Hiring with questionable history

[fireflymedic]

I know of someone (not myself by any means, so please do not take this questioning as such) that is currently looking to get into the EMS profession however, they have a history of mental illness marked by 2 suicide attempts over 5 years ago. One attempt resulted in emergency detainment and a brief stay in a psych hospital. The person has completed their basic EMT and did well, and also has completed significant amount of counseling following the situation which resulted in the mental disability.

My questioning is I would be questionable hiring someone with a known history of this, but yet I feel it unfair to judge them on the past as I feel many people make mistakes or have things beyond their control happen and are able to overcome them as may be the case here. Then again it may not be. Would one be wrong in not hiring the individual and if so, how would you appropriately decline employment without requiring a psych exam prior to employment? Would you personally hire the person? If so, why or why not?

I'm looking for ideas here as I know suicide and depression have been discussed in a round about way on here, but never a direct answer of whether you would hire someone with a psychiatric history or not.

Thanks for the response. Stay safe and well.

[FireMedic65]

Personally, I don't believe this person would be any more endanger to themselves or anyone else if they are employed on an ambulance or not. I know they require a psych eval to become a law enforcement officer, but I haven't heard of requiring them for EMS personnel. It would be unfair to the person if you required them to have a psych eval prior to employment and not anyone else.

I am not familiar with the law on these sorts of things, but as a personal opinion, I would not have an issue with working with a person with that sort of history. They weren't convicted of a crime or anything like that.

[AnthonyM83]

I would consider time since the incident. Best predictor of a person's action is history of previous actions. You want a history of stability, since it was at one point questioned.

Was there a precipitating event to their psych emergency? Maybe something that's mostly over and done with? If so, that might make it not as "big a deal" (someone having an episode after a family death versus just out of the blue). I've also never heard of someone harming a patient because they were once depressed, though if they're not thinking clearly on the job, it could be an issue.

Tough predicament there. But I'd just go with prior history (last few years) as my main indicator. But see what others say.

[WolfmanHarris]

This is both a practical and a personal question.

Practically speaking I'd wonder how an employer would gain access to this information short of the potential employee volunteering it. Is their history one that for whatever reason could be found publicly? (such as a criminal record) If not then the employer has no reason to know about it and this is not an issue of hiring but of the individual and their ability to do the job. Of course if the employer's health insurance requires a physical and full health records, the insurance could be tricky. To be honest I'm not sure how hiring works in the states and health insurance is not a consideration in hiring here.

On a personal level this person needs to be very introspective and realistic about their history and their own ability to cope with stress in life. Simply put, no job is worth potentially permanent mental illness. This person should seek the advice of their Counsellor, Psychiatrist, Psychologist, whoever their seeing before entering a job that may aggravate their past condition. This professional will have a far better handle on their history and their ability to cope and should be able to help them make an informed decision about their future employment.

As far as my or anyone else working with this person, we come back to the question of why would anyone know?

[Richard B the EMT]

I'm "Grandfathered" in to the FDNY EMS, from the NYC Health and Hospitals Corporation run EMS. I do know, however, that for both EMS and fire fighting, they do some kind of Psych eval as a part of pre-employment.

[tskstorm]

I'm "Grandfathered" in to the FDNY EMS, from the NYC Health and Hospitals Corporation run EMS. I do know, however, that for both EMS and fire fighting, they do some kind of Psych eval as a part of pre-employment.

There is a Psych evaluation as part of pre-employment, however out of the many people I know who have taken part of it, say it was complete nonsense, and mostly geared towards why they wanted the job, why they wanted to be in EMS, and about how they deal with Stress.

I myself might have to be looking forward to this with all these hospital closures!

[crotchitymedic1986]

i agree with anthony --- if psych issues were years ago, and they have a steady work history since then, i wouldnt worry about it (unless they are on a psych-med that does not allow the operation of a motor vehicle). If psych issues were last year, not so fast. Most employers do have some sort of psych or personality test they administer these days.

[FormerEMSLT297]

It would concern my to work with such a person, or supervise, one..

They get depressed while transporting a patient and decide to drive the ambulance off a cliff, intoa tree, whatever....

I would not want that person driving my unit ..... but as someone said with privacy laws, how would they find out ? ?

[WolfmanHarris]

It would concern my to work with such a person, or supervise, one..

They get depressed while transporting a patient and decide to drive the ambulance off a cliff, intoa tree, whatever....

I would not want that person driving my unit ..... but as someone said with privacy laws, how would they find out ? ?

I'd be more concerned that you'd be making judgments on their psychological state with an obvious lack of understanding for the spectrum of depression symptoms, the multiple manifestations of clinical depression, treatment options and prognosis. The stigma of mental health is bad enough without people that are health care professionals perpetuating the same misconceptions held by the general public that encourage those with mental health issues to not disclose their problems or openly seek help. This only supports my initial belief that only a mental health professional should be making recommendations on whether this person should be hired or not based on their mental health history and that this information, like any other medical history should not be in the hands of supervisory staff who are not qualified to evaluate these individuals. There are obvious and rational concerns here, but the average EMS manager is not qualified to evaluate them.

[fireflymedic]

Doc - point well taken. My concern would not be so much with the individual, it would be more the length of time since the incident and stability since then. I do believe past performance is a good indicator of future, however, I'll be the first to state there are many factors involved. If the incidents were a direct or indirect result of the job or an incident, I would definitely want a verification that the person was adequately treated and as with any physical problem I would request a return to work statement. If cleared by their treating physician, then yes, I would have no problem employing them (provided it was not immediately following the incident). If the person is actively already on the department, I don't propose firing them, but moving them into a different role within the department as you would a physical issue and discuss with med director and their treating doc time of appropriate return. All parts working together for sure ! I think if this attitude were taken with more employers there would be a bigger push for employees to take care of themselves without reprimand.

As far as the HIPPA thing, I know that is frequently violated. I've had people come to me multiple times saying did you know this or that or I picked up so and so the other day what are you going to do about it? If it is something of concern, I'll address it with the individual privately and find out the situation, but most of the time, I'll just tell people move on and mind their own business.

It's all about respect to ALL patients people. Thanks for the good insight.