Two hours of sleep a night, avoiding friends and losing interest in hobbies.
There were outward signs paramedic Peter Vinnicombe wasn't OK.
But beneath the surface, his brain would recall jobs he hadn't thought about in years.
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"I had been working for 18 years and thought I was fine," Vinnicombe said.
"I was one of the lucky ones where I hadn't been affected."
He said "things went south" after he was attacked on a shift at 2am and he feared for his life.
"I escaped without physical injury and thought I was OK," he said.
"But over the next few weeks, it became obvious I wasn't and I had a breakdown."
Almost two decades' worth of jobs came crashing down on the first responder after the encounter.
More than 100 conversations with families after their children, husbands, wives, siblings and friends had died.
Years of witnessing traumatic situations and "seeing things humans shouldn't see".
"As a paramedic, firefighter or police officer, you never know what the day is going to hold," he said.
"We see things that people are not meant to see - unspeakable sadness, violence, fear and anger.
"We are there when life starts and when it ends.
"We see everything imaginable and some things you couldn't even imagine."
A few weeks later, Vinnicombe went on workers' compensation and began treatment.
He tried to gradually return to the career he loved at Queensland Ambulance Service (QAS) but eventually he realised he had to stop.
He also had to step away from a volunteer role with Ambulance Wish Queensland, which saw him fulfill wishes for palliative care patients.
"We have taken patients to Cowboys games, to the beach and home for a final family gathering," he said.
"It was a role I held dearly."
As a part of his treatment, Vinnicombe enrolled in a trauma course and realised he had post-traumatic stress disorder (PTSD).
"It was something I denied to myself that I had until I realised I ticked nearly every box," he said.
A new mission
There are more than 370,000 emergency services workers in Australia and it is estimated at least one in 10 develops PTSD, according to the Black Dog Institute.
Emergency services workers are also twice as likely to experience a mental health condition than the general population, in large part due to the high risk of trauma exposure at work.
"All of the services have numerous psychological wellbeing programs," Vinnicombe said.
"Most first responders utilise these programs and the stigma to seek help has decreased a lot over the years.
"I certainly saw a psychologist regularly over my career."
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However Vinnicombe said the time limits for workers' compensation payments can hinder recovery and result in financial stress, especially for those who require long-term care and have increased medical expenses.
"PTSD takes a long time to recover from," he said.
Queenslanders on workers' compensation are paid 85 per cent of their normal weekly pay for the first six months before the amount drops down to 75 per cent for up to two years.
After this time, their income can be reduced to an amount equal to the single pension rate for up to five years.
Vinnicombe is calling on state governments across Australia to improve the long-term support available for first responders, with a scheme similar to the federal Department of Veterans' Affairs Gold Card system.
"I don't have any issues with the way I have been treated by WorkCover or the QAS," he said.
"I want the legislation changed for the long-term care of those that suffer as a result of our service."
Vinnicombe has since started a petition, met with ministers and sent letters to politicians.
"I would love to see paramedics, police and firefighters covered by a scheme similar to the Department of Veterans' Affairs," he said.
"These are men and women who are injured by their relentless service of their communities and put themselves in danger every time they go to work.
"As a community, we should be looking after them."
Vinnicombe is also involved with Team Code Blue, an organisation which provides financial and emotional support to Queensland first responders who are in crisis.
"We raise money mostly by auctioning and raffling signed NRL merchandise," he said.
"If I can help one person going through what I have been through feel just a little bit better then it is worth every second.
"This advocacy work has given me something positive out of this experience that has taken so much away."
A QAS spokesperson said the mental health and wellbeing of staff is a top priority.
"We understand that by the very nature of the important work that QAS personnel undertake every day in providing care across our community to our patients in need, there are times where our officers may be faced with potentially confronting situations," the spokesperson said.
"In recognition of this, and the need to support ambulance personnel, the QAS has established a range of long-standing and effective staff support services, which are designed to be both sensitive and responsive to the needs of our people, especially following confronting or serious incidents.
"Access to these services is always encouraged for our employees, their families, and loved ones whenever support is needed."
The spokesperson said employees and their immediate families can access specialised and confidential counselling through an internal program called Priority One.
"Access to this support also extends to members of the Queensland Ambulance Service Retired Officers Association, for officers who have left the Service for any reason, including retirement," they said.
The spokesperson said employees and their immediate families can also access confidential counselling and support through an additional external support program.
Readers seeking support can contact beyond blue on 1300 22 4636 or Lifeline on 13 11 14.
