Thank you very much, Mr. Chair.

Thank you to the committee for this invitation. It is very important, and I am grateful for the opportunity to speak on this issue.

I am an advanced care paramedic with the Region of Peel. I'm also a clinician-scientist, having finished a Ph.D. a little over a year ago. I'm a faculty member in the department of family and community medicine at the University of Toronto. After working clinically as a paramedic for nearly 18 years, I've transitioned primarily into a role now that focuses on applied health research on health and well-being issues that are affecting my colleagues in the paramedic services.

I would say to you that paramedics provide vital care to Canadians. We are an important part of our country's health care and public safety infrastructure. My colleagues provide care from the moment of birth right through to the moment of death. Canadians are coming to rely more and more on paramedics in Canada as we fill gaps in primary health and social care.

However, despite the importance of the services that we provide, in the years leading up to the COVID-19 pandemic, paramedics have been found to have some of the highest rates of work-related mental illness among public safety personnel in Canada. This includes post-traumatic stress disorder, depression, anxiety, disturbed sleep, chronic pain, and alarmingly high rates of suicidality.

We know from research that situations that involve threats to physical safety, such as violence, increase the risk of adverse mental health outcomes, including post-traumatic stress disorder. In the wake of the COVID-19 pandemic, we are seeing that reports of violent attacks on health care professionals and public safety personnel, including paramedics, are growing at an alarming rate.

Unfortunately, most of the incidents are never formally reported or tracked. This means that only the most serious incidents tend to capture attention, and the vast majority go unreported. This makes the true scope of the problem hard to measure and hard to grasp.

My colleagues in Peel Region have been researching this topic extensively. In an earlier study of our personnel in Peel Region, one in four of our active-duty paramedics was found to have significant symptoms of either post-traumatic stress disorder, major depressive disorder, or generalized anxiety disorder as recently as February 2020 when we stopped collecting data just before the pandemic.

In a series of studies that we have done internally in Peel Region, we found that despite a majority of our personnel experiencing some form of violence, less than 40% formally reported or documented the incidents to their supervisors.

In partnership with community and industry experts, we've developed a novel reporting process to track this problem. Whenever our paramedics complete their paperwork after being dispatched from a 911 call, they are prompted to complete a new violence report if they experience violence during the interaction. Over a two-year study period, we found that nearly 50% of our active-duty paramedics filed a violence report. Forty per cent of those reports documented a physical or a sexual assault. Twenty-five per cent of the reports that we saw documented some form of verbal abuse on either gender, sexual orientation, race, or ethnicity, and those incidents were associated with an increased risk of emotional and psychological distress. Eighty-one of our paramedics were physically harmed during this two-year period, and that corresponds to 10% of our active-duty workforce.

Expressed as rates, these findings suggest that one of our paramedics was experiencing violence every 18 hours, was physically or sexually assaulted every 46 hours, and was physically harmed as a result of a violent attack every nine days.

In closing, I would suggest that this degree of violence creates the potential for significant physical and psychological harm, and as Canadians come to rely on paramedic care more and more, this creates a significant vulnerability from our health human-resources perspective. In order for Canadians to be able to depend on paramedics to provide skilled, compassionate and high-quality care, paramedics must be protected from acts of violence.

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