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Goh, who now works as a management consultant, took leave from work to spend more time on the ground fighting the fires. Eventually returning to her day job was hard – it felt like the world had changed. COVID restrictions and the inability to debrief properly with those in her brigade compounded the sense of disconnect.
Goh comes from a military and policing family.Credit: Nick Moir
Being part of the service and coming from a military and policing family, she knew about post-traumatic stress disorder (PTSD). But she didn’t consider that the irritability, anxiety and sleeplessness she was experiencing constituted PTSD.
“[I thought] you have to have experienced something really, really catastrophic,” says Goh. “Some of the other guys saw so much more than me that I didn’t feel like I deserved to actually say I have PTSD. So I was often just trying to say, ‘Oh, work is terrible’ or whatever it was. At the end of the day, you can still drown in 40 centimetres of water versus 40 metres of water.”
PTSD can result from an acute event – being in a bad car accident, for instance – or chronic exposure to trauma, as is often the case for emergency workers, who are twice as likely as the general population to experience mental health problems.
As Goh says, “Everybody’s worst day is your every day.”
Last week, the Black Dog Institute and the University of NSW launched updated guidelines for the treatment of PTSD among emergency workers. These are the first in the world to address the unique challenges they face, which include the cumulative effects of exposure, as well as the common desire to continue working in the field that keeps exposing them to trauma.
It was the influx of workers being treated for PTSD after the Black Summer fires that led to the update, says Professor Sam Harvey, executive director and chief scientist of the Black Dog Institute and the lead co-author of the guidelines.
There are more than 370,000 emergency workers in Australia, and it is estimated at least one in 10 develops PTSD.
Harvey and his colleagues realised they were seeing people too late. “On average it was eight years between when their symptoms began and when they first sought treatment.”
They also realised many were afraid of seeking help in case it affected their career prospects – an issue given many want to keep working in the sector. Also, many were being treated by therapists inexperienced with the nuance of PTSD in emergency workers. This meant some people were going for years without the right evidence-based treatment for their symptoms.
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“The reason why that really frustrates us is we now know that you can get good treatment outcomes if emergency service workers get evidence-based treatment and get it early,” says Harvey.
The guidelines are based on a treatment model which achieved a PTSD recovery rate of 80 per cent, compared with a global average of about 50 to 60 per cent.
It involves free, anonymous support via the National Emergency Worker Support Service (NEWSS) video conferencing for those in remote areas, a combination of talk therapy and sometimes medication, relapse prevention, as well as supporting a return to work for those who want to continue in the emergency services.
For those who delay getting help, the rates of recovery are similar, but it takes longer, says Harvey, and it increases the likelihood of collateral damage, including issues from substance abuse and relationship failure, that also need to be dealt with.
After Goh’s episode, she began seeing an emergency services PTSD specialist twice a week.
“And then, it started to actually improve,” says Goh, who is now a crew leader in training at her brigade and who uses crotchet and photography as tools in her recovery to stay grounded in the present.
Recovery, she says, is a journey.
“But, PTSD won’t hold you back if you get support. And you have an onus to do that for not just yourself, but for the community that you want to support too.”
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