'Patient dying in my ambulance triggered PTSD'

For paramedic Ollie Springett, seeing a patient die in the back of his ambulance of respiratory issues was too much.

It was the run-up to Christmas last year, and Ollie was on shift with the London Ambulance Service during the darkest days of the Covid pandemic.

The pressure of working on the NHS frontline led to him developing post-traumatic stress disorder (PTSD). He is far from alone, NHS staff have been seeking help in record numbers.

PTSD is a mental health condition which can develop immediately after someone experiences a disturbing event, or can occur weeks, months or even years later.

Speaking to BBC Radio 5 Live about that moment, Ollie said he felt "out of control" and like he "wasn't any good" at his job.

"I had a job where a gentleman died in the back of the ambulance and I felt like I'd missed it. I hadn't - it had just been a few moments - but in my mind I felt like I wasn't good at my job," he said.

"I felt like there were a few months of build-up to that one experience in the back of the ambulance.

"During the pandemic, especially at the start, it felt quite scary - protocols were being changed very quickly from day to day with new working styles we had to implement each day.

"You're walking into people's houses you didn't feel very safe in. We in the ambulance service are used to walking into random people's houses, but to walk in with this potentially life-threatening virus, it just hit home that it was scary."

Following the incident Ollie, who has worked as a paramedic for five years, did not feel safe to be on an ambulance, so rang up his team leaders to tell them he was unable to work.

"I felt super-guilty going off the road," he said. "I felt super-guilty for my colleagues and patients, knowing we were in a time when we were thin on the ground anyway, from people catching Covid and patients in mass numbers becoming unwell.

"There was a sense of 'let's continue and keep going' but I know that for the ambulance service, if your mind's not right and you're in a situation where you don't feel you can give 100% to your patients, it's dangerous. So the best decision for me was to go away from the ambulance service for a bit and try to work on myself and get better."

Ollie said the first few months after his trigger incident were the darkest days he has ever experienced.

PTSD is short for post-traumatic stress disorder, and it is an anxiety disorder caused by stressful or frightening events.

PTSD can develop immediately after someone experiences a disturbing event or it can occur weeks, months or even years later.

People who have PTSD can develop symptoms such as having nightmares or difficulty sleeping, flashbacks of the traumatic event or experiencing other anxious thoughts.

"I felt absolutely low to the floor, to the extent where I didn't really see any ending in sight of a positive note," he said.

"It was a very, very deep depression, very anxious about everything. It was genuinely quite terrifying at times for myself and for my girlfriend, my friends and family - it was a worrying time for everybody."

'Opening up extremely difficult'

The London Ambulance Service said at the peak of the pandemic it was receiving more than 8,000 calls a day, with June, July and August 2020 being three of the top five busiest months on record for them, in terms of 999 calls taken.

Ollie was referred to Shape Recovery, a new mental health treatment led by Oxford University being rolled out across hospitals in the south of England, to provide frontline healthcare workers with one-on-one support and access to PTSD or depression treatment.

"That initial trying to open up was extremely difficult," he said. "You have to admit to yourself something is wrong, which I don't think we're good at as human beings.

"I never really thought I would ever be diagnosed with PTSD. I never really understood it.

"It was quite scary when it was happening to me, I didn't feel I could help myself and looking back on it, I potentially haven't helped people [with PTSD] in the past as much as perhaps I could have done - and that was a bit worrying to me."

He embarked on a 10-week cognitive behavioural therapy (CBT) programme to work on "how my mind works, what happened, how I feel about it and how I'm going to be moving on from that".

"Part of the CBT was to go back to the start of that day and think about what did I do? How did I wake up - was I in a good mood, was I in a bad mood? Was I being negative before this job [where the patient died]? Was I being negative after the job?"

Dr Jennifer Wild, who runs the Shape Recovery programme, said: "We have a recovery rate of about 90%. Staff who come into the programme with post-traumatic stress or depression, or often both of those difficulties, are recovering with six weeks of our wellbeing coaching.

"They're learning very active evidence-based tools to help break the link between triggers and past trauma, and tools that we have developed that are very effective for improving mood, so helping people recover from low mood and depression.

"We've also been able to demonstrate we can move somebody's trajectory - so if somebody has sub-threshold symptoms, so they don't have a full-blown diagnosis, by learning these tools it also helps to prevent the future development of post-traumatic stress or depression."

Ollie is now back at work and said the therapy has given him tools to better cope with potentially triggering scenarios.

"If my brain starts to go, I need to put into place the plan to move away from those bad thoughts," he said.

"When I had a trigger and I recognised I was dwelling on that trigger, I would start to think about golf - they talk about going to your happy place, and for me that worked and I could move away from those negative feelings that I had and start to think about something that's more pleasurable."

If you have been affected by any of the issues raised in this article, you can find help and support on the BBC Action line website.