The jobs that can wreck you
THE day Peter Kirwan sat his children down and admitted he wasn't doing a good job as a parent was the hardest of his life.
The Sydney firefighter's decline was a slow one, which he traces back to the day he was injured in a fire truck collision and damaged his back, leaving him suffering from chronic pain.
"Here I was, a 36-year-old male firefighter who suddenly had his whole future turned upside down. It wasn't the way I had intended my future to be.
"The back injury put me on permanent light duty. I was no longer on the fire trucks, I was working in the rescue training team at the time and I was told I was never going back on the fire truck.
"If I had to cough, I would have to brace myself because I didn't have the strength to cough and it would literally bring me to my knees."
Peter descended into a vortex of depression and anxiety, behaving in a way that now makes him ashamed. "I would isolate myself from my family, I would be short tempered, aggressive, I wasn't violent but I was certainly aggressive. I didn't like being interrupted and, I mean, I could have just been watching television.
"I wasn't sleeping, I would lay in bed at night worrying about what had happened that day, or the day before and then I'd be worrying about what was going to happen the next day. I would replay events over in my mind from that day, or the next day, I'd be trying to pre-empt what was going to happen and I'd be trying to work out a response to something that may not have even happened."
Five years after his injury, Peter's problems exploded in what he now knows was a severe panic attack at work.
"It was like that fight-or-flight thing where your body's preparing to deal with it so your heart rates up and your adrenaline's up, it's that hypersensitivity," he said.
His boss told him to go home, but he was struggling to drive, so he pulled over for a conversation with a friend. By the time he reached home an hour later, he had a series of terrified voicemails from the manager.
"They started out quite calm, just sort of checking that I was OK," he said. "By the end of it there was this fear in her voice that I'd never heard in anyone before and she thought I'd done something stupid."
That was a wake-up call for Peter, and he began getting help. He realised his injury had shaken his whole sense of identity. He had bought into the stereotype of what a firefighter should be: strong, reliable, a protector - not someone who needed protection themselves.
In fact, Peter's experience is remarkably common, and is part of our sister paper news.com.au's series this week on Australia's deadly workplace stress crisis, which is costing our economy a fortune. There are specific risk factors for suffering from work-related mental health issues. One is chronic injury. Another is lacking control over what you do. Another is working in the emergency services. Another is fitting the image of the hardworking, stoic male.
While no one is immune from mental health issues, emergency workers such as firefighters and paramedics have an elevated risk. Other roles in the medical industry - doctors, nurses, dentists and vets - also rank higher than most jobs for suicide, thanks to daily contact with death and trauma, the access to means to suicide, high demand and low control - as well as gender issues.
High-pressure professions with extreme stress and long hours such as lawyers and bankers are high risk, and at the other end of the scale, so are low-skilled jobs, in which workers have little job control and high job insecurity.
Jim* had worked in child protection for 14 years when he started to be seriously affected by his job. He was struggling with the daily trauma of the job, having been moved off serious home visits but then put back on to them because of a lack of staff.
A change of government in NSW had left his organisation trying "to do more with less", he told news.com.au, with out-of-home care outsourced to NGOs. "The whole pride in what we were doing was taken away from us," he said.
One day in mid-2013, he spoke abruptly to a female colleague on their way to see a difficult client, and she complained about him. The 63-year-old was uncharacteristically upset, and found himself crying at home that night.
"This sounds terribly minor, it was just the last straw I suppose, and that ended up with me with a couple of days off work I couldn't explain, because normally it was water off a duck's back." he said. "I felt I'd lost the trust of my colleagues, and it was only one, but if one person you really trust can turn on you like that, then who can you trust?
"You see horrific injuries and you know people attempting suicide while you're there, these things, I was able to handle that I thought tremendously well."
Almost without him realising, Jim had become vulnerable to the darker side of his job. "I'd cry at the drop of a hat, I was getting afraid to go outside," he said. "That's when the cracks appeared."
The difficult client had been making "realistic threats" against Jim and his children, telling him they would kill him and track down his family on social media. That wasn't totally unusual in his job, but even after a manager listened in on some abusive calls, his request for a space in the car park under the building was refused.
He began compulsively checking his rear view mirror and trying to drive different ways to work. On Mondays, he would dry retch before work. He thought he must be physically sick.
Then one morning, when giving a report for a manager on a young girl who was being verbally abused by the grandparents caring for, he fell apart. "I just cracked up, I burst into tears and I told her how scared I was that this kid could even have suicided over the weekend and I was really very worried and I just fell to bits.
"I couldn't even drive myself home, she got someone to drive me home and from that moment on, I just never got back, I only ever once went back into the office and that was one of the most horrible experiences.
"I couldn't even drive past a block away from the building, I can't explain this, I was just, I was shaking, I was crying all the time. I just shut myself inside, I was suicidal.
"I never actually made a serious attempt but I was making plans, I wasn't me."
Jim began seeing psychologists and psychiatrists and was diagnosed with PTSD. After less than a year, his insurance company dropped him, so he's turned to Shine Lawyers to try to reinstate his payments.
"I've accepted I won't be going back to working in the public service, certainly I'm not going to be going back to an office environment," he said. "I'm hopeful from what the solicitor said that the part payments from what I was receiving in the first 12 months will be reinstated.
"I have very modest means and I've got a little bit of superannuation. If it means early retirement then it'll be a very modest one, but that's all it'll be, and perhaps a bit of selling produce out of my garden - a very modest income but that's the best that I can hope for, and that doesn't sound too bad to me."
Shine Lawyers' General Manager James Chrara said: "Unfortunately, Jim's situation is not rare and we are hearing from a growing number of both women and men who are inadequately supported in the workplace when it comes to their mental health.
"People in high-risk jobs, who are exposed to tragedies on a daily basis need training and resources readily available to them to assist them in processing and recovering from the trauma they regularly deal with. There should be systematic mental health checks on staff exposed to tragedies and mental-health breaks should be scheduled and encouraged to ensure all staff perform at optimum standard and aren't afraid to ask for help when they need it."
Allison Milner, a UNSW epidemiologist researching workplace suicide, told news.com.au: "The overall quality of the job, so how many adversities you experience in your job, is what really makes the difference. So if you're experiencing long working hours, job security, low job control … it's a combination of all these things that can contribute to somebody's death.
"We can't necessarily do too much about the fact somebody might become acclimatised or become used to the idea of death and we can't change their cognition about that, but we can think about the context of the work we're putting people into, that goes for all occupations."
Share your story of workplace stress, mental health or suicide with firstname.lastname@example.org or leave a comment below.
If you or someone you know needs help, contact:
Beyondblue(1300 22 4636) for 24-hour phone support, online chat, resources and apps.
Mindout for mental health and suicide support for lesbian, gay, bisexual, transgender and intersex (LGBTI) people.
Kids Helpline1800 55 1800 - free confidential 24-hour counselling for young people aged 5 to 18.