07/03/2015 04:00 EDT | Updated 07/02/2016 05:59 EDT

Ombudsman investigating Toronto Paramedic Services for stress injury incidents

TORONTO - Unlike the spray of bullets in downtown Toronto on Boxing Day in 2005, the post-traumatic stress Rob Ichelson experienced as a first responder to the scene was slow and muted, unfolding insidiously over time.

Ichelson said he was one of the first Toronto paramedics to respond to the Yonge Street shooting that left 15-year-old Jane Creba dead and six others injured, and he was one of the last to leave the scene that day.

So when the flashbacks started, accompanied by anger, lost focus, sleepless nights and thoughts of suicide, Ichelson said he was diagnosed in hospital with PTSD. He reached out to his employer for help, but Toronto Paramedic Services gave none, Ichelson said.

"After the Boxing Day shooting, I was reaching out for help and there was nothing. To this day, I have never had a debrief or a discussion or anything with my ex-employer," he said. "I left because of the lack of support, unwillingness to accommodate."

Toronto Paramedic Services wouldn't comment on his case, but said employees have access to a number of resources, including an employee assistance program and a peer support team.

"Each employee concern is really important to us, and we have quite a few supports in place for our employees to access," spokeswoman Kim McKinnon said. "But there's always room for improvement."

This week the city's ombudsman announced an investigation into Toronto Paramedic Services and how it handles incidents of post-traumatic stress disorder and other operational stress injuries among employees. Fiona Crean said she has taken no position on the matter yet, but has already heard complaints from paramedics. She is inviting more to come forward and share their stories in confidence.

"PTSD still lives in the shadows," she said. "(The investigation) is really about looking at whether the employer gives adequate supports and services, whether the organization has good training and awareness about operational stress injuries."

Toronto Paramedic Services has been working co-operatively with the ombudsman's office, Crean said.

Ontario's Tema Conter Memorial Trust tracks suicide rates among Canadian first responders. Executive director Vince Savoia said 25 first responders across the country have died by suicide since Jan. 1, 10 of whom were paramedics. Three lived in Ontario.

Savoia said the Tema Conter Memorial Trust supports the ombudsman's efforts. Paramedics share unique experiences with the patients they try to save, he said, making it common for them to experience operational stress injuries such as PTSD and compassion fatigue syndrome.

"Sometimes the medic has to spend two, three, four hours with a patient before they're extricated. How can you not, over that timeframe, actually bond with the patient you're trying to help?" he said.

"That personal interaction, the amount of time paramedics spend with the patients, is far greater than police or fire will ever spend, usually."

Approximately 24 per cent of paramedics suffer from an operational stress injury, Savoia said.

Ichelson praised the ombudsman's investigation as a "wonderful first step" and said he's hopeful other Toronto paramedics will come forward and share their stories. While his PTSD is currently in remission, he said, many of the colleagues he has known suffer from the same disease and also have to battle the stigma tied to it.

"If we're going to get real change that looks after the well-being of paramedics, than you have to stand up. You have to tell your story. You have to be willing to seek out help," he said.

"It doesn't mean we're not strong. I'm not weaker than anyone else. I'm not less important or less valuable or less functional. But I have a disease. I have an illness that I got and contracted from work, and it needs to be managed like a disease."