About the Author

The Trauma that Lingers
by Anne Fawcett - Sydney Morning Herald

A new book puts the stress endured by emergency workers under the microscope. Fatal motor vehicle accidents or drug overdoses barely warrant a mention in the papers these days. In a few short sentences we're spared the gory details endured by the emergency services personnel at the scene.

But police, ambulance officers and firefighters don't have the luxury of detachment. They may be extracting a mutilated body from a burnt-out car or informing parents they have lost a child. Those experiences can have long-term effects on the health of those working at the scene. Up to 20 per cent of emergency services personnel suffer from post-traumatic stress disorder.

Esther McKay - a former NSW Police forensic investigator and the author of Crime Scene: True Stories From the Life of a Forensic Investigator - wishes she had known about the condition earlier.

At the age of 23, McKay became one of the first female police officers to work in forensics.

"I wanted to do something more involved," she says. "Forensic work involved investigating more serious crime scenes, preparing detailed statements, giving evidence in court. I thought it would be really rewarding." But the training was minimal.

"I found myself at incredibly challenging crime scenes, with very little training and totally inadequate equipment. I was mostly working alone so I didn't have someone to ask."

As McKay's confidence and skills developed she noticed a change in herself.

"Once I knew what I was doing I was able to take more notice of the actual crime scene, the smell, being alone with a dead body and the shock. I started to get a bit emotional, although I always held it in."

McKay lost her sense of humour. She was often on call for weeks at a time, working around the clock. Her first marriage broke up. She turned to alcohol. It was the hours spent alone at home, rather than those spent at murder scenes, that McKay found most difficult to bear.

"I would lay awake at night. When I did sleep I had nightmares. I became jumpy and nervy and I couldn't eat, the adrenaline was pumping through my system non-stop."

She developed a phobia of the telephone, which she associated with bad news. She became irritable and prone to angry outbursts. Things got worse when she had children with her second husband.

"I couldn't stop thinking about jobs I'd been to where children had been killed or injured. I was constantly worried that something would happen to them and I was very overprotective."

Finally, a decade after the onset of symptoms, McKay suffered a breakdown. She was medically discharged from the police in 2001, after 17 years in the force, classified hurt in the line of duty. Her GP referred her to the post-trauma treatment program at St John of God Hospital in Burwood.

"For the first time I looked at my symptoms and why I had them and understood much better why I had become bitter and twisted and burdened."

She learned techniques to control flashbacks.

McKay says she will never completely recover from her disorder, but she understands herself a lot better now. "I can see how it happens. A lot of police, for example, don't want to tell their spouse what they've been through when they come home from work. So they have a few drinks, maybe a few too many, and everything simmers away. That's why they call [post-traumatic stress disorder] speechless terror - people really can't talk about it, and their families really go through hell."

TRAUMA EXPOSURE KICKS OFF STRESS DISORDER

Post-traumatic stress disorder is an anxiety disorder resulting from exposure to traumatic situations. Symptoms include flashbacks, nightmares and involuntary thoughts about the experience. Sufferers have increased levels of arousal and may avoid anything that reminds them of the traumatic experience. Up to 25 per cent of trauma survivors develop chronic PTSD, with some of us more likely to develop it than others.

Clinical psychologist Dr Rachel Guthrie has studied risk factors for the development of PTSD in firefighters.

"Emergency service workers are at risk of developing PTSD because of the amount of trauma-exposure associated with their work," she says.

Guthrie believes the likelihood of an individual developing PTSD is influenced by their proximity to the traumatic event and the duration of the trauma, as well as individual factors such as prior trauma exposure. Chronic exposure is a big risk factor as exposure to trauma over time has a cumulative effect. The most effective treatment for PTSD is cognitive behaviour therapy, which allows the sufferer to correct unhelpful thinking patterns and to face situations they might fear because of their association to the trauma.

PTSD treatment programs are offered by St John of God Hospital in Burwood. contact Dr Selwyn Smith on 9715 9215 and also available at Westmead Hospital on 9845 7979.