Easing the burden

Post-traumatic stress disorder can affect any worker. How can an employer help?

By Keith Howard, associate editor

In industries across the country, when an incident occurs on the job, people can be seriously hurt, leaving both physical and mental damage. And dealing with mental scars can be just as tough as dealing with the ones on the outside.

A serious or fatal work injury can cause people who knew the victim or witnessed the incident to experience symptoms of traumatic stress. Watching a close colleague suffer a serious fall or witnessing a workplace fire can have a devastating effect on the human mind.

After a traumatic event, people may have difficulty concentrating, show signs of irritability, become hyper-alert to danger, have an exaggerated startled response or feel on edge.

Although these symptoms may be considered normal for a person who recently witnessed a traumatic event, when symptoms continue beyond 30 days, they become part of a debilitating condition known as post-traumatic stress disorder.

What is PTSD?

Many people do not realize that PTSD can happen to anyone; it is not limited to soldiers returning from combat or 9/11 survivors, said Dr. Frank Ochberg, a clinical professor of psychiatry at East Lansing-based Michigan State University and founder of Gift from Within, a nonprofit organization that develops educational materials for people suffering from PTSD.

“The most common cause of PTSD in America is a traffic accident – a bad accident,” Ochberg said. “An accident where a loved one is killed or a person is trapped for a while in a vehicle, or someone comes up suddenly and sees a dead body. These are far more common than combat or rape, and then there are times when workplaces are the scenes.”

PTSD sufferers commonly experience feelings of numbness and isolation, causing them to avoid seeking the treatment necessary to resume everyday activities, Ochberg said. He recommends intervening as early as possible, and said treating a mental disorder is just as important as treating a physical illness.

“PTSD is real, and persons with PTSD and related traumatic stress syndromes deserve the same respect and support that individuals and families suffering the impact of cancer, heart disease and strokes receive,” Ochberg said.

Ochberg added that PTSD sufferers have great difficulty readjusting to personal and work routines while dealing with symptoms. And people who lose their jobs as they struggle with the disorder may have trouble acclimating themselves to new jobs.

The impact of PTSD in the workplace

The American Psychiatric Association estimates that roughly 8 percent of the general population may be affected by PTSD in their lifetime, with women more than twice as likely to be victims as men.

Employees and employers must understand the importance of supporting a person coping with PTSD, said Bob VandePol, president of the Crisis Care Network, a Grandville, MI-based provider of response services through consultation and managerial assistance.

“There’s a higher risk that a person may tell off their boss, quit precipitously, be afraid to come back to [the] site the next day or respond harshly to co-workers,” VandePol said. “There are a lot of bad things that can happen. It’s important psychologically to contain that incident through facility resiliency so that people can bounce back.”

Helping to overcome the effects of PTSD in the workplace requires paying close attention to employees, especially when a traumatic event occurs on the job, VandePol said.

“Having others witness you experience the symptoms of PTSD can be uncomfortable and embarrassing or shame-inducing,” VandePol said. “People experiencing PTSD will sometimes avoid situations where people can see them not at their best. So for people who witness the situation to normalize their reaction would be invaluable.”

Leaving PTSD untreated, regardless of its cause, likely will contribute to chronic pain, depression, drug and alcohol abuse, and sleep problems that inhibit a person’s ability to work and interact with others.
 
Shared experience among sufferers

Those who suffer from PTSD may re-experience their trauma in the form of flashback episodes and intrusive recollections of the event. They often will remove themselves from events or situations that remind them of the trauma, said Dr. Richard J. Ottenstein, CEO of the Sykesville, MD-based Workplace Trauma Center, a provider of crisis management and training services.

“It can be a sight, it can be a sound, it can be a smell, it can be a voice, it can be a sudden movement,” Ottenstein said. “Memories are stored in the brain coming from all our senses, so that when we experience something, there are memories that are stored about the sounds, the visual images, the smell, possibly even the taste, the temperature, sometimes even the atmospheric pressure.”

Ottenstein said to imagine how difficult it must be for a machinist to return to work after a colleague lost an arm, or how it would be for a truck driver to take the same road where he watched a crash that took the lives of a family a month before.

“PTSD is treatable. It’s difficult to treat; it’s challenging, but it’s definitely treatable. Providing support to employees early is important. I think it is important to provide support the day of or the day after the event so the employee can take [his or her] time to help themselves or to help each other,” he said.

Preparing for a trauma

Preventive medicine is the most effective form of medicine for employers to treat PTSD, according to George S. Everly Jr., associate professor of psychiatry at the Johns Hopkins School of Medicine and executive director of Resiliency Science Institutes at the University of Maryland Baltimore County Training Centers.

“Preventative medicine is always more important than the treatment. Why would you sit around waiting for something to happen?” Everly said. “Personally, I’ve spent my career treating trauma. But the best medicine is preventative medicine. We should obviously be as good at treating something as we possibly can. Think of cancer: Do you want to treat cancer or do you want to prevent cancer?”

Everly said companies should build a relationship with an organization that provides crisis intervention services. These organizations can dispatch trained professionals to help employers restore health and productivity to their workforce after a traumatic event.

Employers also can train managers and give them a concise plan on how to handle the traumatic events that cause PTSD. Everly has helped companies by providing training on how to manage personal stress and develop “psychological body armor” long before an incident occurs, he said.

“If you want to change the culture of communication, you should change it by changing the front-line leadership environment so [managers] are cohesive and resilient and they can bounce back with greater speed,” Everly said. “It’s important to have a plan on how to handle these issues when they do arrive.”

Mark Galban, a social worker at the Jesse Brown VA Medical Center in Chicago, recommends supervisors review their company’s policies to know how to deal with employees who have had an experience that causes PTSD on the job.

“With PTSD, there’s reasonable accommodations that can be made by an employer. If someone finds they are having a hard time working in customer services, for instance, they can be reassigned to a position where there are less interactions with the public,” Galban said. “It’s important in the sense that it’ll allow them to keep their job, instead of just being let go, and it allows them to feel supported by their employer.”

Specific laws vary from state to state, but most require a psychological disability evaluation by a trained professional to verify that a person is suffering from PTSD and not average job stress. This psychological disability evaluation will be submitted to the employee’s workers’ compensation insurance carrier. If the claim is approved, compensation may include pay for lost wages, as well as treatment for any physical symptoms and for the traumatic stress.