive experience of this kind, but there is no research on how their experience has affected their health or performance. Yet, stress research clearly affirms that any factor in 9-1-1 call management and dispatch that increases the PSTs’ experience of intense fear, horror, and/or helplessness will increase their risk of traumatic stress, compassion fatigue, and burnout.
Imagine again the “worst calls,” but this time view the scenes through the eyes of the PST who, via the caller’s iPhone, is now watching a raw streaming video feed at the console monitor as the events unfold. While the dispatcher may experience an enhanced sense of mastery from video when the call works out well, the addition of real-time video exposure could—as we have already stated—increase the likelihood that dispatchers will experience traumatization.
Texting also represents a stress risk for dispatchers because of a format that significantly limits information, including the essential elements of verbal exchange that accompany traditional verbal communication (voice tone/inflection). For example, callers at high risk of suicide struggling with significant ambivalence in choosing death versus life may only provide their addresses and pledge cooperation when they have achieved trust in the dispatcher to assist them non-judgmentally—a condition often only achieved through caring personal exchange with the dispatcher.
Troxell’s research and current knowledge from the field of traumatology (see Lanier, 2008) supports our concerns for the PST and urges us to encourage the 9-1-1 community to join in facing more crucial questions: Will NG9-1-1 create greater emotional labor for dispatchers? How will they be expected to use new video information; and what shared legal liability will the PSAP and the dispatcher assume if video records are summoned to court?
Our goal in asking these difficult questions is not to stir pandemonium and opposition related to NG9-1-1. It is to affirm that “failing to plan” for evidence-supported risks is “planning to fail” should these predictable risks play out in our nation’s PSAPs at great expense personally to our PSTs--—and for the public if 9-1-1 operations are compromised by their impaired performance under enormous unmanaged stress.
So then, how do we prepare and plan to get our PSTs ready for the exciting and challenging changes in PSAP dynamics that NG9-1-1 will bring to bear? Stayed tuned to future articles in The Journal addressing the challenges and exploring the psychological impacts of NG9-1-1 related to real-time video, texting, and increased multitasking demand.