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Supporting staff following critical incidents in the workplace

Events in the workplace that involve real or perceived risk of serious physical harm or potential death are often referred to as Critical Incidents. These may accidents, emergencies, natural disasters and assaults. Critical Incidents differ from other stressful workplace events in that they are potentially traumatising to both victims and witnesses.

Although it is reassuring to know that most people will not go on to experience long-term mental problems there is much that workplaces can do to help their staff to cope following Critical Incidents.

Practical strategies for workplaces and managers

Immediately after an event:
– Ensure physical safety: remove people from the incident site and treat their physical injuries.
– Avoid unnecessary exposure of other staff to the critical incident site, particularly where it may be potentially distressing.
– Provide shelter, food and comfort: Ensure that the physical needs of those involved are met and that they have the ability to contact loved ones. This may include simple things such as providing shelter, appropriate clothing, food, showers, and access to phones.
– Reassure staff about their safety. Let them know that it is normal to experience a wide range of reactions and how they can access support if they need to.
– Keep staff informed and prevent the spread of rumours. Provide information about the status of the event, any ongoing emergency support, and the health status of anyone who has been injured.
– Watch for people who are very distressed. This may include those who are acting out of character, who appear to be ‘in shock’ or who are ‘out of it’. People experiencing acute stress reactions may require individual support in the days to weeks following an event.

Days to weeks after:

Early intervention has been shown to lead to improved mental health outcomes. If your staff have been exposed to a significant incident it makes sense to get advice on what post-incident support would be appropriate as soon as possible.

Formal and Informal Responses: There is no one-size fits all solution to supporting staff after traumatic events. What is appropriate will depend on the nature, severity and duration of the event; the number, skills and cohesiveness of those involved; and the severity of their physical and emotional symptoms.

At times no formal interventions may be required and you might simply be encouraged to help staff make use of existing social supports, provide them with information regarding signs that they may need further help and ways to easily access more help if required.

Individual counselling can be useful and should be offered to those who desire it and those who are experiencing strong, ongoing reactions. It should only be conducted by an experienced mental health professional with training in post-trauma support. Sometimes people who are not coping well don’t want to have formal assistance and its best to seek advice on how you can best fulfill your duty of care to these people with your mental health care consultant.

There are a number of evidence-based psychological therapies offered by psychologists and psychiatrists that are suitable for treating those who go on to develop psychological injuries as a result of their experiences.

Debriefs and Investigations: People without appropriate training should not ‘debrief’ staff about their experiences. Where formal investigations are required it is advisable that you get advice as to how these can be conducted in the safest manner.

Mental health responses will need to be coordinated with any investigation process to ensure that people’s memories of the event are not influenced by counseling or discussion of their experiences with others.

But what about group debriefing?

Group debriefing is no longer supported by evidence and can be harmful to some people, effectively re-exposing them to the event or to other people’s upsetting experiences.

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