IRSST - Institut de recherche Robert-Sauvé en santé et en sécurité du travail

Musculoskeletal disorders and psychological health Support approach for 911 call centre work


This study is a continuation of previous research projects aimed at reducing the psychosocial risks associated with musculoskeletal disorders and psychological problems among 911 call centre agents. More specifically, it is based on the results of the previous study (Toulouse et al., 2011), which suggest that agents in difficult call situations require better support. The study found that call processing difficulties cause an increase in workload, as well as in cognitive or emotional strain, which in turn are correlated to an increase in neck and shoulder pain intensity, while lower back pain was found to escalate with an increase in negative emotions. Call handling difficulties stem from communication problems—inherent to the work of emergency call agents—that complicate the application of procedures used to determine whether to send first responders to the location. Support mechanisms are needed to help agents develop and maintain the skills that will enable them to do their jobs effectively while preserving their health. It is therefore essential to understand the practices currently in use in order to propose an approach aimed at improving them. To this end, interviews were held with managers, trainers and call agents in 10 emergency call centres. Interviewees were asked about the existing support system for dealing with situations such as arrogant callers, callers in crisis, callers with mental health issues or suicidal tendencies, calls where the degree of urgency is uncertain, calls where the agent has to serve as an intermediary between a citizen and the police during a crime, exposure to dramatic situations, and dispatching for major emergency events. They were also asked what improvements they would like to see in the support system.

The results are summarized in Appendix B. For each difficult call situation, a summary sheet describes the nature of the problem, the call processing instructions and strategies, the main observations and the improvements needed. The main problems stated by the agents were as follows:

• Difficulty taking control of the call and getting information from the caller;

• Difficulty determining a line of inquiry considering the state of the caller, which can be difficult to ascertain, and considering the wide range of possible caller reactions;

• The risk of failing to detect an urgent situation, or of mobilizing police officers for no good reason;

• The risk of conflict with a dissatisfied caller;

• The stress of holding a lengthy conversation with a caller who threatens to commit suicide;

• The stress of sustained attentiveness and uncertainty when the agent has to serve as an intermediary between a caller and the police during a criminal act;

• Difficulty controlling one’s emotions when faced with a dramatic emergency situation or an arrogant caller.

To manage these difficulties, agents develop skills by relying on the procedures and practices implemented at their workplace. This is because the initial training for dealing with difficult call situations is minimal, often limited to listing off a few instructions. Some efforts have nevertheless been made in 911 call centres to offer employee support in the form of continuing professional education. Call agents are interested in these training sessions, especially when they include information about intervention methods, such as those used by the police. However, the sessions often have content that is too general, that doesn’t provide adequate solutions to problems, or that doesn’t meet the specific needs of call centre agents. The call centre team leader seems to play a key role in facilitating support within the team. The support role is not always clearly defined, however, and team leaders are not trained in this area.

To improve support for difficult call situations, a cooperative approach is proposed whereby occupational know-how can be collaboratively compiled. The objective of this approach is to form a cooperative training network for 911 call centres. The approach consists of six steps, the first of which is to set up a network coordination committee. Interested centres would work together to develop and share training content on difficult call situations, including the support role played by team leaders. Each centre would establish a working group tasked with designing training content about a specific situation. The working group would be composed of a network coordinator and two or three experienced agents. If necessary, the group could seek the expertise of a specialist in the field. The training content would then be presented and discussed by the centre personnel, and then in the other participating centres so it could be adapted to each particular context. In addition to developing a training program with a curriculum that is relevant to the work of emergency call centre agents, this approach will lead to increased recognition of the professional skills needed for the job and of the human beings behind the job title. This recognition will translate into protective and preventive measures for employee health, as has been demonstrated in various studies in the field (Dejours, 2000, 2009; Vézina et al., 2011).

Additional Information

Category: Research Report
  • Georges Toulouse
  • Louise St-Arnaud
  • Mariève Pelletier
Research Project: 2010-0065
Online since: April 08, 2015
Format: Text