A THIRD of ambulance workers suffer from mental health problems, most commonly burn-out and symptoms of post-traumatic stress, according to a survey published today.

Many workers experience mental health problems because of regular exposure to accidents and emergencies in the course of their work, the survey of an un-named Scottish regional ambulance service found.

The research, published in the January 2001 issue of the British Journal of Psychiatry, was carried out among 110 ambulance personnel by Professor David Alexander and Dr Susan Klein.

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Its aims were to identify the prevalence of psychopathology and its relationship to personality and exposure to critical incidents.

The study of personnel carrying out accident and emergency duties found that 32% had some form of psychopathology or mental disorder, compared with 18% in the general population.

Those questioned said that road traffic accidents and medical emergencies are the most disturbing incidents.

The most upsetting elements of the job were when the victim was a child or someone known to the ambulance crew, or if there were severe injuries at the scene, respondents said.

The study found that 82% of those questioned had experienced a particularly disturbing incident in the past six months.

Nearly 70% said they never have time to recover emotionally between incidents, but around half of those questioned said that the more frequent their exposure to critical incidents, the better they coped with them.

One third of respondents said there was a need for better training and pre-incident briefing, while 73% said the ambulance service was never concerned about staff welfare after critical incidents.

Jim Devine, the Scottish organiser for health for Unison, the biggest health care union, was not surprised by the findings.

He said yesterday: ''Ambulance personnel have a very traumatic and a very stressful occupation and the increase in work adds to that.

''This survey merely emphasises the arguments we have been putting forward to the Scottish Executive and the Scottish Ambulance Service for the need for more support and for more personnel.''

Mr Devine highlighted one case of under-staffing in August 1999, when a one-man ambulance was sent to a woman who fell from the fifth floor of a block of flats and later died.

The service was criticised at the time because, according to national agreements, all emergency ambulances should have a two-man crew.

Mr Devine said that under-staffing was putting lives in jeopardy and placing ambulance crews under unnecessary pressure.

''We still have single-man ambulances now and that causes problems,'' he said.

''I can't imagine how bad that ambulance driver must have felt when the woman died last year - even though it was not his fault.''

Mr Devine's call for greater staff support was echoed by Susan Russell, the Scotland organiser in the health service for the GMB union.

She said: ''All frontline staff - nurses, casualty staff, and ambulance drivers and workers - are suffering increasing demands and levels of stress.

''Stress in the workplace has been identified as a very real industrial injury in the NHS.''