State EMS Director Tackling Mental Health Issues Head-On

The job stress and trauma for our first responders too often becomes both overwhelming and internalized.

Randy Yohe spoke with state Emergency Medical Director Jody Ratliff on what’s being done to relieve the mental anguish these frontliners face on the job. 

This story has been lightly edited for clarity.

Yohe: Tell us about the impact of the early morning personal calls that you periodically get from EMTs and paramedics across the state that had a traumatic night at work.

Ratliff: When I get these phone calls, they could be early morning, could be in the middle of day while I’m at work, or it could even be at nighttime. Usually it starts with, hey, I want to run something by you. And they usually run the call by me to see if I felt like they did everything they could have to help the patient. And from there, it kind of turns into, “So, it kind of bothered me, this call bothered me, can we talk about it?” 

For example, whenever I did give the speech at the legislative interims, two days later, my boss from years ago, Kelly Crozier, called me, and she told me she heard about it. Kelly is very tough and rough and kind of cold-hearted, nothing gets to her. She calls me and says, “God, I cried.” I broke down on that one because it was so true, and that really hit home with me to know that what I said affected someone who was such an influence in my life and my career.

Yohe: Here in 2023, talk about the “suck it up” mentality being a thing of the past. And, how pervasive are the mental health challenges these days for first responders?

Ratliff: It’s not what it was. When I was brought up, it was that “suck it up” mentality, we’ve got to move on to the next call. Unfortunately, that’s still EMS, we still have another call that’s coming, we don’t know when it’s going to stop for the shift. What we don’t want to do is put these young ones in the same shoes that we were in, we don’t want them to suck it up. We don’t want them to walk away from it, say okay, I’ll tuck it away and then we don’t have to deal with it anymore. That just doesn’t work.

When you tuck it away, it’s going to come out in the worst possible way that you can think of. Instead, we want them talking about it, we want them to come to those older paramedics, those older EMTs and get it out of their system, because otherwise it comes out in the most horrible ways you can think of.

Yohe: I heard a new term recently I hadn’t heard before – compassion fatigue. Talk to me about that.

Ratliff: Compassion fatigue is not something that we speak about a whole lot. When you see so many things, and you deal with so many things, you kind of get hardened. I don’t want to say it’s hard to feel compassion, but you’ve almost got to tuck it away. When you’re dealing with a parent whose child has died, and you have to tell them that their child has died, as much as you want to feel compassion for that you still have to maintain, because you have a job to do. It’s rough to maintain that level of compassion on everything that you do on a daily basis, because there’s only so many emotions that you can get out at a time. Whenever you see it on a daily basis, I can tell you it’s difficult to feel emotions, after 23 years of seeing the things that we see.

Yohe: And so that can swell up inside of you and become a ticking time bomb, right?

Ratliff: Exactly. That goes right back to what I was talking about. If you don’t get it out, it always comes down in the most horrible ways you can think of.

Yohe: One program you’ve instituted is the 988 Crisis Lifeline. So how does that work for EMTs? And how does it help?

Ratliff: 988 was developed by Lata Menon, the CEO at First Choice Services. It’s been in the state for a while and we just attached ourselves to it. We went up and met with Lata, and she jumped on board, and we jumped on board. We convinced her to let some of her folks do ride-alongs with EMS so they could get an idea of what we go through and what we see.

What we’ve got now is if you’re having a little bit of a mental health crisis, or you had that bad night at work, you just need to talk to someone, you can call that 988 Crisis Lifeline and you’re gonna have someone on the line that can help talk to you and maybe talk you off the edge. He’ll call me whatever the case might be. We just kind of got into the EMS part of it, we’re going to get it with fire and law enforcement also. 

Yohe: You are also developing regional critical debriefing teams. What exactly do they do? And how are they in action?

Ratliff: Whenever it’s all said and done, we hope they’re made up of EMS, law enforcement and fire, and then a mental health specialist. If they have that big scene out there, and it’s traumatic and it’s bothering people, it’s right then and there is when they need to have that debriefing. That’s when they can make that phone call to the regional team. They load up, they come out, they sit down with them, they go through the process, whether it be crying with them or whatever the case might be. 

Yohe: What are your plans and hopes for how this will develop?

Ratliff: My hope is, once we get everything in place, as far as the money and get people trained, and things like that, that people will use it. We can do everything that we can do, but if it’s not being used, then it’s pretty much for nothing. So we are really pushing this hard in the EMS world. We’re hoping to push in the fire world, we’re hoping to push in the law enforcement world – so everybody takes advantage of it.

My other hope is that the older medics out there have to be the leaders in mental health. It’s not just the directors, it’s not just a supervisor. It’s those 20, 30 and 35 year medics out there. They’re the ones who have to be the leaders and get the young ones talking about mental health and encourage them to speak about the problems and not keep it in. 

Yohe: There’s still a shortage of EMTs statewide. Talk about the risks and rewards associated with the job.

Ratliff: Unfortunately, there are risks. I believe it’s within three years of being hired that you’re going to be assaulted in EMS, for not the best pay. Those are the risks, the mental health risks. The reward of the job is, you’ve got to experience it. I wish I could sit and describe it, but the truth of the matter is, after 23 years, I love EMS. I’ve given my life to EMS. I know it. I love it. And I can’t imagine doing anything else in life.