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Illustration by Hunter French
Health

911 Dispatchers Hear the Worst Moments of Our Lives. Who Listens To Them?

Everyday, they grapple with traumatic experiences, punishing hours, and high rates of PTSD. No one seems to care—not even the people they call colleagues.
March 13, 2020, 2:16pm

Jamie Acosta still remembers the first call in which someone died. Over the phone, she learned that a 16-year-old had wrapped his car around a telephone pole. Afterward, she replayed it in her head, trying to figure out if she somehow could have gotten the ambulance to the scene faster.

She went home in tears, she said. This kid is dead, she told her boyfriend. And I don't know if I did everything right. I don’t know if I could have saved him.

For almost anyone, an experience like that would register as traumatizing—the kind of thing that keeps you awake and agonizing over what else you could have done to save the person's life. But for Acosta, it was something else, too: another day on the job.

Stories about the mental health struggles of people working new Silicon Valley jobs, like Facebook and YouTube moderators, have recently gained deserved attention. Largely forgotten are people like Acosta, who worked a job that has long existed with intrinsic problems and little effort to remedy them. As a 911 dispatcher in Illinois for 19 years, Acosta’s job was to sit and listen to the worst moments of people’s lives. The general public doesn’t always understand how difficult the job can be, but 911 telecommunicators have taken to calling themselves the “first first responders,” since they often serve as the very front line of life-saving communication.

Every day, 911 dispatchers sift through the most stressful of situations, obtaining vital information from people in distress, figuring out what kind of help they need, and mitigating the situation as much as possible, which sometimes includes giving potentially life-saving instructions to people who are panicked and scared. “We take a big pile of crap and we turn it into something workable,” one of them said.

At some agencies, there are two people involved with 911 calls: the call takers, who spend their long days listening to people pleading for help; and the dispatchers, who initiate life-saving care by sending the police, firefighters, and paramedics to the person in need. In other agencies, the two operator positions are blended, and one person does both.

“It’s their job to keep the caller calm, to get the information, give instructions for life-saving medical treatment. They’re just dealing with one after the other, one after the other,” said David Reiss, a psychiatrist and trauma expert who has treated dispatchers.

For many of them, the role takes its toll physically and mentally over time. “The calls where a mother or father is hysterical or their teenager has hung themselves or overdosed; the female you get on the line who's literally in the middle of being beaten or raped—all those screams and visualizations get trapped in our head” one of them said.

VICE spoke to seven 911 telecommunicators for this story, some of whom requested to change their names and locations because they are still employed as dispatchers. They described a working environment with long hours in which they are left disturbed in a lasting way by the things they hear—conversations they can’t help but replay in their heads. But internally, they are provided little in the way of support. The 911 telecommunicators VICE spoke to said they felt looked down upon by the police officers and firefighters who work alongside them. And in contrast to their higher-profile colleagues, they were given few internal resources to cope with their experiences on the job.

Much of the data collected about emergency service providers focuses on police and firefighters, but the mental-health statistics available about 911 telecommunicators are striking. In 2019, the state of Virginia surveyed its emergency services personnel and found that “Public Safety Communicators”—i.e. 911 call-takers and dispatchers—were more than twice as likely as the general population to experience suicidal thoughts, and also more likely to than police officers and firefighters. While around 8 percent of the general population grapples with PTSD, the number is far higher among emergency dispatcher personnel. Michelle Lilly, a psychologist who studies 911 telecommunicators, said her research suggests somewhere between 17 and 24 percent of them suffer from it.

“The calls where a mother or father is hysterical or their teenager has hung themselves or overdosed; the female you get on the line who's literally in the middle of being beaten or raped—all those screams and visualizations get trapped in our head.”

In the mid-2000s, Troy, a 41-year-old 911 dispatcher in Michigan, picked up a call that would stick with him. You’ll find my body in a red Honda parked outside, the man on the other end of the line said. The man had given his address, and Troy was hard at work trying to persuade him not to kill himself. After a few minutes, Troy heard the sound of a gunshot over the phone. Authorities would later determine the caller had shot himself in the head.

Troy wasn’t offered counseling after the shooting he heard over the phone. Nor was Candace, a 40-year-old dispatcher in Ohio, after one of her worst days on the job. She received a whispered call from a woman who was hiding in her closet. Two people had broken into her house and she’d fled to the closet in fear. The police were driving down the woman’s street when the burglars found her. “She screamed so loud you couldn’t hear the sirens right outside. Then they shot her point blank in the head, Candace said. She still recalls her 45-minute drive home that night: “I remember just sitting on the interstate beating my hands on the steering wheel.”

When police officers, firefighters, and paramedics answer a call that’s especially traumatic, they meet as a group with a facilitator to talk about it in what is known as a “critical incident debriefing.” The debriefings serve an important purpose, according to Reiss. “They aren't perfect, but at least you’re being recognized as having experienced something significant,” Reiss said. “The dispatchers often don't get that now.” Neither Candace or Troy were included in critical incident debriefings following their traumatic events. Only once in his 22 years on the job has Troy been invited to a critical incident debriefing, and he was the only 911 telecommunicator VICE spoke with who had attended one at all.

Despite their critical role in traumatic emergency processes, dispatchers often feel dismissed and disrespected at work. Candace said a deputy once told her that all she does is “sit here and watch TV and answer the phone.’” Other dispatchers who VICE spoke with say they’re routinely called lazy, dumb, and asked to perform tasks like call cabs for police officers who’ve just finished a shift.

While police officers and firefighters receive accolades, dispatchers are rarely even privately lauded when they save a life. “No one is even telling you, ‘Good job,’” Acosta said. Her own commander used to call her a “glorified secretary”—a particularly insulting characterization in the wake of traumatic experiences. Acosta was once in the police precinct taking calls while a detective was questioning a murder suspect. The detective and the suspect had an altercation, and the suspect grabbed the detective’s gun. Another detective called Acosta for help, but before she could respond “the suspect shot Wally [the detective] execution-style—ten feet from where I was sitting.” After the incident, it was difficult for Acosta to get anyone to recognize that she had experienced a traumatic event just like the police officers. Acosta said she had to “fight for any kind of time off.”

Ultimately, she and the other dispatcher on duty were given three days off. When she came back, the administration told her that she couldn’t have been psychologically affected because she came back to work. Acosta was outraged. “I came back to work because I have bills to pay!” she remembers saying. Acosta said the police officers, in particular, didn’t understand why she was so affected by the incident. “They say we can’t have trauma because we’re just secretaries and answer the phone and that’s it.”

Paul, a 48-year-old dispatcher in Maryland, said that’s a widespread perception among people who work with call takers and dispatchers. “They say we work in a controlled environment. And yes, the building we work in is supposed to be secure,” Paul said. “But we have no control over the next call that comes in.”

“They say we can’t have trauma because we’re just secretaries and answer the phone and that’s it."

The notion that not being physically present immunizes someone against trauma represents a fundamental misunderstanding of how PTSD works, according to Lilly. Lilly believes the calls meet the criteria for what they call “direct trauma exposure” in clinical psychology. “Simply because you’re not seeing the traumatic incident doesn’t mean you’re not exposed firsthand to distress and trauma,” she said.

Reiss agrees, and says what the dispatchers sometimes imagine is even “worse than what’s actually happening.” Unlike the first responders on the scene who can assess the situation more completely, dispatchers are often left wondering if they could have done something differently. “With 911 telecommunicators, there’s so much they don’t know because they’re not physically there,” Lilly says. “Self-blame is fuel on the PTSD fire.”

For a long time after she heard of the kid who crashed his car, Acosta struggled with the guilt. Looking back now, she understands that there’s nothing she could have done. But, she added, “you still question yourself all day long.”

Troy, who was diagnosed with depression as a teenager, believes he also has PTSD, though he’s never gotten a formal diagnosis. “I don’t know what the point of a diagnosis would be,” he said. “I don’t know how that would work with the job.”

The Family and Medical Leave Act requires employers to offer “reasonable accommodations” after a diagnosis like PTSD. But Troy said he’s not going to quit his job and doesn’t see the point in getting tested, since the nature of dispatching can make fulfilling the “reasonable accommodations” requirement feel impossible. “The job just doesn’t lend itself to PTSD,” Troy said. “We’re so short-staffed, it wouldn’t be reasonable for me to take a month off of work. It wouldn’t be reasonable to say, ‘This person has PTSD so they’re going to get a shorter shift’ and make everyone else work overtime.”

Troy and his peers aren’t federally classified as first responders; they’re designated as clerical workers—the same classification as bookkeepers and office managers. Though it might seem like a trivial formality, the label limits the benefits 911 dispatchers receive and is illustrative of the way the challenges of the job are often overlooked (first responders, for example, are eligible for retirement earlier than administrative workers).

None of the dispatchers VICE spoke with said they’d been offered any kind of mental health support. Diminishing the challenges and psychological ramifications of their job isn’t just hurtful because it’s inaccurate and exclusionary, it actually makes call takers and dispatchers less likely to seek help. “If they are struggling but they’re being told, ‘Oh, you’re just a secretary, that shouldn’t be bothering you,’ they’re going to think ‘Why am I being affected by this if I’m not on scene?’” Lilly said. Indeed, dispatchers are often reluctant to talk about the issues they face. Paul said he “just tried to deal with things on my own.” “There’s this whole thing about being fit for duty,” Candace said. “You can’t tell someone you’re depressed. You can’t tell somebody that you’re feeling suicidal. You can’t tell anybody at work you’re feeling these things because of the stigma.”

In lieu of actual services, call center administration sometimes offers vague encouragement to engage in self-care. But even that often feels diametrically opposed to the nature of the job that can last up to 16 hours a day if there’s a double shift involved. “They tell you to eat right and exercise and get plenty of sleep, and in the next breath they’re like ‘I’m going to need you to work 12 hours today, you’ll be off for eight hours, and then you need to work for another 12 hours,’” Troy said. He said he accrued about 600 hours of overtime last year—two-thirds of which was forced overtime. In their field, Troy explained, forced overtime is when “they tell you to come in and if you don’t want to, that’s fine, but don’t bother showing up to this job again.”

Acosta and others said the long hours can take just as much of a toll on dispatchers’ mental health as the calls. “You go to work at 7 in the morning and you don't know if you're going to get off at 3 or at 11. You get to the point where you don't even remember your first name because it gets so crazy,” Acosta said.

The long shifts make it hard to muster much energy for taking care of yourself with the little time you have at home. Or as Candace put it: “After a long day of taking care of everyone else’s shit, you just don’t have the bandwidth to take care of your own.”

Candace found a different way to deal with the stress of the job. “When you take calls, there’s a ton of adrenaline,” she said. “In some weird way, it’s kind of like a high.” Candace says she bought a sports car and would “drive way, way too fast” to try to replicate the adrenaline rush. “I wasn’t taking care of myself,” she said. “I wasn’t dealing with anything, and that’s when I realized I just can’t do this anymore.” Candace sought therapy and is taking classes in hopes of transitioning out of her dispatch job.

Troy believes the long, sedentary hours contribute to the internal belief that 911 telecommunicators are lazy. “The vast majority of dispatchers are overweight because we don’t move. We don’t get breaks; we eat at the console—healthy options you can eat while typing are pretty limited. Plus, stress eating is a very real thing,” he said. “Then an officer will come in and say ‘All you do is sit around and talk on the phone. Why are you so tired?’’

When PTSD goes untreated, it can lead to “avoidance coping behaviors” like binge drinking, avoiding social situations, and disordered eating, according to Lilly. About 83 percent of dispatchers are overweight or obese, according to one study she conducted. “Getting fat and alcoholic is pretty common,” Troy said.

“I know people who've been dispatching for 27 years and I don’t know how they do it. I think they're crazy. I just want to ask, ‘Why? Why are you doing this? Do you hate yourself that much?’”

The days aren’t always filled with traumatic calls. But even mundane calls aren’t exactly a welcome respite, since there’s always the chance that they’re preventing a call about a real emergency from getting through. Troy explains the bizarre juxtaposition of calls he’s gotten: “‘My child won't eat his broccoli. I need a police officer to come up and talk to him.’ But then the next call will be ‘the prisoner I was guarding at this hospital just stole my gun and now he’s running around the hospital with it.’” Because dispatchers never know which kind of call it’s going to be, they’re often stuck in a heightened fight-or-flight state—ready to react to the next life-and-death situation.

Several 911 telecommunicators who spoke to VICE said they avoid social situations because people who don’t really understand their job will ask them about “all the gory details.” “I’m just like, ‘do you really want to hear about this?’” said Candace. “‘Do you really want me to tell you about the couple that was in a motorcycle accident and the boyfriend died? And how I had to shut down the highway because the girlfriend was so inconsolable?’”

It can be easier for dispatchers to simply avoid situations where people might ask about their job. Acosta said that before the detective was killed, she and her cousin frequently talked on the phone. But “not long ago, [my cousin] told me, ‘After Wally [the detective] was killed, you stopped wanting to talk to me on the phone, and you withdrew from events.’ It’s probably true,” she admitted. “I don’t trust anybody because of what I’ve seen. It changes you as a person. It changes how your family sees you.”

The stress of the job often leads to burnout. Candace has been doing it for 12 years and says she’s hit her limit, though she knows people who have been doing it for decades.

“I know people who've been dispatching for 27 years and I don’t know how they do it. I think they're crazy,” she said. "I just want to ask, ‘Why? Why are you doing this? Do you hate yourself that much?’”

Lilly believes more can be done to support dispatchers, especially during training, making them more equipped for the challenges of the job. “Folks in the public safety field should know in advance that having a reaction to distressing events is normal. And that using things like avoidant coping is a real problem,” she said. Because avoidant coping prevents someone from processing events, “it kind of cascades into a lot of these other PTSD symptoms,” Lilly explained. She’d also like to see more acknowledgment that PTSD is treatable. “Just because you are diagnosed with PTSD doesn’t mean you’re going to have it for your whole life,” she said.

Lilly said that the stigma around admitting to mental health struggles or reaching out to a mental health professional is still very real in public safety circles. While she hopes that changes, she believes in the importance of peer support networks. “Just reaching out to a peer who understands the work and can empathize can help mitigate some of that early avoidance,” she said.

Candace makes an effort to do exactly that with her coworkers. She’s been open about seeking therapy and has encouraged other emergency services personnel to talk to her if they’re struggling.

“I've gone to deputies and firefighters and said, ‘Listen: if you want to talk, you can come to me. Because none of us are 100 percent okay and we’re here to help each other,’” she said.

There is one legislative effort that would help dispatchers get the recognition they deserve. Congresswoman Norma Torres (CA-35), herself a former 911 dispatcher, has proposed the 911 SAVES Act, which would reclassify 911 telecommunication as a “protective service occupation”—the same classification as firefighters, paramedics, and police officers. Not only would it allow dispatchers to reap benefits like earlier retirement, but it would more accurately represent 911 telecommunicators’ role. Being classified as a first responder, Candance said, “is about the respect. Period.”

Though there is bipartisan support for the legislation, it’ll likely face opposition from both dispatch agencies and municipalities that don’t want or can’t afford to pay the benefits that come with first responder classification. VICE reached out to Congresswoman Torres to discuss the 911 SAVES Act but didn’t get a response.

In the meantime, some smaller government bodies have started to take action. Texas has reclassified 911 dispatchers as first responders, as have two counties in Colorado. Other states are currently considering similar legislation.

The dispatchers VICE spoke with all seem, in varying degrees, to be resigned to the fact that PTSD is an inevitability on the job. What keeps call takers and dispatchers going is the small fraction of calls where they can have a positive impact.

“There are times when you’ve instructed an infant’s brother how to do CPR and it saves the baby’s life and it’s the best feeling in the world,” Acosta said.

“Look, we just want to be able to help someone, that's why we're in this,” Candace agreed. “The shit we have to handle is terrible. And there's a lot of ways that this whole setup could be better.”

“But we are in it to help people,” she added. “We’re going to do it until we can’t anymore.”

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This article originally appeared on VICE US.