The City of Toronto is not doing enough to help paramedics and dispatchers suffering from emotional distress, according to a new report.

The 89-page report was published Friday by Toronto Ombudsman Fiona Crean, and initiated by a series of complaints about how the Toronto Paramedics Service (TPS) was handling operational stress.

Crean issued a statement in July announcing the investigation, and said she received a total of 123 complaints and submissions from TPS members by November. Her team then conducted 139 interviews, including discussions with complainants, retired TPS staff and stakeholders.

"TPS has been a leader in providing psychological services for first responders," Crean wrote.

"The Ombudsman's office heard multiple times that the service is leading the way in a field that has no road map."

Crean found that TPS has had an in-house staff psychologist for 29 years, and is the only paramedic service in Canada to do so. The service also has a group of staff members available to support colleagues in need.

Though TPS has made several steps to aid its employees, Crean noted that staff receive significantly less employee assistance funding than other first responders in Toronto. TPS employees can receive up to $300 per year for psychological services, compared to $3,500 for Toronto police and $1,000 for the city's firefighters.

Some paramedics and dispatchers told investigators that they are reluctant to ask for help because "they are afraid of showing weakness," Crean wrote.

"Witnesses reported that some in the service still felt they should 'suck it up,' that traumatic calls were part of the job, and that employees should have known what they were signing up for when they chose this career."

Crean made 26 recommendations in her report, including many meant to address issues related to confidentiality, policy development and education.

She recommended the organization develop a suicide prevention and intervention strategy, and that "after hours" psychological supports be available for all employees. The full list of recommendations can be read in Crean's report. 

The recommendations have been accepted by the city manager and the TPS, she wrote.