PREVENTION

Establishing roles and responsibilities is an important step in Just Getting Started. As you move through Taking Proactive Steps and Implementing Best Practices you may find that you are adjusting and refining your roles and responsibilities documentation.

Establishing Organizational Commitment

Your organization should establish policies and protocols that illustrate commitment to prevention of PTSD and to fostering a culture of support and anti-stigma in the workplace. To demonstrate their commitment, senior leadership should be actively involved in the mental health, wellbeing and psychological safety policies, programs and services. Senior management should also express that the PTSD prevention plan is a vital component of the organization’s Occupational Health and Safety Program across all operations, processes, and procedures. Part of creating a supportive culture also includes allowing for open dialogue between all employees, peers and management. Information should be shared from both the top down and across the organization.

A zero-tolerance policy for harassment and discriminatory practices should be enforced at all levels to demonstrate commitment and support to PTSD Prevention and anti-stigma. Enhanced benefits and wellness may also be considered as they relate to incidents of traumatic mental stress and post-traumatic stress disorder. Additionally, the Joint Health and Safety Committee should be engaged in continuous improvement and evaluate the policies and programs at planned intervals.

Creating a Culture of Support

It is important the organizations establish procedures that create a culture which promotes fairness, caring, honesty and trust. This is done by establishing a collective set of assumptions, expectations and beliefs which foster employee trust in their employers and supervisors intentions and motivations. PSHSA’s survey of workers found that in some cases this trust is broken which creates a barrier to help-seeking because workers feel management is not supportive, even if supports are offered, and there is a sense that workers are stigmatized, not supported, believed, respected or listened to.

Things that organizations can do to create a culture of support include:

• Engaging workers in conversations about psychological well-being to understand what their needs are and how the employer or supervisors can be supportive of worker
• Offering skill-building session to increase awareness of psychological health and safety at work
• Establishing, communicating  and monitoring workplace civility and respect in the workplace policies
• Defining employers, supervisors and workers roles and responsibilities
• Promoting work-life balance
• Having conflict resolution procedures in place
• Stopping stigmatizing behavious by using person-first language, educating everyone about stigma, being kind to one another, listening and asking how you can help someone and talking about mental health in the workplace
• Ensuring that workers can advocate for themselves and have confidence in their ability to communicate with their manager. In order to feel psychological protection in the workplace, workers need to feel confident and safe to ask questions, report mistakes without fear that they will be judged negatively or put their current or future career at risk
• Consistently applying of policies, procedures and programs and quickly responding to workers requests for support

Engagement of the Joint Health & Safety Committee

The Joint Health and Safety Committee or Health (JHSC) and Safety Representative (HSR) can play an important part your PTSD Prevention Program. These engagement procedures should be aligned to the role that the committee members or representative play in your existing health and safety program which include:

• How the JSHC/HSR will be involved in review of the PTSD Prevention Program and make recommendations for improvements to the program
• Review of training programs for staff
• Identification and/or tracking of trauma exposures, injury/illness reports
• Training for JHSC members to ensure understanding of PTSD risk factors and symptoms, including organizational and job factors that impact on PTSD
• Consulting the JHSC when assessing or modifying the existing program(s)
• Sharing the results of any organizational assessments with the JHSC
• Consulting and including the JHSC when new programs or resources are created, as they relate to PTSD Prevention
• Involve JHSC in the communication strategy of programs and resources to employees across the organization
• In a commitment to continuous improvement, the JHSC and management should review the programs and policies relating to PTSD Prevention annually

It is important your committee or representative be familiar with what internal and external resources are available as well, as they may be asked by peers or help promote resources. In some instances, the JHSC committee or Health and Safety Representative may also be used as a resource for any concerns or complaints regarding the PTSD prevention program from fellow staff or peers. The Committee may be helpful or required in investigations as well.

Exposure Reporting and Tracking

The organization should establish procedures to collect objective information on exposures to traumatic events so that staff can be appropriately supported, should they begin to develop symptoms acutely or in the months post exposure. In many cases, symptoms may arise as a result of multiple or cumulative exposure emphasizing the need for proper tracking.

Orientation and Training

As part of your PTSD Prevention Program, you should incorporate PTSD Awareness and Anti-Stigma Training for all employees. This training should include general mental health information for employees about signs and symptoms of mental health injury including PTSD, distress, and reduced coping, what to do if they recognize these signs and symptoms in themselves or a coworker, and how to seek help, both internally and externally. Post-exposure education is significant as it may include techniques to manage PTSD, organization specific return to work policies and procedures, roles and responsibilities, and other peer support or counselling options that are available. Additionally, PTSD Awareness training should include anti-stigma training, such as how to support open dialogue, dispel myths about PTSD, frame help seeking as adaptive, and increase awareness in order to decrease the amount of negativity and prejudice as it relates to PTSD.

You may also want to consider additional training for all managers and supervisors so that they are able to support their staff and answer any questions when implementing the Prevention Plan. Other aspects to consider when creating PTSD Awareness training include the frequency of training, type of delivery, and timelines for completion.

Risk Management

There is limited research on the sensitivity and specificity of using any potential marketing for identifying individuals at risk for PTSD and there is no guide for the employer to reliably identify an employee as high risk. According to research the most appropriate way to identify risk is to focus on those individuals who have risk factors (prior history, repeated exposures to trauma, observed changes in performance or an increase in difficult interpersonal reactions) (Alexander & Richard, 2007). Procedures should be established for monitoring and offering the opportunity for mental health assistance.

Screening

Based on the type of work that first responders do and the potential for high exposure to traumatic events, establishing “routine” screening protocols, rather than just voluntary, is extremely important. It is recommended that more formal screening take place immediately for those in high distress or not functioning, at one month for those exposed and at risk, as well as 6 months following exposure to identify those with slower onset of difficulties.   Those symptomatic should be referred to appropriate mental health resources.

Recovery and Return to Work Procedures

The organization should identify roles and responsibilities related to recovery and return to work within the organization. This could include mechanisms for referral to psychological support, Employee Assistance Programs or Community supports.