Mr. Chair, I would like to thank the committee for giving me the opportunity to talk about the health and well-being of paramedics in Canada.
I'd like to frame our discussion in terms of what the Paramedic Association of Canada is and isn't, and to talk a little bit about mental health. Paramedics are in distress, and I have some information that highlights the severity of the issue. I'll also talk about some good initiatives that are taking place. Lastly, I'll speak about how we can work together. I think there are some great opportunities to work with the chiefs, the different levels of government and, in particular, the Canadian safety and security program.
First, the Paramedic Association of Canada is an association of paramedics. It's not the union. That's a distinction I'd like to make. We take care of the competency profile of paramedics—the things that define paramedics. We determine the skills, abilities, and knowledge of paramedics as well as the roles they undertake in providing service to the community.
It really is about the education that a paramedic needs to do the job and do it well. By the year 2025, we hope to be at a baccalaureate level in the training that's required. The job has changed that much.
There are 20,000 members of the Paramedic Association of Canada, and there are around 40,000 paramedics in the country. Often we say it's about 1,000 paramedics for every million people. That's a broad number but it's pretty accurate. This makes the paramedic community the third-largest health care provider group in the country.
In defining paramedics, the terminology is usually primary care paramedic, advanced care paramedic, and critical care paramedic. We have those three designations. The nomenclature surrounding paramedics has been consolidated in the last 15 years or so. Across the country there's a fair bit of uniformity in the terms and the titles.
Where we work is an important thing. People used to think paramedics worked strictly in ambulances. Today you see paramedics in helicopters, in clinics and hospitals, and you're starting to see them in community health centres. A great example of that is the Health Bus in Saskatoon, where paramedics form part of a team in the community paramedic program. In the spectrum of health services, the job of a paramedic has evolved from being focused on urgent care to also providing preventative care.
Mental health has become important for paramedics. There has been some fantastic research done over the last number of years. Dr. Lori Gray and the Paramedic Chiefs of Canada did a fantastic report a couple of years ago looking at occupational stress injury in paramedics. Since then we've identified that the disease process at the end of the spectrum is not the only thing that matters. We also need to focus on general wellness. We are investigating how to build up people's capacity so that they don't fall into the illness category. This is important. With PTSD, in some ways there has been a failure. We still haven't figured out how to take care of people so that they don't fall into this category.
Most distressing of all is the number of suicides that have been related to mental health and mental health issues. I think the number was 14 or 15 last year. My apologies, I don't have the exact number, but that is a wake-up call. It's a flashing red light for us that more has to be done. Recently, the Paramedic Association of Canada did an online survey of paramedics, and there were 6,000 respondents. The numbers are startling. Thirty per cent of paramedics have contemplated suicide, sixty per cent know of a colleague who has contemplated suicide, and seventy per cent are concerned that a paramedic colleague is at risk of suicide. So in spite of all the evolution in what we do and where we do it, paramedics feel that in some ways they haven't been taken care of. All of us, really, are accountable. I'm not singling out any one group. It's a societal issue that we have to address. That's why both Randy Mellow and I are so appreciative of the mandate letter that was given to Minister Goodale. This is an issue for all first responders, including paramedics.
Talking about some of the good initiatives that have taken place, there has been presumptive legislation with respect to PTSD in several provinces, including just recently in Ontario, but also Manitoba and Alberta.
There's an initiative with the University of Regina, and a round table took place at the beginning of this year, which we think is a great foundation for the first responder community to work together on this issue. That's an important piece. Recognizing that paramedics still have their own uniqueness, there's a commonality among the public safety occupation, or the first responders, that this round table is addressing quite well. We advocate that those kinds of initiatives be supported.
Recently Queen's University did a study to solicit how paramedics “feel”, but it's about understanding the scope of the issue in a research-based study. Dr. Renée MacPhee and Queen's University started this process. Other good work is going on about rooting out and defining the problem and the problem space.
The whole idea of that first responder community coming together and this committee being willing to listen to us is an important piece of starting the process of understanding what the problem is, so that we can work back. We can deal with the disease process, but we can also look back at the wellness component.
With respect to the ask—and Randy Mellow and the chiefs and the Paramedic Association are very much on the same page on this—we continue to support initiatives such as the round table at the University of Regina, and what's come out of that round table.
Recognizing that paramedics still have a unique job—we're not firefighters; we're not police officers—the understanding of how we get to the illness phase, whether it's cumulative or whether single events are triggers, we don't know. There's research to be done there.
There's an opportunity with the Canadian safety and security program, which has been very much an advocate going back the last 10 years or so in support of our community. Targeted investments could be coming from that group in support of research for paramedics, not just on PTSD but also on mental health and wellness.
Thank you very much for the opportunity to speak. I'm willing to answer any questions.