The air feels different inside an ambulance bay at 3 a.m. The fluorescent lights cast a pallid glow across the concrete floor where paramedic Sasha Kroeker stands, hands wrapped around a coffee cup that stopped being warm an hour ago. She’s just finished a 14-hour shift—her third this week.
“Sometimes I feel like I’m drowning,” she tells me, her voice steady despite the weight of her words. “We’re trained to compartmentalize trauma, but eventually, those compartments get full.”
Across British Columbia, paramedics like Kroeker are reaching a breaking point. The mental health crisis among these frontline healthcare workers has been building silently for years, but the combined pressures of the pandemic, the toxic drug crisis, and chronic understaffing have pushed many to the edge.
According to data from the Ambulance Paramedics and Emergency Dispatchers of BC, calls for service have increased by nearly 30% since 2019, while staffing levels have risen by less than 10%. The resulting pressure has created what Troy Clifford, president of the union, calls “a perfect storm for psychological injury.”
“We’re seeing unprecedented rates of PTSD, depression, and burnout,” Clifford explains during our interview at the union’s Burnaby office. “About one in four of our members is currently on some form of mental health leave or accommodation.”
I’ve spent the past three months following paramedics across the Lower Mainland and Vancouver Island, witnessing firsthand how these essential workers navigate a system that often leaves them without adequate support. Their stories reveal a troubling pattern: repeated trauma exposure, difficult working conditions, and insufficient mental health resources.
On a rainy Tuesday in Victoria, I join veteran paramedic Martin Chen for what he calls a “typical shift.” Within the first hour, we respond to an overdose, a cardiac arrest, and an elderly patient who has fallen in her home. Chen handles each call with remarkable calm, but later, as we wait for hospital staff to take our patient, he reveals the toll of this daily routine.
“Every shift, we see people on the worst day of their lives,” Chen says, watching rain streak down the ambulance window. “And we’re expected to absorb that, process it, and be ready for the next call minutes later.”
BC Emergency Health Services has implemented several mental health initiatives in recent years, including a peer support program and access to specialized trauma counseling. But many paramedics report barriers to accessing these services, from long wait times to concerns about career implications.
Dr. Shannon Wagner, a professor at the University of Northern British Columbia who studies occupational stress injuries among first responders, explains that the culture within emergency services can sometimes work against mental health support.
“There’s still this perception that acknowledging psychological distress is somehow admitting weakness,” Wagner says. “Combined with legitimate concerns about confidentiality and career advancement, this creates significant barriers to care.”
According to research published in the Canadian Journal of Emergency Medicine, nearly 50% of paramedics will experience symptoms of post-traumatic stress during their careers—nearly double the rate of the general population. Even more concerning, first responders are at higher risk for suicide, with rates approximately 30% higher than other occupational groups, according to a 2019 study from the Centre for Suicide Prevention.
In Nanaimo, I meet with Sarah Longhurst, who left her paramedic career after 12 years due to PTSD. Now an advocate for first responder mental health, she describes the gradual erosion of her resilience.
“It wasn’t one big traumatic call that broke me—it was the cumulative effect,” Longhurst explains as we walk along Departure Bay. “The nightmares, the hypervigilance, the emotional numbness. Eventually, I didn’t recognize myself anymore.”
Longhurst believes the system fails paramedics by focusing on crisis intervention rather than prevention. “We teach paramedics how to save others, but not how to save themselves,” she says.
The provincial government has acknowledged these concerns. In March, Health Minister Adrian Dix announced an additional $2.5 million for first responder mental health programs. The funding will expand peer support networks and create more specialized counseling options tailored to emergency services personnel.
However, Clifford and other union representatives argue that while additional mental health resources are welcome, they don’t address the underlying issues of staffing shortages and increasing call volumes that create unsustainable working conditions.
“We need systemic change,” Clifford insists. “Better staffing levels, manageable shifts, and time between traumatic calls for proper processing.”
Back in Vancouver, paramedic Kroeker is preparing for another overnight shift. She’s been seeing a counselor for the past six months—a step she initially resisted but now credits with helping her continue in a profession she loves despite its challenges.
“I became a paramedic because I wanted to help people on their worst days,” she says, checking her equipment with practiced efficiency. “But I never considered what absorbing all those worst days would do to me over time.”
As British Columbia continues to face healthcare challenges on multiple fronts, the wellbeing of those who respond first deserves greater attention—not just for their sake, but for all who depend on them in moments of crisis.
For paramedics like Kroeker, Chen, and thousands of others across the province, the hope is that acknowledging their mental health struggles might finally prompt the systemic changes needed to make their essential work sustainable.
“We’re trained to run toward danger when everyone else runs away,” Kroeker reflects as she heads toward her ambulance. “But sometimes the biggest danger we face isn’t what we find when we arrive at a call—it’s what we carry with us long after.”
