Groups representing Canada's paramedics are calling for improved mental health services as staff shortages and unprecedented call volumes fuelled by the pandemic and the overdose crisis take a toll on workers.
In British Columbia, BC Emergency Health Services reported more than 840,000 ambulance dispatches in 2021, but the union representing ambulance workers said the figure is likely much higher.
Troy Clifford, president of the Ambulance Paramedics of B.C., estimates paramedics responded to more than a million calls last year, pointing out that calls that require multiple ambulances aren't counted as separate events by their employer.
"These numbers are just not sustainable," said Clifford.
Figures released earlier this month by BC Emergency Health Services said B.C. paramedics responded to nearly 100 overdoses a day in 2021, which Clifford said has taken a toll on the service.
"The numbers of our members off and in treatment because of psychological injuries is incredible, and the opioid epidemic is definitely a significant part of that," he said.
Clifford said the service is having a staffing crisis with an inability to recruit and retain paramedics, and the union is calling for better wages and benefits.
"If we don't see changes soon, we will continue to see our ability to respond to patients suffer and wait times increase," he said.
Dave Deines, president of the Paramedic Association of Canada, said ambulance-paramedic services across the country are reporting increases in call volume, decreased staff due to COVID-19 and a greater need for mental health resources.
"All the paramedic services are feeling a crunch with the demand on the service going up, (and because) it's emotionally, psychologically and physically fatiguing," Deines said.
The Manitoba Association of Health Care Professionals, representing more than 800 rural paramedics, said a Jan. 6 internal report obtained by the union shows ambulances were idle for a cumulative 17,000 hours in October due to limited staff.
It said in a release that the report, from the Medical Transportation Co-ordination Centre, which dispatches emergency medical services, shows the service outages have spiked to a five-year high.
“During the pandemic, rural paramedics have worked unprecedented levels of overtime and continue to do so, but they can’t keep up,” said union president Bob Moroz in a release.
Manitoba Shared Health said in a statement it has made recruitment a significant area of its focus.
"During the pandemic, these efforts have included redeployment, engagement of relief staff and call-outs for recently retired or former paramedics to rejoin the workforce as part of our COVID response."
Zaid Noorsumar, a spokesperson for the Canadian Union of Public Employees in Ontario, said it surveyed 1,440 of its paramedic members in October and 92 per cent of respondents said they were understaffed.
Noorsumar said 84 per cent reported an increased workload was impacting their mental and physical health, while 73 per cent said their employer was not doing enough to address mental health concerns. The full data set will be released later this month, he said.
The Ontario Ministry of Health said in a statement "paramedic services across the province offer services to support the mental health needs of their employees," including family assistance plans, in-house counselling, peer support, and access to publicly funded mental health and addictions services.
Robert Parkinson, health and wellness director for the Ambulance Paramedics of B.C., said last year's heat dome shifted the need for better mental health resources into focus when record-breaking temperatures overwhelmed the 911 service.
The BC Coroners Service reported a total of 595 heat-related deaths last summer and Health Minister Adrian Dix confirmed there were 2,000 ambulance dispatches on June 28, the highest-ever one-day total.
Parkinson said the event exposed understaffing issues and brought to light the mental health impacts paramedics and dispatchers face.
Ambulance Paramedics of B.C. said it estimates about 30 per cent of the workforce is accessing psychological support, either through benefits, participating in the critical incident stress program or by taking paid time off.
BC Emergency Health Services said in a statement that mental health-related claims represented about 46 per cent of all its long-term disability claims in 2020, though 2021 data is not yet available.
The B.C. Health Ministry has said it will offer more clinical supports and resources for front-line staff and their families. It also said it was adding 85 full-time paramedics, 65 dispatchers and 22 ambulances to the system.