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Study: 112 call centre workers' PTSD often undiagnosed

Mental health workers say police officials are unable to recognise symptoms of post-traumatic stress.

ERC operators are the people who answer when you dial 112. Image: Toni Pitkänen / Yle

Operators at Finland's Emergency Response Centres (siirryt toiseen palveluun) (ERC, reached by dialling 112 in Finland) are prone to extreme mental strain as part of their work, but police resources are ineffective at diagnosing and treating their post-traumatic stress (PTSD).

The occupation's high psychological toll entered public discourse in December with the publication of researcher Susanna Sankala's sociology thesis, the first ever to study the wellbeing of Finland's ERC operators.

Sankala, who was an operator herself, said she was surprised when her interviewees opened up about their stress spontaneously, some breaking down in tears.

Juha Järvelin runs a national PTSD workshop unit for the police, which he started together with fellow organiser Pasi Härkönen. Järvelin said he is glad that the serious effects of the ERC workload are finally coming to light.

Getting to grips with the ERICA response system in Kerava in 2018. Image: Markku Pitkänen / Yle

"It's really great that this grad school level paper has been able to raise this issue. It's very impressive indeed that this research has been conducted," Järvelin said.

Järvelin wrote about the efficacy of police occupational health services during crisis situations in his own dissertation in 2011. He said now that the problem has been recognised, police administrators can finally take steps to alleviate the pressure on ERC operators.

"I've met with call centre workers abroad who have PTSD. I've been waiting for someone to tackle the issue properly here in Finland, too."

Workshops help with trauma

PTSD is a condition that may arise from exceptionally menacing or catastrophic events that cause intense anxiety.

ECR operators do not directly see any corpses or guts on the job, nor the victims they speak with. However, they constantly hear the sounds of domestic violence, desperation and panic through the telephone.

Symptoms of PTSD include replaying memories of traumatic events, nightmares about then or even experiencing momentary but harrowing flashbacks.

"In my experience, PTSD isn't acknowledged within the police force. Or if someone does admit they're having trouble, our health care services don't know how to identify it as PTSD," Järvelin said.

The first PTSD workshops for police were organised in 2012. Seven investigators who work with crimes against children came to one of these sessions, and Järvelin said he remembers how staggering the amount of accumulated stress turned out to be.

"The ECR involves so many similar factors that it would be odd if the operators didn't show any signs of long-term stress or even full-blown PTSD," he said.

When the agony subsides

Call centre operators are essentially first responders, says Järvelin, who was a police officer for 32 years. He knows from experience that the quality of life of the officers, firefighters, medics and operators would increase dramatically if the stressors involved were identified, acknowledged and discussed.

"That way, there would be no need for the false professional facade that makes workers say 'I don't feel a thing'."

Some of the participants in the mental health workshops have PTSD themselves. They often report feeling awful without a clear reason, or they feel anger at home as well as at work. After just three full sessions they already felt much better, Järvelin said.

"When the agony subsides, they feel immense relief. They regain their joy of life."

The "112 mongoose" stuffed toy is used to teach children how to call 112 in an emergency. Image: Susanna Sankala

He said he hopes that the current discussion will lead to real changes in the way ECR operators' jobs are understood by their employers and health care providers.

"If we could get a PTSD retreat organised, Finland would be number one in the world in dealing with the trauma that emergency operators face. But it means we need all ECR personnel to be on board with the plans," Järvelin said.

He emphasised that all operators and other first responders share the fact that they experience stress over things that no regular job entails. They face the dramatic trauma of life and death.

"And this is the crux, what we don't talk about. The old way of thinking is that this is just a job, if you can't hack it then you've failed somehow. That is hardly the case; we simply need better support systems to respond to the realities of the work they do," Järvelin said.