When you hear about people traumatised by a life on the frontline and suffering depression or anxiety due to their work protecting others, you automatically think of the armed forces.

Post-traumatic stress disorder (PTSD) in the armed services created by action in warzones has been on the agenda for a generation, with soldiers now routinely being treated for the effects of their terrifying experiences – but the new frontline for this type of mental health treatment is on our own streets.

Healthcare workers are increasingly seen as being susceptible to PTSD and a higher proportion than average are falling victim to depression and other psychological conditions.

Britain’s National Health Service has calculated that it loses around 350,000 working hours to sick leave, with managers in the 1.5 million-strong workforce most likely to mention anxiety, stress or depression as the reason for absence. And that is in just one month!

The effects of mental health problems do not just impact on healthcare staff and their families, patients who are treated by these workers may not be receiving the optimum care from a person who is internally suffering themselves.

It is further concerning when you understand that the pressures on healthcare workers across the Western world are growing due to an increasing elderly population who have more complex needs.

There has been a call for those in healthcare to be given the same level of access to mental health treatment that emergency workers have been afforded over recent years. A number of initiatives across the globe have given frontline SOS responders better mental wellbeing support.

Mental health charity Mind has pioneered a programme in the UK which focuses on helping staff in the police, fire and ambulance services.

Since 2015, Mind has been delivering the Blue Light Programme, a project which has been involved in “reducing stigma, promoting wellbeing and improving mental health support for those working or volunteering in the ambulance, fire, police and search and rescue services”.

Ahead of the project, the charity found worrying trends in the mental wellbeing of emergency staff, including:

• Emergency services staff and volunteers experienced more mental health problems than the general workforce, but were less likely to take time off

• They were twice as likely to identify problems at work as the main cause of their problems, compared with the general workforce

• 88 per cent had experienced stress and poor mental health while working for these services.

• 71 per cent said their organisation did not encourage them to talk about mental health, and nearly one in two thought their colleagues would be treated less favourably if they disclosed a mental health problem at work.

Over the past four years, there has been training, information distributed and 9,000 calls have been made by SOS personnel and their families to a dedicated helpline.

The charity says: “The programme has had a significant impact on how positive staff and volunteers feel about mental health at work, in particular about how far their organisations encourage them to talk about mental health and support people with mental health problems.”

Photo by Philip Wyers on UnsplashTalking about mental wellbeing in emergency organisations has been deemed more acceptable after Britain’s Prince William spoke about his own demons sparked by working as a helicopter rescue pilot. He has told how “very traumatic” callouts involving children took him “over the edge” while he was working for the air ambulance.

The Duke of Cambridge served as a pilot at the East Anglian Air Ambulance until summer 2017, after moving from the RAF. He said having his own children deepened his feelings when sent to distressing jobs.

“I worked several times on very traumatic jobs involving children,” said the prince. “After I had my own children, I think the relation between the job and the personal life was what really took me over the edge and I started feeling things that I have never felt before.

“Talking was really important but even that wasn’t quite enough for one particular incident for me… I got very sad and very down about this particular family.”

He added: “There should be a much more open, supportive and compassionate working environment. There’s still a stigma about mental health. We are chipping away at it but that wall needs to be smashed down.”

Help from the Blue Light Programme is for all emergency workers but many see firefighters as having particular needs.

In the UK, Chief Executive of The Fire Fighters Charity, Dr Jill Tolfrey, says: “Fire and rescue service personnel can face extreme situations on a daily basis, whether working as frontline firefighters, or in control and support roles.

“These can take a significant mental and physical toll on individuals and teams and we have seen a significant increase in demand for our mental health support services over recent years.”

It is also seen on the other side of the world. In New Zealand, the number of medical emergencies that firefighters attended doubled over a few years after new rules. This increased the need for PTSD help as over that time 10 firefighters committed suicide.

The country’s Professional Firefighters Union general secretary Wattie Watson wants psychologists to have further training to deal with firefighters.

She says: “Their situation is unique in that they face mortality every time they go out, they know they could die every call. Like police and ambos, they will also face trauma every time they go out. So they have that combination as well as the fact that no one is trained to walk into fire like they are. Their mental gymnastics is extraordinarily unique and therefore their treatment has to be targeted at them.”

Mind is now demanding the lessons learned by the Blue Light Programme be extended to healthcare workers. This is especially important as the charity claims that staff in this sector can be worried about being deemed unfit to practice if they ask for help.

Emma Mamo, Head of Workplace Wellbeing at Mind, says: “We know there can be particular barriers for healthcare staff when disclosing a mental health problem to their employer, such as fears about being deemed unfit to practise.”

The charity’s chief executive has called for healthcare organisations to quickly bring in support for their staff facing mental wellbeing issues.

Paul Farmer, who is also independent chair of the NHS Taskforce on Mental Health, says: “Mind’s Blue Light Programme, supporting the mental health of staff across the emergency services, has shown what is possible with the right investment. By the end of the four-year programme, we saw a 64 per cent increase in staff saying their organisation talked openly to them about mental health, a 19 per cent increase in employees saying people with mental health problems were well supported in their workplace, and a 19 per cent increase in staff awareness of support offered by their organisation to improve mental wellbeing.

“Our work in emergency departments has also shown how good working conditions inspire loyalty and high performance from staff. We found the right environment can also prevent people developing mental health problems, and support those living with them to thrive.

“All NHS trusts must put in place preventative measures to keep staff well at work, not just support them when they need to take time off. Having the right workforce, with the right skills, in the right place is central to achieving the NHS long-term plan’s ambition to improve services and take a more joined up approach to healthcare. To do this, staff need to feel supported by their employer.

“This means promoting staff wellbeing, tackling the work-related causes of mental health problems and offering support to employees who are struggling with their mental health. NHS staff are vital and can make a real difference to the experiences of people accessing help.”