Every Emergency Responder faces big stressors in the line of duty. It is important to recognize that The Very First Responder experiences...
The Nine Unique 9-1-1 Stressors
Revised from The Resilient 9-1-1 Professional, Chapter 3, by Jim Marshall
What's so Unique about 9-1-1 Stress?
If you are not a 9-1-1Professional (whom I also refer to as 9-1-1Pro, dispatcher or telecommunicator) it can be very hard to comprehend the nature and psychological demands of this extraordinary work. To gain a full understanding of the nature of 9-1-1 work, you would have to do it yourself, or at least witness a 9-1-1 Professional in action by spending time doing a "sit-along" in a 9-1-1 center.
Yet, all stakeholders need to strive for a greater understanding of the specific stressors to which 9-1-1 Pros are exposed to help protect and empower them. So, I offer this initial description as a starting point, with the hope that you will pursue more steps of awareness offered below.
Impacts of 9-1-1 Stress
Evidence of dispatchers' exposure to traumatic stress in the line of duty is found in the rate of PTSD they likely experience: a national study conducted by Lilly and Allen (2015) concluded that 24.6% of 9-1-1 telecommunicators may suffer from Post Traumatic Stress Disorder (based on a sample of 808 participants utilizing civilian cut-off scores on screening tools used). This rate is four to five times greater than for the general public.* For an extensive discussion of this research, see our interview with Dr. Lilly in Chapter 4 of The Resilient 9-1-1 Professional, entitled Facing the Impacts of 9-1-1 Stress: The Reality of PTSD and Depression in the Comm Center.
So what could be so unique and psychologically demanding about the 9-1-1 telecommunicator's work that it could contribute to such a high rate of PTSD? While personal characteristics of each individual worker are a probable factor, the risk of PTSD among dispatchers is also related to their work experience. They not only interevene in callers' life-and-death scenarios, they also face what I call 9-1-1's Nine Big Risk Factors. These factors, fully described in Chapter 3 of The Resilient 9-1-1 Professional, are unique from those experienced by field responders and non-emergency dispatchers. Let's take a look...
9-1-1’s Nine Big Risk Factors
#1: No warning Before Potentially Traumatic Calls. While dispatchers warn field responders about what they will face in the line of duty, 9-1-1Pros hear the sounds of violence, tragedy and suffering in their headests without warning, when it is still raw and fresh. That is why I call them The Very First Responder; not as a slight to our responders in the field, but to precisely acknowledge the reality of their experience and role.
#2: The big “C” of 9-1-1—Lack of Closure After Potentially Traumatic Calls. One important part of managing stress, is gaining a clear sense when a dangerous event is over and those at risk are "safe now".. Yet, 9-1-1Pros typically end their communication with callers in tragedy once they are under the care of field responders and en route to triage destinations. So dispatchers seldom get closure about the life outcomes for the people they served.
#3: Telecommunicators are Psychologically On-scene but Physically
Unable to Reach It. This limitation fuels a sense of helplessness since dispatchers often cannot act as fully on their empathy for their callers and field responders as they would like to if they were on scene.
#4: 9-1-1Pros “Send their Own” into Harm’s Way (their field responders). The dispatcher places the very highest priority on assuring "everyone comes home safe". Yet they cannot ultimately protect their responders from danger in the field. So when responders face serious injury or death, 9-1-1Pros may struggle with unfair yet understandable guilt---a serious factor in their potential traumatization.
#5: Limited Sensory Engagement with Those on Scene. Relying only on the sense of hearing to connect with those in harm's way, dispatchers strain to gain crucial insight and information to manage the emergency.
#6: High Call Volume and Frequency. For every call a field responder goes to, the dispatcher handles many times more. That means there may be far more "data bits" of high-stress information left to process mentally after their shifts are over. And that high volume of data can accumulate within the dispatcher over the weeks, months and years of their career.
#7: The "Crazy-Tasking" Demand (in additional to high volume and frequency of crisis calls, dispatchers must rapidly shift between a high number of tasks of many types to accomplish their objectives. This work represents a high degree of emotional labor, per hour of work.
#8: Little to No Downtime to De-stress (after high-stress calls throughout their shifts). While responders in the field often have downtime between calls to which they are sent, dispatchers typically have little or no time to shift gears, re-set mentally, to use the bathroom, or even to leave the console to eat their meals.
#9: Lack of Appreciation and Professional Respect from stakeholders. 9-1-1Pros are still not fully recognized as emergency responders and may not be affirmed within their workplace or by their communities for the extraordinary work they do. This can lead to demoralization and lower rates of retention.
If you’re not a 9-1-1Pro, your first glance at this list may prompt the same reaction my clinical colleagues at conferences have had when it was presented:
“I never thought of their job this way before!
What incredibly stressful work!”
Now that you know...
911 Training Institute encourages you to read the full explanations of these 9-1-1 Risk Factors in Chapter 3 of The Resilient 9-1-1 Professional, entitled Understanding Stress and the Nine Unique 9-1-1 Risk Factors Faced by Every Dispatcher. These descriptions will help to shed light on a profession that has been “out of mind” for most of our citizens because telecommunicators are “out of sight”.
Indeed, 9-1-1Pros are not on scene physically, but they are literally our Very First Responders on scene psychologically and they perform life-saving interventions regularly. With all nine of these unique risk factors in mind, you can likely see why 9-1-1 Professionals need specialized training in stress resilience and prevention of stress-related conditions and much more well-designed support, with the support of their comm center leaders.
This content is based on Chapter 3, Understanding Stress and the Nine Unique 9-1-1 Risk Factors Faced by Every Dispatcher, pp. 27-28, The Resilient 9-1-1 Professional: A Comprehensive Guide to Surviving and Thriving Together in the 9-1-1 Center. South of Heaven Press. 2018.
*Source: Lilly, M.M., & Allen, C.E. (2015). Psychological inflexibility and psychopathology in 9-1-1 telecommunicators. Journal of Traumatic Stress, 28, 262-266. doi: 10.1002/jts.22004.
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