Friend or foe? Violence against emergency responders

 

It was a matter of centimeters away, although firefighter Frank Hachemer only became aware of this fact when a colleague pointed out the beer bottle that had smashed next to him. The nighttime callout in a small town in Rhineland-Palatinate triggered resentment among neighbors: generators, hose connections, blue lights – sleep was disturbed, the firefighters were attacked. Why do some individuals direct their anger at those who help people and are already working at their limit? Some hospitals in the USA are now protected by walls and checkpoints. Employees are trained in the art of deescalation. Even in Germany, ambulances only drive through certain areas under police protection.

Sniper shots

For Frank Hachemer, vice president of the DFV, the association representing the interests of German firefighters, the smashed beer bottle was a wake-up call: Helpers are no longer untouchable, regardless of whether they work for the police, voluntary fire department, professional fire department, ambulance service, or in hospitals or medical practices. Hachemer has been a member of the voluntary fire department since he was a boy and is now trying to raise awareness of the issue through the campaign “Never Assault Helping Hands!” The group representing the interests of young police officers in Germany is also attracting attention with a similar campaign: “Human too” wishes to raise awareness of the increasing violence and aggression faced by police officers. There has been an 11 percent increase in violence perpetrated against emergency workers in Germany compared to last year. Over the past 12 months, there were more than 26,000 cases, with over 2,000 police officers injured, some of them seriously. Acts of aggression committed against public officials and authorities have also risen in Switzerland over the last 20 years – from 423 to 2,808 annually. More public officials than ever before were attacked in Austria in 2016, with no fewer than 1,039 suffering injuries. In the USA, the number of police officers killed on duty has reached a five-year high at 135, although this figure is still below the average (151) for the last ten years. However, the number of those killed with intent is particularly alarming: Of 64 fatal shots, 21 were fired by snipers.

Two firefighters died in 2012 following a targeted attack in the US state of New York – two others were injured. The men from the West Webster Fire Department carry one of their colleagues to the grave on a fire truck

Not really welcome

For her study “Violence against Emergency Workers” – one of the first of its kind in Germany – the lawyer Dr. Janina Lara Dressler surveyed more than 1,600 firefighters and emergency workers. No fewer than 85 percent of them sensed a loss of respect for their profession. The study reveals the number of assaults is much higher than those actually reported. “For the vast majority of people, firefighters are still seen as the good guys, but there appears to be a growing number of people who no longer see it that way,” says Dressler. “In their concept of the enemy, they classify the firefighters as ‘servants of the state’ and thus fail to recognize the intention to provide assistance.”

In some situations, firefighters are virtually denied the right to bodily integrity, because they are seen as “servants of the state” in their uniform. “People seem to completely ignore the fact that more than 95 percent of firefighters in Germany work on a voluntary basis,” stresses Frank Hachemer, “and such attacks especially affect them in particular.” Anyone who physically or verbally assaults a firefighter is in all likelihood confronting someone who neither represents the state per se, nor receives remuneration for their service.

Hospitals also report an increase in assaults and a readiness to use violence. In addition to overworked staff, the main reason for this is often a lack of communication. Those who are waiting are kept in the dark about the treatment plan and there is a failure to identify emergency cases, or the ability to do so is obscured by an individual’s own feelings. Almost a quarter of German general practitioners have experienced violence on at least one occasion. “The risk is even higher in the field of psychotherapy or psychiatry. Yet there is hostility everywhere, as reported by colleagues in other disciplines. I receive verbal abuse and threats when I have no free appointment slots or am unable to issue a certificate,” confirms Dr. Hans Ramm, neurologist and psychotherapist and board member of Hamburg’s medical council. Dr. Ellen Douglas, a consultant at Buchholz Hospital, just outside Hamburg, says: “Even though the level of violence has not increased, we are more frequently dealing with patients who do not understand why they have to wait. The tone then becomes more aggressive.” They view the fact they are not being immediately treated as victimization. Dr. Douglas highlights a problem with which many hospitals are familiar: emergency departments overwhelmed with non-emergency cases. And it is especially those individuals who have waited weeks for an appointment with the consultant and lose their patience at the weekend who finally flip out while waiting at the hospital. The experience of Dr. Daniel Schachinger, medical director at the central emergency department of the Berlin/Westend DRK Hospital, is similar, although much more conspicuous. “There has been a significant rise in the number of attacks over the past ten years. Verbal abuse, altercations, and even considerable physical violence are now a reality.”

Bremervörde: Following a fatal accident in July 2015, three men hamper the work of the emergency services. An altercation breaks out. They faced charges last year – the sentence was passed in April 2017

The problem is more visible

Even though the reports and statistics are clear, many experts are playing down the issue. The German social scientist and aggression researcher Klaus Wahl speaks of subjective experiences and sees no overall social trend toward barbarization in the bigger historical context. “We are generally living in an ever more peaceful world – violence is steadily on the decline.” Dr. Rafael Behr, a professor of police science who specializes in criminology and sociology at Hamburg Police Academy, also tries to reassure people: “The latest studies reveal no spectacular or overall rise in violence.  The problem is merely in the public eye to a greater extent and is more visible.”

The assaults involve less than one percent of all police officers. And anyone who has even suffered concussion and spent 24 hours under observation in hospital is deemed to be seriously injured. “The latest studies show that people’s perception of violence and aggression is changing,” explains the Hamburgbased police scientist. People nowadays are much more horrified and affected when confronted with aggressiveness. Media reports on such incidents increase the sense that everything is only getting worse and more brutal. “We see matters from a comparative perspective, based on the maxim that things like this never used to happen. However, anyone who believes that people used to know when to stop and nobody ever kicked anyone while they were down on the ground is mistaken.” This is merely an attempt to categorize and interpret the development by means of seemingly accurate recollections. In actual fact, it is often no more than astonishment at the inexplicable.

An expression of emancipation

When acts of aggression are committed against helpers, a distinction must first be made between the violence shown toward police officers and that shown toward other emergency services. While attacks on firefighters and other helpers can be explained by a rejection of assistance, those committed against police officers tend to be a form of rebellion against the state. It seems that the idea of respect has continually changed over the course of the years. Parents and schools teach children to meet state authority on an equal footing. This is combined with a latent fury about everything that is not going well in their own lives or in the country. The state is blamed for this, which then stands in front of them in uniform – as a police officer, for example. The citizen no longer sees the officer as a fellow citizen, but as the personification of the state. The media sometimes projects a distorted view of this confrontation. Rainer Wendt, president of the German police union, stresses that 80 percent of attacks on police officers do not occur at demonstrations, but in the course of everyday duties. And the criminologist Professor Behr talks about the increasing insubordination of civil society toward the state. Firefighters, emergency workers, doctors, and nurses are often placed in this very pigeonhole.

People often take out their built-up rage on the emergency services. A patient with two painful legs in plaster in the Austrian city of Wels even assaulted a paramedic because a hospital refused to admit him

Respect thanks to fairness

“Our society articulates whatever it finds displeasing and makes things difficult, which essentially isn’t wrong,” says Behr. “Many police officers, however, perceive precisely this as something stronger than resistance.” They fail to understand that the aggression is not directed at them as individuals, but at the state they represent in their uniform. So is an increasing lack of respect the cause? It would certainly explain the attacks on those who are there to help. Yet even here there is no universal answer. “Fairness is the prerequisite for respect,” stresses Behr. “Respect is not simply there, but is created in the course of social interaction.” It takes good communication. However, not every situation is conducive to this: Situations such as a burning house, a serious accident, or an overcrowded emergency department require a professional approach, although there is often no time for explanations, let alone discussions. Time is tight, which can appear authoritative and contribute to the escalation of the situation. More than 60 percent of actual attacks are committed by people under the influence of alcohol. “Alcohol is like a catalyst: It lowers people’s inhibitions, eliminates control mechanisms, and amplifies existing behavioral tendencies,” says social scientist Wahl. Those with a proclivity for violence will, find it more difficult to control themselves under the influence of alcohol.

A growing level of brutality

The proclivity for violence is determined by a number of factors. Some are biological, such as sensitivity or temperament. Learned elements have an even greater impact. “Violence is generally learned violence,” says Dr. Ulrich Wagner, professor of social psychology at the University of Marburg. “We learn from others how to commit it and use it successfully.” Yet frustration, dissatisfaction, and the inability to solve conflicts can also lead to violent behavior. Aggressive tendencies are particularly striking and have their own distinct dynamism in groups. “Being part of a group leads to the disparagement of others who are not part of it,” says Wagner. “This goes as far as a dehumanization of outsiders.” Above all else, this disparagement explains many of the acts of violence – on both sides. After all, the same behavior pattern based on group dynamics is present among the police. “You see them opposite side committing assaults on your own group,” says Wagner. “This increases the readiness to reciprocate with counter-violence.”

Criminal damage: In Bergisch Gladbach an emergency vehicle was stolen and smashed up during a callout

This is also the reason why the ban on obscuring the face is a good idea, because anonymity in a crowd only increases the readiness to commit violence of this kind. And yet it is frequently individuals who turn into perpetrators and throw bottles, smash equipment, and harass care staff; individual, aggressive perpetrators who are not under the influence of alcohol, are not affiliated to any group, and have no preexisting mental illness. The conflict researcher Professor Klaus Wahl explains the possible development of this aggression as a combination of thoughts and feelings: “These people with an oversensitive social radar find themselves in a world of enemies. At least that is their subjective impression.” Remarkably often, they have a distorted perception of the feelings and behavior patterns of others – and interpret normal behavior as provocative, threatening, or aggressive toward them. They often have a tendency to defend themselves and preempt such perceived behavior by committing their own acts of violence. In contrast to his colleagues, Professor Wagner sees a rise in the severity of assaults. “For quite some time, there appears to have been a growing level of brutality among some perpetrators,” he says, albeit rather cautiously. From a psychological perspective, this may be due to two reasons: a high degree of excitability, and the learning of violence. “Watching violent media and playing aggressive computer games increases the propensity for aggression. That is scientifically proven.” People then tend not only to be prepared to react with aggression; it also influences the way in which they react. “The human being is a learning creature.”

Everyone seeks their own solutions. While firefighters work on their image as helpers, the updated sentencing guidelines recently passed in Germany promise more severe consequences for those who attack police officers. Both doctors and other emergency workers feel aggrieved. Social scientist Wagner views this not uncritically: “What kind of signal does it send out when assaults on one profession are penalized more heavily than those on another?” Ways of equipping people with efficient de-escalation strategies as well as staff with strong communication skills appear to be more promising approaches. Modern emergency departments have recognized the problem and are responding to it with large, open-plan waiting areas and transparent admission and treatment procedures. Fire departments and other emergency services have also been helped more by increased staffing levels, shorter waiting times, and training than by harsher penalties for perpetrators of violence. Dealing with one another in a respectful manner is a two way street. “In most cases, the conflicts themselves aren’t the problem, but rather the lack of ability to solve them,” says Wagner.

Photo credits

  • PHOTO: REUTERS / CARLO ALLEGRI
  • PHOTO: STEFAN SIMONSEN, DPA
  • PHOTO: LAUMAT.AT / MATTHIAS LAUBER
  • PHOTO: FEUERWEHR BERGISCH GLADBACH

Republication from Draeger Review Magazine

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