#mentalhealth

First responder assaults – the shocking stats

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We must question the sanity of the world we live in. First responders – police, fire and ambulance – are generally people trying to save the community from danger by putting themselves in harm’s way. Yet the incidence of assaults against them has grown to shocking levels around the world. These are not exhaustive stats (this will come in a more comprehensive piece) but this piece paints a picture of what is going on and why we shouldn’t be surprised at the growing incidences of PTSD suffered by first responders. Something must be done. The next journey for CM is to provide a solution.

By branch:

POLICE

The FBI noted in 2016 that 57,180 (c.10% of all) US police officers were assaulted while performing their duties. 28.9% were injured (enough to enforce time away from work). The largest percentage of victim officers (32.2%) were assaulted while responding to disturbance calls (domestic violence, family disputes, pub fights).

Assailants used hands, fists or feet in 78% of the incidents, firearms in 4.2% of incidents, and knives or other cutting instruments in 1.9% of the assaults. Other types of dangerous weapons were used in 16% of assaults. Assaults on police in the US are up 17% in the past two years. 

In NSW, Australia some 2,343 (13.3%) police officers out of 16,500 have been at the receiving end of assault in 2017. That’s 6 per day. With regard to official statistics, the NSW Police Force indicated that over a three year period from 2013 to 2015, an average of 2,236 police officers per year were assaulted during the course of their duties. Around 7% of officers actually end up physically injured. 

 AMBULANCE/EMS

In the US health care professionals experience the highest rate of workplace violence (WPV) compared to all other industries, with the majority of violent injuries committed by their patients according to the Bureau of Labor Statistics. Studies show EMS responders were three times higher than the national average for all other occupations to suffer WPV. In regards to occupational fatalities, the rate among paramedics is more than twice the national average for all occupations and is comparable to those of police and firefighters at 12.7 per 100,000 workers per year.

The rate of nonfatal injuries among US paramedics was 34.6 per 100 full-time workers per year — a rate more than 5x higher than the national average for all workers.  In regard to fatal injuries, a retrospective cohort study of nationally registered emergency medical technicians (EMTs) in the U.S. found that 8% of fatalities were due to assaults. 

Males have been reported as the most frequent perpetrators of violence however, a separate study found female patients of the mean age of 32.5 years +/- 8.1 years to be the most frequent perpetrators. 

In the NSW Ambulance Service, approximately 51% of assault incidents were attributed to mental illness, 22% to alcohol, 15% to drugs. Similarly, statistics provided by the NSW Bureau of Crime Statistics and Research (BOCSAR) concerning violence against Police from July 2006 to June 2016 suggest alcohol is a factor in many incidents.  Assaults on ambos in NSW are up 8-fold since 2001. Median lost hours for those EMS crew assaulted is around 8.6 weeks.

FIRE FIGHTERS

In what world do people shoot fireys? Here are 3 specific incidents in 2016 of attacks on fire fighters in the US. 

April 15, 2016: Firefighter fatally shot, second wounded in Prince George’s, Baltimore, Maryland

Jan. 22, 2016: Ark. firefighter shot, killed on EMS call, Pulaski County, Arkansas,

Jan. 20, 2016: Denver fire chief stabbed near station, Denver, Colorado,

Fire and Rescue NSW indicated its officers do not have the sort of violence prevention training of police and paramedics better able to protect their crew’s health and safety, including in respect of violent incidents. At the Parliamentary Committee’s hearing on 14 November 2016, Fire and Rescue NSW witnesses provided the following evidence:

Basically, when a crew arrives at an incident, you have a station officer and a station commander in charge of the crew and the…truck. That person undergoes promotional programs to get to that position. Part of that is understanding how the legislation is applied in reality from a practical point of view. Also, during that experience – we are talking probably eight to 10 years for that to occur …The promotional programs…cover the responsibilities of the officer and advise around the standard operational guidelines of when to withdraw and ask for police support and what is safe or not safe.

…If we look overseas for experiences and tried to align our experience to that, you would have to say that the civil unrest that is happening in the United States probably would not occur here to that degree. However, there is also an underlying issue in the United States where emergency service is seen as part of an arm of government and there is, hopefully, a small growing trend where emergency service ambushes are occurring…random shooters are calling emergency services to locations to make a point. We hope that never crosses to this country here, but we would always have an eye on what happens in other jurisdictions…because it is quite possible someone would pick that up as a possibility in this jurisdiction….”

PRISON GUARDS

The UK HMPS note that there were 7,159 assaults on staff in the year to March 2017 up 32%YoY. Serious assaults were up 25%YoY to 805 incidents. The National Tactical Response Group (NTRG) which is only called under extreme levels of prisoner violence  surged from 120 in 2010 to an annualized 630 by the end of 2016.  

THE PTSD IMPACT

This was the fascinating part of the research. It isn’t that the job isn’t hard enough already, it’s the lack of resources to support first responders when waiting for incidents. Lots of idle time to ponder.

US FEMA note stress has not only been categorized by exposure to traumatic incidents, but also the monotonous operational characteristics of EMS organizations, such as paperwork, lack of administrative support, low wages, long hours, irregular shifts, and cynical societal attitudes toward public safety officers.

Cumulative stress associated with the monotonous duties or low acuity calls has led to feelings of desensitization for patients, and their job as a whole. Concerns have also been raised regarding sleep quality and fatigue and the impact it has not only on the provider, but also job performance and patient  outcomes. Some research has posited that organizational stress often contributes more to the development of PTSD than traumatic events.

Also noteworthy is the notion that paramedics are often the source for a lot of criticisms by society for the decisions they make in determining life or death situations for patients and themselves. This can affect EMS providers in many ways and may contribute to the slow decline in provider morale.

Burnout (emotional exhaustion) is one of many organizational outcomes that may arise as a result of violence experienced by EMS responders. The question of whether or not violence would eventually lead to burnout was first raised in the early 1990s . Exposures to violence were noted as a reason many EMTs, especially volunteers, left the profession. In an early study from 1998, 7% of survey respondents within one urban fire department considered leaving EMS as a direct result of an abusive situation they encountered while on the job. Knowing how to emotionally cope following a tough incident can help to reduce anxiety and burnout.  

Mixed methods studies conducted in the U.S. and Sweden found that violent encounters altered the patient-provider relationship. Yet, some in the industry feel that exposures to violence do not cause stress or negatively impact providers. This lack of effect has been attributed to the internalization of the mentality that violence is a part of the job.  It has been posited that years of experience may be a protective factor that allows more experienced responders to experience less stress and anxiety after violent events. 

Evidence weighing the social and economic costs associated with increased violence and burnout is based mostly upon anecdotal evidence, with no assessments conducted on monetary value. Some suggest that, as violence increases, the need for police backup also increases, thereby increasing response time and delaying potentially critical care to a patient in need. 

Other concerns include altered operations for the private sector of EMS. Intent to leave the profession is also a concern. As more EMS responders leave the profession, numerous organizational and patient impacts have been hypothesized, including increased costs for training new EMTs and paramedics, greater numbers of inexperienced paramedics serving at any one point in time, and increased error rates committed by new and inexperienced paramedics. EMS responders also report seeking a job change away from their ambulance role. In some cases, responders stated they lost interest in fieldwork and tried to get off the road and into desk positions. 

What’s clear is that not enough is being done to help first responders cope with occupational hazards and handling the stress that comes from it. That is going to change very soon. Stay  posted!

While you’re at it, why not thank those first responders randomly in the street for the great work they do. It goes a long way! They need you just as much as you will need them when you’re in a bind!

A link between crime & IQ?

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While updating all of the data for crime in Japan, CM was intrigued by the IQ test data compiled by the Ministry of Justice (MoJ) for all 20,000 new inmates in 2016. The average IQ recorded was 81.4. All said and told, 57.4% of new inmates scored an IQ of more than 80. The MoJ also recorded that the level of education attained by criminals showed 62.5% had attained a maximum of middle school (years 7-9) or dropped out of high school (years 10-12).

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Japan has a high school matriculation rate of around 95% which places it in the top 4 countries around the world. The US has around a 76% completion rate (rank 13) for high school according to the OECD.

To study IQ for inmates on a more global basis, a 2003 study by Ellis & Walsh revealed that of all the Texas inmates who entered the prison system in 2002 approx. 23% of the inmates scored below 80, almost 69% scored between 80 and 109, and only 9.6% scored above 110. The average was 85. The Prison Reform Trust in the UK said 1/3 of prisoners had an IQ less than 80 and one-third of that was less than 70. A Levine study in 2011 showed that those who had been to jail had a mean IQ of 89.61 while those who had not who had a mean IQ of 100.6.

Although a deeper look at serial killers showed extremely high IQs. The Dating Game serial killer Rodney Alcala had a reported IQ of 170. Uni-bomber Ted Kaczynski 167 and Jeffrey Dahmer 144. Hideo Murai, chief scientist of the Aum Shinrikyo (responsible for the Tokyo subway sarin attacks), was also reported t have an IQ of 160. On the other and, Australia’s worst mass murderer, Martin Bryant, reportedly has an IQ of only 68.

We shouldn’t forget that months after winning a national title, Harvard’s debate team lost to a group of New York prison inmates. A three-judge panel concluded that the jailbirds had raised arguments the Harvard team had failed to consider or was it a slight bias that the judges feared repercussions were they ever released?

Many prevailing theories of intelligence suggest people with lower IQs are most likely to break the law, since impulsivity, struggles at school and a lack of social bonding are all linked to criminality.  Although James Oleson, a criminologist based at the University of Auckland in NZ, suggests real-life geniuses have a penchant for breaking the law. He noted there may be an IQ threshold after which a high it becomes more of a risk factor for committing crimes. Intelligent offenders were more likely to get away with their crimes.

The flip-side to claiming mental disability is also that of avoiding execution. In the US, there are some states debating whether an inmate with an IQ below 70 cam be executed on the grounds he or she may not have sufficient mental faculty. Abandoning the 70-point IQ cutoff could double the number of death row inmates who claim they are mentally disabled.

According to the 2005 Annual Report on Government Measures for Persons with Disabilities published by the Japan Cabinet Office, of the total estimated 3,600,000 people with a mental disability, 459,000 people possessed the Certificate of Mental Retardation – 12% of all mentally disabled people in Japan possess it vs. 6.3% of mentally disabled inmates. The Yokohama National University suggested this clearly indicates a tendency that people who are bound to be in prisons are less likely to have possessed the certificate, therefore likely to have missed some form of assistance from social welfare programs.

Morie and Matsushi wrote, “5.9% of all population on average is categorized as intellectually disabled. However, the percentage of children who are classified as mentally disabled and receiving special education as well as social welfare is stagnant at 1%. Because the Certificate of Mental Retardation is only issued upon request, many of the parents/guardians are reluctant to apply due to the fear of being stigmatized. This is especially true for a mild case of mental retardation. Lack of appropriate education and opportunity to receive social welfare can lead the children with mental disability to anti-social behavior, ultimately connecting them to crimes. Therefore, guardians should be strongly recommended to apply for the certificate without hesitation…”

Although it is worth noting that despite prison capacity in Japan expanding 50% over the last decade, the number of inmates is 31% lower at around 56,000 or 62% capacity, down from 105% at the peak. Compared to the 2.2mn prisoners in the US, Japan is still at the very low end of the crime spectrum. That is to say the US has 13.1x the number of prisoners relative to the population than Japan. The US ranks 1st while Japan ranks 35th.

FedEx gives a lesson in corporate communications over the NRA

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CM wrote earlier in the week on the hypocrisy of corporates disassociating themselves from the NRA after the Parkland, Florida school shooting despite having decades of similar incidences to have done it. Yet their conscience never got the better of them because targeting  5,000,000 members was good for business. FedEx on the other hand has made it clear on its position with respect to gun control. Despite that it will continue to provide a service and will not be bullied, coerced or cave into activism to target members who did not commit a crime. Good on FedEx for making it clear where they stand rather than cower to social media pressure.

The adolescent media spokesman of choice, David Hogg, made very clear that he wants to hold a proverbial gun to the head of every corporate to ditch the NRA. FedEx and Amazon were also singled out as targets by the Florida student for continuing to offer discounts to the NRA. He even threatened to cancel his Amazon TV subscription because it broadcast NRATV. It is absolutely his choice to make. By all means Mr Hogg can vote however he chooses with his wallet. He should extend the same courtesy.

No one is questioning or trivializing the trauma of such a tragic event but the constant hunt to ‘shame’ people (who’ve done nothing illegal) always ends up causing those ‘shamed’ to do the opposite of the intended strategy. Many corporates could have followed FedEx’s lead. Shouldn’t it be up to individuals to freely consider whether they want to fly United, rent a Hertz car or send packages via FedEx? It is absolutely their choice to do. Most people are thinking of the function of the service at the time, not conduct pre-flight checks on whether the company has an affiliation with the NRA or any other group disliked by others.

If people are honestly abhorred by any corporate that offers discounts to the NRA then they will naturally adjust consumption patterns. 19 years since Columbine would suggest most corporates didn’t care and saw no appreciable impact to revenues by staying with the NRA. Consumers do not require people bashing them over the head to swallow a message they may already agree with or not. Surely observing the actions of those exercising unbridled volition is a superior barometer of mood over issues rather than force feeding.

Does David Hogg think he will win over NRA members by slapping them on his Twitter feed? Does Hogg seriously believe that slamming the president by branding him a coward and a draft dodger on social media will turn him, especially given his track record? If he wished to gain traction he would go far further asking to meet with Trump in the White House with his school mates and lay out a comprehensive plan to try get some leverage on the NRA. It may be a futile exercise but if he wants to show the moral high ground and win over the masses (the mainstream media would only be too happy to oblige) then acting in a manner which shows that he embodies that spirit will have a far better chance of converting others.

It will be interesting to see whether the NRA sees a surge in membership on the back of being attacked in this way. Earlier this week, a yearly membership was $30, Today it is $40. Could it be the hike is on the back of overwhelming support? Surely a club that is hemorrhaging members would be cutting prices to stay afloat.

The group published a membership recruitment drive which was viewed over 10 million times this week. The idea that all of the members at the NRA are deranged gun-toting lunatics incapable of listening to sensible suggestions is quite an accusation but often made. This was its response to those corporates that dumped it:

NRA STATEMENT ON CORPORATE PARTNERSHIPS

(FAIRFAX, VA) – The more than five million law-abiding members of the National Rifle Association have enjoyed discounts and cost-saving programs from many American corporations that have partnered with the NRA to expand member benefits.

Since the tragedy in Parkland, Florida, a number of companies have decided to sever their relationship with the NRA, in an effort to punish our members who are doctors, farmers, law enforcement officers, fire fighters, nurses, shop owners and school teachers that live in every American community. We are men and women who represent every American ethnic group, every one of the world’s religions and every form of political commitment.

The law-abiding members of the NRA had nothing at all to do with the failure of that school’s security preparedness, the failure of America’s mental health system, the failure of the National Instant Check System or the cruel failures of both federal and local law enforcement.

Despite that, some corporations have decided to punish NRA membership in a shameful display of political and civic cowardice. In time, these brands will be replaced by others who recognize that patriotism and determined commitment to Constitutional freedoms are characteristics of a marketplace they very much want to serve.

Let it be absolutely clear. The loss of a discount will neither scare nor distract one single NRA member from our mission to stand and defend the individual freedoms that have always made America the greatest nation in the world.

Having said all of the above, the voting down of a tax break for Delta Airlines by the Senate in the State of  Georgia which openly admitted that it was punishment for cutting sponsorship ties with the NRA was no less juvenile. No doubt many might view this as the NRA cashing in on favours for all those donations. Whether they played a direct hand is not determined. This is the political class trivializing sensitive matters. Cut Delta’s support for the right reasons but not because it made a commercial decision, no matter how daft the reasoning.

While we should be reflecting on the memories of 17 students that died from senseless gun violence and how to ensure it doesn’t happen again, we see that Mr Hogg and others believe that holding a metaphorical gun to peoples’ heads is the way to fix the problem. It is a sad lesson for society today. Sensible debate can’t be had with threats of coercion or aggression. Introducing ‘common sense’ gun laws requires compromise and the freedom to express opinions, no matter how absurd. All this threatening behaviour sends either party to the debate to the opposite side of the room.

Ridding the country of guns and taking homicides to zero would be a Utopian dream. That is a matter for voters to get the law changed. The irony is that tighter gun laws could have been pushed through under the Obama administration, which had majorities in the lower and upper houses. It didn’t. Clearly Democrats didn’t view it as a priority at the time.

N.B. CM is not debating the rights and wrongs of the NRA’s activity or their positions. None-the-less the fact it has 5 million members shows that it has a following and is well organized. Were it a complete crackpot organization then people would be leaving it in droves. Seems like the opposite is occurring. That would probably be a factor for so many corporates signing up in the first place. FedEx hasn’t forgotten that. It is hard not to agree with the way it handled the debate – We dislike your views on guns but we observe the legal rights surrounding them. CM congratulates FedEx for its candor on the matter.

Did you put on your bulletproof vest sweetheart?

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Is this the next school uniform? As written yesterday, gun violence in US schools has been a problem for decades. Metal detectors have been installed at certain schools since the 1990s. Gun massacres have still occurred. The problem stems from a growing tide of broken homes and kids venting out. The Zero Hour documentary on the Columbine massacre reveals in chilling details how premeditated and well prepared (not to mention preventable) the attack was – propane bombs, pipe bombs, machine guns, pistols and even handgrenades. Perpetrator Eric Harris’s father called up the police on hearing of the shooting fearing his son maybe behind it. The police had received multiple enquiries from concerned parents over death threats Harris had made online to students yet chose to do nothing. Harris and Klebold openly documented their intent in videos and diaries. It is patently clear they wanted revenge for their subjective feelings of having had their esteem crushed by society, especially by more popular class mates. It is clear there were no role models trying to pull them back from the brink.

Still the ‘banning guns will solve it all’ solutions still avoid dealing with the real problem. The psychology of kids lost in a world where they feel outcasts. Feelings of rejection, loss and trodden on self esteem are shown to be time and time again to be a leading factor in kids picking up a weapon and seeking to right perceived wrongs. Many American high school kids drive to school. Can we envisage one deciding to drive a car on campus mowing down students at lunch time? Will banning cars be a solution?

What next? Will parents be decking out kids in bulletproof vests and hoping teachers who are incentived to arm themselves in the class room step up if all hell breaks loose? One wonders whether kids like Harris & Klebold would have been deterred by teachers packing heat. Even worse, SWAT snipers at a distance of 500 meters may not be able to determine at the time who are the ‘bad guys’. Even worse, how terrible it would be for a teacher to be tasked with ‘offing’ a student who he or she teaches in remedial maths class. One would hope the motivation of teachers is to want to educate students to get ahead rather than aim at their head. Or have things got so bad in some schools that such a remedy gets leant a sympathetic ear. Having armed security at schools is less and less a rare occurrence.

In 2015, about 3,000,000 teens ages 12 to 17 had had at least one major depressive episode over the year according to the Department of Health and Human Services. More than 2 million admitted they were experiencing depression in ways that impair daily function. The National Institute of Mental Health reported about 30% of girls and 20% of boys– some 6.3 million teens–have had an anxiety disorder.

A Seattle Children’s Hospital study tracked hashtags people use on Instagram to talk about self-harm. It noted a dramatic increase over the past two years. In 2014 researchers got 1.7 million search results for “#selfharmmm”. By 2015 that number had surged to over 2.4 million.

The American Psychological Association (APA) released a report several years ago during the school year saying that teens report their stress level is higher than levels reported by adults in the past month. Many teens admitted feeling overwhelmed (31%) and depressed or sad (30%) as a result of stress. More than one-third of teens report fatigue or feeling tired (36%).

Sales of antidepressant drugs is expected to be a $17bn industry in the US in 2020, up $3bn from 2015. The National Center of Health Statistics reports the prevalence of teenagers taking such drugs has grown to 13%, in 2015 up from 11% in 2008. 68% of people ages 12 and up said they had been taking their antidepressant for two years or more. A quarter who took antidepressants reported taking them for 10 years or more. Clinical depression affects about 16mn people in the U.S. and is estimated to cost the U.S. about $210 billion a year in productivity loss and health care.

Is this honestly seen as the best way to tackle a mental health crisis? Just dope up teenagers and hope they are comfortably numb so as to not want to do harm to themselves or others? It was shown that Harris had switched antidepressants which could have fueled not quelled his homicidal and suicidal tendencies. This isn’t about guns. It is about ignoring the elephant in the room – stressed out kids with no mentors or role models to coax them out of their problems.

In some respects, schools are only making it worse by pandering to safe spaces and enforcing trigger warnings. Instead of dealing with the psychological problems at source and proactively targeting attention starved kids growing up in broken homes by counselling them in ways to build self esteem and how to get on in the “real” world, the problem will only fester because irrational feelings of hopelessness will get reinforced by ignoring the real issue.

Tranquilizing people with mental issues by molly-coddling them is also the mantra in the world of identity politics. By muzzling people from speaking truths we only build barriers around effective solutions. That regulations around hurting people’s feelings are increasingly being enforced, is it any wonder we are growing a generation of victims who can pin the blame on irrelevant and unrelated things? Healing comes through listening and understanding by open and transparent dialogue. Not by banning it.

Will an hypothetical ban on guns prevent the growing trend of kids growing up in single-parent households (and all of the psychological data which shows clear evidence of a higher rate of delinquency in children) from committing  such terrible acts of violence because they have no access to firearms? Feelings of desperation will only lead them to find other ways of seeking their distorted view of attaining inner peace. More kids will die and at the end the exact same problems will manifest themselves again – what lead to the act? At least in this case, Parkland, Florida shooter Nikolas Cruz survived. Perhaps we will learn much more about the psychological timeline of him if the press can wake up for 5 minutes and stop trying to link the act purely to white supremacy because it fits a narrative.

#METOO – shame on #YOUTOO

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I really didn’t want to do this. Seriously. Not for the reason you think either. To all the women posting ‘Me Too’ and encouraging others to do the same ought to think very carefully about what they are doing. So much of what of what I’ve read so far is to be honest trivial. It doesn’t condone bad behaviour but life isn’t perfect.

When I was 13 I was raped by a total stranger. A man. I buried that trauma for over 25 years. I didn’t tell my parents, family or friends. Even today I’m tormented by the sheer horror of that night. I live with it every day. He is likely dead by now but it is etched in my memory. A stain that can’t be bleached. Which is probably why you might read me protest at the professional victimhood industry as I do via this blog. Maybe you understand a bit better as to why I am such a fighter of the truth.

In my year at high school there have been six suicides. People I knew in some case for 40 years. As tragic as it is we are sometimes are so tied up in our own lives that we fail to see warning signs of our friends. Of course in my darkest days the thought crossed my mind but I made a pact with myself that taking the easy way out was letting that bastard win. Not on my watch. In fact I think it is in part why I am so stubborn. I tend not to believe anything I read unless I study it first. I have a statistical database in my memory in the widest of fields – from gun ownership, illegal drugs price/purity coinciding with economic cycles to education levels and almost anything else you can think of. My mind is always spinning looking for data that challenges conventional group think.

In the previous post I wrote of the sexual assault of my daughter on a train in Tokyo. I think I was worse than she was. I was a mess. I wanted to take her place because the last thing I wanted was for her to experience any of the years of emotional troubles it might bring down the line.

I could consider myself a legitimate victim in every sense of the word and I haven’t written this post to receive sympathy or soothing words! Please understand that. On the contrary real victims are the ones who shout the least. They’re too busy dealing with it to bother seeking sympathy and cyber hugs. The fake victims are ones that scream about stuff that is more attention seeking than anything else.

The difference is I am not out here today to draw attention to my own situation. I’m here to say that unless you’ve truly been impacted by something heinous that has given you endless trauma don’t post willy-nilly #metoo post about some drunk jerk at a bar trying to pick you up.

I honestly had no intention of telling people about my past but this constant “poor me” attitude that pervades the world today must end. If one wants to raise awareness to any cause don’t dilute it with petty claims you probably haven’t thought about til given this opportunity. You discredit the real people battling with demons and actually make it far worse in helping them cope.

Men can be impacted by sexual harassment, abuse and assault. It is just underreported. So to the feminists using #metoo to attack (in many cases innocent) men with this campaign – shame on you.