AMU Emergency Management Original Public Safety

EMS Workers Need Pre-Employment Mental Health Checks

By Allison G. S. Knox
Contributor, EDM Digest

Homeland security is a particularly important federal concern that filters down to the state and local levels of government.

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Federal homeland security positions require employees to undergo background checks to ensure that those in these positions are of sound mind and are capable of doing the work.  The American people accept these intrusive personal checks because our safety is at stake.

Surprisingly, however, there are no requirements at the local level that all public safety professionals undergo mental health background checks before they are hired.

Considering the surge in mental health and post-traumatic stress issues among emergency medical services professionals, don’t you agree that we need more mental health background checks for EMS workers before they are hired?

Background Checks for Police Officers

Most public safety workers go through a background check, which is critical for the safety of their community. Police officers are required to have a mental health check, a requirement that makes sense considering they often work with firearms.  Most civilians too are required to undergo a background check to legally purchase a firearm.

EMS professionals work with medications that can greatly aid in lifesaving efforts, but can have disastrous effects if used incorrectly or illegally.  Currently, local jurisdictions focus background checks for potential EMS employees on any criminal history, but not on their mental health. How do we know that patients being transported in an ambulance are safe if the EMS attendants have not undergone a mental health check? Surely it is in the best interests of patients to make sure that those who will be helping them during an emergency are in a good mental state.

EMS Mental Health Care Needs a Baseline

It is particularly important to keep people safe during a 911 call. But those working the call need to be cared for too. There have been lots of discussions about PTSD as well as a big policy push to ensure that EMS professionals have the mental health care they need to manage potential onset of post-traumatic stress.  Several states have worked to include PTSD in workers compensation claims to aid EMS professionals who suffer from post-traumatic stress.

It is in the best interests of local jurisdictions to conduct mental health screenings of potential EMS employees, just as they receive physical exams before being hiring. It is also important to establish a baseline to help EMS employees cope with their high-stress environment.

We need to greatly expand mental health services in the United States for paid and volunteer EMS employees.  The process should begin when new workers join the service. That way the hiring department can create a baseline to help EMS workers cope with their high-stress environment.


Allison G. S. Knox teaches in the fire science and emergency management departments at American Military University and American Public University. Focusing on emergency management and emergency medical services policy, she often writes and advocates about these issues. Allison serves as an Intermittent Emergency Management Specialist with the Department of Health and Human Services, as At-Large Director of the National Association of Emergency Medical Technicians and as Chancellor of the Southeast Region on the Board of Trustees with Pi Gamma Mu International Honor Society in Social Sciences. She is also chair of Pi Gamma Mu’s Leadership Development Program. Prior to teaching, Allison worked for a member of Congress in Washington, D.C. and in a Level One trauma center emergency department. She is an emergency medical technician and holds multiple graduate degrees.

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