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Roadmaps to Resiliency, CMHA May 14, 2019 PTSD Next Steps

PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing

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Page 1: PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing

Roadmaps to Resiliency, CMHAMay 14, 2019

PTSD Next Steps

Page 2: PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing

MENTAL HEALTH AMONG FIRST RESPONDERS

• A national study, completed in 2017, found that 44% of Canadian First Responders screened positively for clinically significant symptom clusters consistent with one or more mental disorders.

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Page 3: PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing

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Firstrespondersfirst.caBuilding a PTSD Prevention Plan

MOL by April 23, [email protected]

Page 4: PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing

A Prevention Plan will Help You…• U n d e r s t a n d t h e i m p a c t o f t r a u m a t i c

e x p o s u r e s o n w o r k e r s a n d t h e w o r k p l a c e• T a k e s t e p s t o i d e n t i f y a n d i m p l e m e n t

p r e v e n t i o n , i n t e r v e n t i o n a n d r e c o v e r y a n d r e t u r n t o w o r k s t r a t e g i e s , s t r u c t u r e s a n d s u p p o r t s

• B u i l d a c u l t u r e t h a t p r o m o t e s p s y c h o l o g i c a l h e a l t h a n d s a f e t y i n t h e w o r k p l a c e a n d b r e a k s d o w n s t i g m a b a r r i e r s

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Page 5: PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing
Page 6: PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing

Big 3

T h r e e e l e m e n t s o f y o u r p l a n • P r e v e n t i o n• I n t e r v e n t i o n• R e c o v e r y a n d R e t u r n t o W o r k

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Page 7: PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing

Prevention

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Getting Started Taking Proactive Steps Implement Best Practices

• Understand legal requirements

• Incident reporting• Customize sample

policies and procedures

• Define roles and responsibilities

• What are signs and symptoms?

• Anti-stigma campaigns

• Manager Training• Awareness Training• Resiliency Training

• Leadership commitment

• Engage JHSC/HSR in continuous improvement

• Identify link with HSMS

• Open dialogue• Enhanced benefits

and wellness

Page 8: PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing

Intervention

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Getting Started Taking Proactive Steps Implement Best Practices

• Crisis intervention• Know how to access

treatment andsupport options in the community

• Manager response to signs/symptoms

• Understanding of intervention options

• WSIB• OHIP

• Knows signs and symptoms

• Emergency response and mitigation strategies

• Peer support,Psychological first aid

• Employee Assistance Program

• Worker exposure screening

• Suicide and substance abuse

• Evaluation leads to specialized OSI resources

• Research on emerging treatments

• Response and support for co-workers in the event of a suicide

• Engagement of the family in PTSD prevention programs

Page 9: PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing

Recovery and RTW

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Getting Started Taking Proactive Steps Implement Best Practices

• Duty to accommodate

• Customize sample procedures

• Understand reintegration within the workplace and working with WSIB

• Information for families on how to support worker

• Return to work coordination

• Relapse prevention• Understand how EAP

can assist and cost considerations

• Provisions of family support

• Family/community engagement

• Dedicated psychological support for returning workers evaluation

Page 10: PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing

Current State Assessment• W h a t ’s a l r e a d y i n p l a c e a t y o u r

o r g a n i z a t i o n ?

• H i g h l e v e l s u m m a r y • H i s t o r y w i t h P T S D• W h y i t ’s i m p o r t a n t t o y o u r o r g a n i z a t i o n

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Page 11: PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing

Policy Statements

• C o r p o r a t e P T S D P o l i c y• A n t i -S t i g m a P o l i c y• M a n a g e r r e s p o n s e t o s i g n s /s y m p t o m s• I n t e r v e n t i o n p r a c t i c e s• R e c o v e r y a n d R T W

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Page 12: PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing

PREVENTION

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Page 13: PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing

Training

R e v i e w a n d c u s t o m i z e t h e T r a i n i n g w o r k s h e e t s t o f i t y o u r o r g a n i z a t i o n . M a k e s u r e t h e f o l l o w i n g c o m p o n e n t s a r e r e f l e c t e d a c c u r a t e l y i n t h e w o r k s h e e t s :

W h a t d o e s t h e t r a i n i n g i n c l u d e ?W h o r e c e i v e s t r a i n i n g ?

W h o d e v e l o p s t h e t r a i n i n g ?R o l l -o u t d a t e ?

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Page 14: PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing

PTSD Awareness and Anti-StigmaTraining

Recognizing Signs & Symptoms and Response Training

New Worker Orientation Training

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Page 15: PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing

INTERVENTION

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Page 16: PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing

Intervention Components

A n i m p o r t a n t p a r t o f d e v e l o p i n g i n t e r v e n t i o n s t r a t e g i e s f o r P T S D i s a n t i c i p a t i n g p o s s i b l e t r a u m a t i c e x p o s u r e s a n d t h e n p l a n n i n g h o w t h e s e t h i n g s m i g h t b e a d d r e s s e d i n y o u r o r g a n i z a t i o n . H e r e a r e a f e w t h i n g s t h a t y o u m a y n e e d t o c o n s i d e r :

• E a r l y i n t e r v e n t i o n• R e s p o n d i n g P T S D s i g n s a n d s y m p t o m s• S c r e e n i n g p r o t o c o l s• P T S D i n j u r y r e p o r t i n g• R e s p o n d i n g t o a c r i s i s s i t u a t i o n• A c c e s s i n g t r e a t m e n t a n d s u p p o r t o p t i o n s

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Page 17: PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing

Early InterventionStrategies

• A n i m p o r t a n t p a r t o f p r e v e n t i n g a n d m a n a g i n g t h e c r i s i s i s h e l p i n g y o u r w o r k e r s m i n i m i z e s t r e s s w h e n t h e y r e t u r n t o w o r k .

• W h a t d o y o u w a n t t o c o n s i d e r a s p o s t -e v e n t i n t e r v e n t i o n s ?

• W h a t d o t h e s e e a r l y i n t e r v e n t i o n s l o o k l i k e ? t i m e o f f ? c o u n s e l l i n g s e r v i c e s ? d e b r i e f i n g ? s c r e e n i n g ?

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Page 18: PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing

Responding to Signs and Symptoms• P o l i c y s t a t e m e n t w o r k s h e e t• O u t l i n e e x p e c t a t i o n s o f m a n a g e r s a n d

S u p e r v i s o r s i .e . E n s u r e c o n f i d e n t i a l i t y B e s u p p o r t i v e , I n d i c a t e “ n o r m a l r e a c t i o n ” t o e v e n t , P r o v i d e i n f o r m a t i o n a n d a s s i s t a n c e s e r v i c e s ,

e t c …

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Page 19: PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing

Sample Screening Protocol

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Page 20: PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing

Self-Assessment ToolDo I have PTSD?

Avoidance SymptomsSelect (☒) all that apply. In the last month have you experienced any of the following avoidance symptoms:

T r y i n g t o a v o i d t h i n k i n g a b o u t t h e e v e n t a v o i d i n g p l a c e s , o b j e c t s , a c t i v i t i e s o r p e o p l e t h a t r e m i n d y o u o f t h e e v e n t .

I n c r e a s e d n e g a t i v e f e e l i n g s a b o u t s e l f o r o t h e r s . F e e l i n g e m o t i o n a l l y n u m b o r i n a b i l i t y t o e x p e r i e n c e

p o s i t i v e o r n e g a t i v e e m o t i o n s . F e e l i n g h o p e l e s s a b o u t t h e f u t u r e . L o s i n g i n t e r e s t i n a c t i v i t i e s t h a t w e r e e n j o y a b l e i n t h e

p a s t . F e e l i n g s t r o n g g u i l t , d e p r e s s i o n o r w o r r y . M e m o r y p r o b l e m s i n c l u d i n g n o t r e m e m b e r i n g

i m p o r t a n t a s p e c t s o f t h e t r a u m a t i c e v e n t . D i f f i c u l t y m a i n t a i n i n g c l o s e r e l a t i o n s h i p s .

Hyper-arousal SymptomsSelect (☒) all that apply. In the last month have you experienced any of the following hyper‐arousal symptoms:

I r r i t a b i l i t y , f e e l i n g t e n s e o r “ o n g u a r d .” D i f f i c u l t y s l e e p i n g . A n g r y o u t b u r s t s o r a g g r e s s i v e b e h a v i o u r s . B e i n g o n c o n s t a n t g u a r d f o r d a n g e r . F e e l i n g s o f o v e r w h e l m i n g g u i l t o r s h a m e . S e l f ‐d e s t r u c t i v e b e h a v i o u r s . T r o u b l e c o n c e n t r a t i n g o r s l e e p i n g . B e i n g e a s i l y s t a r t l e d o r f r i g h t e n e d

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E d u c a t e t h e w o r k e r a n d p r o v i d e i n f o r m a t i o n o n h o w t o a c c e s s t r e a t m e n t a n d c a r e i f t h e y h a v e b e e n e x p e r i e n c i n g t h e s y m p t o m s f o r m o r e t h a n o n e m o n t h a n d a r e e x p e r i e n c i n g a t l e a s t : O n e i n t r u s i v e m e m o r y s y m p t o m T h r e e a v o i d a n c e s y m p t o m s a n d T w o h y p e r ‐a r o u s a l s y m p t o m s

Intrusive Memory SymptomsSelect (☒) all that apply. In the last month have you experienced any of the following intrusive memories:

R e c u r r i n g , u n w a n t e d d i s t r e s s i n g m e m o r i e s o f t h e t r a u m a t i c e v e n t .

R e l i v i n g t h e e v e n t a s i f i t w e r e h a p p e n i n g a g a i n . U p s e t t i n g d r e a m s a b o u t t h e e v e n t . S e v e r e e m o t i o n a l d i s t r e s s o r p h y s i c a l r e a c t i o n s (h e a r t

r a c i n g , h a n d s s w e a t i n g ) t o s o m e t h i n g t h a t r e m i n d s y o u o f t h e e v e n t .

Page 21: PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing

Intervention Components

A n i m p o r t a n t p a r t o f d e v e l o p i n g i n t e r v e n t i o n s t r a t e g i e s f o r P T S D i s a n t i c i p a t i n g p o s s i b l e t r a u m a t i c e x p o s u r e s a n d t h e n p l a n n i n g h o w t h e s e t h i n g s m i g h t b e a d d r e s s e d i n y o u r o r g a n i z a t i o n . H e r e a r e a f e w t h i n g s t h a t y o u m a y n e e d t o c o n s i d e r :

• E a r l y i n t e r v e n t i o n• R e s p o n d i n g P T S D s i g n s a n d s y m p t o m s• S c r e e n i n g p r o t o c o l s• P T S D i n j u r y r e p o r t i n g• R e s p o n d i n g t o a c r i s i s s i t u a t i o n• A c c e s s i n g t r e a t m e n t a n d s u p p o r t o p t i o n s

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Page 22: PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing

Reporting an Injury

• E s t a b l i s h r e p o r t i n g p r o c e d u r e s f o r P T S D• C o n s i d e r e x i s t i n g a c c i d e n t a n d i n c i d e n t

r e p o r t i n g p r o c e d u r e s• C a n b e e x p a n d e d t o i n c l u d e m e n t a l h e a l t h

c o n c e r n s l i k e t r a u m a t i c m e n t a l s t r e s s o r P o s t T r a u m a t i c S t r e s s D i s o r d e r.

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Page 23: PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing

Internal Reporting ProceduresO c c u p a t i o n a l H e a l t h a n d S a f e t y A c t

• F o l l o w i n g t h e n o t i f i c a t i o n o f a n i n j u r y / i l l n e s s M i n i s t r y o f L a b o u r J H S C o r H & S r e p r e s e n t a t i v e t r a d e u n i o n (i f a p p l i c a b l e )i f a n e m p l o y e e i s c r i t i c a l l y i n j u r e d , d i s a b l e d f r o m p e r f o r m i n g t h e i r o w n w o r k o r r e c e i v e s m e d i c a l a t t e n t i o n r e s u l t i n g f r o m a n i n c i d e n t .

• D e t a i l s r e q u i r e d a n d t h e p a r t i e s w h o m u s t b e n o t i f i e d a r e o u t l i n e d

b a s e d o n t h e s e v e r i t y o f t h e i n j u r y i n c l u d e s t e p s t o p r e v e n t f u r t h e r i l l n e s s .

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Page 24: PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing

Reporting to the WSIB

• P T S D h a n d l e d i n t h e s a m e m a n n e r a s o t h e r i n j u r i e s o r i l l n e s s e s .

• N o s p e c i a l r e q u i r e m e n t s a t t h i s t i m e .

• F o r m 7 R e p o r t o f I n j u r y /I l l n e s s w i t h i n t h r e e d a y s .

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Page 25: PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing

Responding to a Crisis SituationT h e f o c u s o f a p e e r s u p p o r t p r o g r a m i s t o e s t a b l i s h p o s i t i v e c o p i n g s t r a t e g i e s , u s i n g c o m m o n l a n g u a g e w h i c h f o s t e r s t r u s t a n d c r e d i b i l i t y b e t w e e n t e a m m e m b e r s .

• P e e r s u p p o r t i s a n i n t e r v e n t i o n : t h a t l e v e r a g e s s h a r e d e x p e r i e n c e f o s t e r s t r u s t r e d u c e s s t i g m a c r e a t e s o p e n c h a n n e l s o f c o m m u n i c a t i o n f o r :

s e e k i n g h e l p s h a r i n g i n f o r m a t i o n s e e k i n g s u p p o r t r e s o u r c e s .

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Page 26: PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing

Peer Support Program Crisis Intervention TeamsI f y o u a r e J u s t G e t t i n g S t a r t e d , h e r e a r e s o m e a p p r o a c h e s y o u m a y w a n t t o c o n s i d e r :

• U t i l i z i n g t h e S e r v i c e C h a p l a i n a s a s o u r c e o f p e e r s u p p o r t .• U t i l i z i n g a v o l u n t e e r P e e r S u p p o r t M e n t o r f r o m t h e J H S C .

T h i s p e r s o n s h o u l d b e p r o v i d e d t r a i n i n g t o h e l p t h e m f u l f i l l t h e i r d u t i e s w h i c h i n c l u d e s :a . b a s i c s k i l l s t o b e a p e e r s u p p o r t m e n t o r,b . l i s t e n i n g s k i l l s ,c . p s y c h o l o g i c a l f i r s t a i d , a n dd . r e f e r r a l o p t i o n s f o r w o r k e r s w i t h i n t h e o r g a n i z a t i o n .

T h e b e n e f i t o f u t i l i z i n g t h i s a p p r o a c h i s t h a t t h i s p e r s o n i s a l r e a d y f a m i l i a r w i t h y o u rh e a l t h a n d s a f e t y p r o g r a m a n d t h e y a r e a m e m b e r o f t e a m . W h e n s e l e c t i n g t h i s p e r s o nt h e y s h o u l d b e v i e w e d a s b e i n g a c r e d i b l e r e s o u r c e , a r e r e s p e c t e d b y p e e r s a n d u n d e r g oa s e l e c t i o n p r o c e s s .

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Page 27: PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing

Accessing Treatment and SupportUnderstanding the Strengths and Limitations of your Service’s Employee Assistance Program (EAP)

A n i m p o r t a n t p a r t o f d e v e l o p i n g y o u r p r e v e n t i o n p l a n

• u n d e r s t a n d i n g t h e s t r e n g t h s a n d w e a k n e s s e s o f y o u r s e r v i c e ’s E A P

• t h e e m p l o y e e s o f t h e E A P a r e n o t a l w a y s e q u i p p e d t o d e a l w i t h t h e t r a u m a t i c e v e n t s t h a t f i r s t r e s p o n d e r s a r e e x p o s e d t o

• u n d e r s t a n d t h e s e r v i c e s t r e n g t h s a n d l i m i t a t i o n s s o t h a t y o u c a n a d d r e s s a n y g a p s i n y o u r p r e v e n t i o n p l a n

• A r e t h e r e s p e c i f i c p r o v i s i o n o f s e r v i c e f o r y o u r w o r k e r s w i t h r e g a r d s t o P T S D ?

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Page 28: PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing

EAP Provider Checklist

• R e f e r e n c e t h e c h e c k l i s t i n t h e P W• L e v e l s o f s e r v i c e a r e g e o g r a p h i c , s o e n s u r e

E A P p r o v i d e r i s r e s p o n d i n g t o s e r v i c e s a v a i l a b l e i n y o u r a r e a

• I n c l u d e i n q u i r i e s a b o u t d i s t a n c e s t o o b t a i n s e r v i c e s

• W i l l t h e s e r v i c e s b e s u i t a b l e /e f f e c t i v e ?

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Page 29: PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing

Community Support Options

• W h a t ’s a v a i l a b l e i n y o u r c o m m u n i t y ?

• W h a t a r e t h e s p e c i f i c s e r v i c e s ?

• A n y t h i n g P T S D s p e c i f i c ?

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Page 30: PTSD Next Steps - Mental Health Works...• Responding PTSD signs and symptoms • Screening protocols • PTSD injury rep o rting • Responding to a crisis situatio n • A ccessing

Distress Centres

T h e r e a r e a n u m b e r o f d i s t r e s s a n d c r i s i s c e n t r e st h r o u g h o u t O n t a r i o

• I s t h e r e o n e i n y o u r a r e a ? D o y o u p r o v i d e s p e c i f i c s e r v i c e s i n s u p p o r t o f P T S D ? W h a t a r e t h e q u a l i f i c a t i o n s o f a v a i l a b l e c o u n s e l o r s ? A r e t h e y t r a i n e d t o r e c o g n i z e t h e s i g n s a n d s y m p t o m s

o f P T S D a n d p r o v i d e a p p r o p r i a t e s u p p o r t a n d d i r e c t i o n ?

D o t h e y p r o v i d e t r a i n i n g o r r e s o u r c e s f o r m a n a g e r s o n h o w t o r e c o g n i z e t h e s i g n s a n d s y m p t o m s o f P T S D ?

D o t h e y p r o v i d e p e e r s u p p o r t t r a i n i n g ?

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Distress Centres

T o f i n d y o u r l o c a l d i s t r e s s c e n t r e c o n t a c t i n f o r m a t i o n v i s i t t h i s w e b s i t e :h t t p ://w w w .d c o n t a r i o .o r g /T h e G o v e r n m e n t o f C a n a d a a l s o h a s a M e n t a l H e a l t h H e l p l i n e . I n f o r m a t i o n a b o u t t h i s s e r v i c e c a n b e f o u n d o n t h e i r w e b s i t e :h t t p ://w w w .m e n t a l h e a l t h h e l p l i n e .c a /

• W o r k s h e e t 2 0 : W i l l c o m m u n i t y s u p p o r t o p t i o n s f o r m p a r t o f y o u r P T S D p r e v e n t i o n p l a n ?

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OHIP PTSD Treatment Options• I t i s i m p o r t a n t t o u n d e r s t a n d t h e

t r e a t m e n t o p t i o n s w h i c h a r e c o v e r e d b y O H I P

• Y o u w i l l n e e d t o c o n t a c t y o u r l o c a l h e a l t h c a r e p r o v i d e r t o u n d e r s t a n d t h e t r e a t m e n t o p t i o n s a v a i l a b l e t o y o u i n O n t a r i o .

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Intervention Training Programs M e n t a l H e a l t h F i r s t A i d - M e n t a l H e a l t h C o m m i s s i o n o f

C a n a d a : T W M F R - M e n t a l H e a l t h C o m m i s s i o n o f C a n a d a :

M i l i t a r y , P o l i c e , F i r e a n d E M S v e r s i o n s a v a i l a b l e L i v i n g W o r k s E d u c a t i o n I n c H E A R T P r o g r a m - B i z L i f e S o l u t i o n s B e y o n d S i l e n c e - P u b l i c S e r v i c e H e a l t h a n d S a f e t y

A s s o c i a t i o n

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Additional Mental Health Resources• N o t M y s e l f T o d a y .c a• W o r k p l a c e S t r a t e g i e s F o r M e n t a l H e a l t h .c o m• C h e c k U p F r o m T h e N e c k U p .c a• F e e l i n g B e t t e r N o w• W o r k L i f e H e a l t h .c o m• C a n a d i a n M e n t a l H e a l t h A s s o c i a t i o n• e M e n t a l H e a l t h .c a

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RECOVERY AND RETURN TO WORK

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RTW Principles

• S t r o n g c o m m i t m e n t t o O H S• M o d i f i e d w o r k o f f e r s• R T W p l a n s u p p o r t s w o r k e r, c o w o r k e r,

s u p e r v i s o r• S u p e r v i s o r s t r a i n e d a n d i n c l u d e d• E a r l y c o n t a c t w i t h i l l /i n j u r e d w o r k e r• R T W c o o r d i n a t o r• E m p l o y e r /h e a l t h c a r e p r o v i d e r

c o m m u n i c a t i o n

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June-26-19

A Toolkit for Supervisors

M A N A G IN G M E N TA L H E A LT H S TAY A T W O R K A N D R E T U R N T O W O R K IN F IR S T R E S P O N D E R O R G A N IZ A T IO N S

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June-26-19

T h e p u r p o s e o f t h i s c o u r s e i s t o h e l p y o u b u i l d y o u r o w n “ S u p e r v i s o r s T o o l k i t ” o f r e s o u r c e s t o h e l p y o u s u p p o r t h e a l t h y , s a f e a n d s u c c e s s f u l s t a y a t w o r k a n d r e t u r n t o w o r k a f t e r a n a b s e n c e .

IN T R O D U C T IO N

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Time Topic

9:00 Section 1: Introduction

9:55 Section 2: Mental Health in First Responder Organizations

Section 3: Organizational Facilitators and Barriers

Section 4: Disability Management and Prevention Practices

Section 5: WSIB Policy Review and Legal Requirements

Section 6: Supervisors Toolkit for Stay at Work and Return to Work

AGENDA

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• T h e m e n t a l h e a l t h c o n t i n u u m m o d e l p u t s m e n t a l h e a l t h o n a c o n t i n u u m f r o m g r e e n (h e a l t h y ) t o r e d

• S t r e s s o r s t h a t y o u e x p e r i e n c e c a n m o v e y o u a l o n g t h i s c o n t i n u u m t o w a r d s i l l (r e d ), a n d y o u c a n t a k e s t e p s t o m a n a g e o r r e d u c e t h e s e s t r e s s o r s t o m o v e b a c k t o w a r d s h e a l t h y (g r e e n ).

MENTAL HEALTH CONTINUUM MODEL

40

Healthy Reacting Injured Ill

CAF Road to Mental Readiness (R2MR) mental health continuum model

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Healthy

ReactingInjured

Ill

WHAT CAN BE DONE FOR SELF-CARE?

41

• Focus on tasks at hand• Break work into

manageable chunks• Nurture a support

system• Use deep, controlled

breathing

• Recognize limits, take breaks

• Rest, eat properly, take breaks as needed

• Identify and resolve problems

• Reduce barriers to help seeking

• Talk to someone, ask forhelp

• Pay attention to your ownsigns of distress

• Make self care a priority• Identify and resolve problems early• Maintain social connections

• Ask for help• Follow care plan• Take steps to stay active,

eat healthy and regain physical and mental health

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What it is not What it is

• Diagnosis or treatment of health concerns (mental or physical)

• Counselling/Therapy• Employee personal life concerns

(marital issues, change in family make-up, childcare, financial concerns, legal challenges)

• Creating a Safe and Healthy Work Environment (physically and mentally)

• Accommodation following direction from health professional

• Coaching• Providing Information• Sharing Resources• Work concerns (interpersonal conflicts,

ergo, workload, organizational change, attendance, harassment, violence, etc)

WHAT IS THE SUPERVISORS ROLE?

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• W o r k -r e l a t e d c h r o n i c m e n t a l s t r e s s i s a m e n t a l d i s o r d e r t h a t h a s b e e n p r e d o m i n a n t l y c a u s e d b y a s u b s t a n t i a l (e x c e s s i v e i n i n t e n s i t y a n d /o r d u r a t i o n ) w o r k -r e l a t e d s t r e s s o r o r s e r i e s o f s t r e s s o r s .

CHRONIC MENTAL STRESS

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• W o r k -r e l a t e d t r a u m a t i c m e n t a l s t r e s s i s a n i n j u r y c a u s e d b y o n e o r m o r e t r a u m a t i c e v e n t s a r i s i n g o u t o f a n d i n t h e c o u r s e o f t h e w o r k e r ’s e m p l o y m e n t .

• A t r a u m a t i c e v e n t m a y b e a r e s u l t o f a c r i m i n a l a c t , a h o r r i f i c a c c i d e n t , a n d m a y i n v o l v e a c t u a l o r t h r e a t e n e d d e a t h o r s e r i o u s h a r m a g a i n s t t h e w o r k e r, a c o -w o r k e r, a w o r k e r ’s f a m i l y m e m b e r, o r o t h e r s .

TRAUMATIC MENTAL STRESS

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• P o s t T r a u m a t i c S t r e s s D i s o r d e r (P T S D ) i s a m e n t a l h e a l t h c o n d i t i o n c a u s e d b y w i t n e s s i n g o r e x p e r i e n c i n g a c t u a l o r t h r e a t e n e d d e a t h , s e r i o u s i n j u r y o r v i o l e n c e

• P T S D i s d i a g n o s e d u s i n g t h e D i a g n o s t i c a n d S t a t i s t i c a l M a n u a l o f M e n t a l D i s o r d e r s (D S M -5 ) w h i c h l o o k s a t a s p e c i f i c s e t o f c r i t e r i a

POST TRAUMATIC STRESS DISORDER

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June-26-19

SECTION 3: FACILITATING STAY AT WORK

Important factors that improve on inhibit a persons ability to stay at work, or return to work

Understanding the impact of stigma

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• E s t a b l i s h p o l i c i e s a n d g o o d l e a d e r s h i p p r a c t i c e s• B e a w a r e a s a s u p e r v i s o r i n c h a n g e s i n e m p l o y e e

b e h a v i o u r s a n d u n d e r s t a n d i n g t h e a v a i l a b l e m e n t a l h e a l t h s u p p o r t s , s h a r i n g r e s o u r c e s a n d p o i n t i n g o u t a v a i l a b l e s u p p o r t s

• D o n ’t e n g a g e i n s t i g m a s u p p o r t i n g c o n v e r s a t i o n s a n d a d d r e s s t h e s e b e h a v i o u r s i n o t h e r s

• P r o m o t e o f w o r k l i f e b a l a n c e• B r i n g m e n t a l a n d p h y s i c a l h e a l t h a n d w e l l b e i n g i n t o t e a m

m e e t i n g c o n v e r s a t i o n s

THINGS YOU CAN DO AS A SUPERVISOR TO REDUCE STIGMA IN THE WORKPLACE

47http://hrprofessionalnow.ca/health-and-safety/140-healthy-minds-reducing-stigma-in-the-workplace

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• L a n g u a g e M a t t e r s• E d u c a t e Y o u r s e l f • B e K i n d• L i s t e n a n d A s k • T a l k a b o u t i t

5 STEPS TO ELIMINATE STIGMA – DR. HEATHER STUART

http://letstalk.bell.ca/en/news/135/bell-lets-talk-the-5-simple-ways-to-help-fight-the-stigma-around-mental-illness

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June-26-19

In this section you cover components included in disability management, including prevention and return to work. You will also be able to describe the impact of triggers in the workplace how to incorporate exposure to them into the return to work process.

UNDERSTANDING DISABILITY MANAGEMENT AND POINTS OF PREVENTION

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1. Commitment to Health and Safety

• Strong commitment to health and safety, which is demonstrated by the behaviors of the workplace parties

2. Offer of Modified Work

• The employer makes an offer of modified work to injured/ill workers so they can return early and safely

3. Plan Supports Returning Worker & Co-Worker

• RTW planners ensure that the plan supports the returning worker without disadvantaging co-workers if possible

SEVEN PRINCIPLES FOR RETURN TO WORK

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4. Supervisors Receive Training on RTW

•Supervisors are trained in disability prevention and included in RTW planning

5. Early and Considerate Contact

•Early and considerate contact with injured/ill workers

6. Clear Responsibilities for RTW

•Assigned responsibilities in coordination of RTW

7. Ongoing Communication

•Communication between employer, health-care provider, employee, and supervisors about workplace demands and appropriate accommodations

SEVEN PRINCIPLES FOR RETURN TO WORK

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M o d i f i e d w o r k p r o g r e s s i v e l y m o v i n g t o w a r d s r e s t o r a t i o n t o t h e o l d p o s i t i o n (a s m u c h a s p o s s i b l e , p r i o r i t i z i n g s a f e t y ). E x a m p l e s :

D e s k w o r k S h o r t e r s h i f t s

Incorporating exposure into return to work program W i t h r e p e a t e d e x p o s u r e s , s e v e r i t y a n d d u r a t i o n o f

a n x i e t y d e c r e a s e s

WHAT SHOULD BE UNIQUE ABOUT FIRST RESPONDERS’ RETURN TO WORK PROGRAM

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• “ T r i g g e r ” – a s t i m u l u s t h a t a c t i v a t e s t h e f i g h t -o r -f l i g h t r e s p o n s e b e c a u s e i t r e m i n d s o n e o f s o m e t h i n g t r a u m a t i c a n d /o r a n x i e t y -p r o v o k i n g .

• T h e r e w i l l b e m a n y t r i g g e r s i n t h e w o r k p l a c e t h a t o t h e r s m a y n o t s e e a s r e l a t e d t o t r a u m a , e v e n i f t h e r e t u r n i n g e m p l o y e e w o r k e d w i t h t h o s e t h i n g s f o r m a n y y e a r s .

S o m e e x a m p l e s a r e : u n i f o r m s , s q u a d c a r s /a m b u l a n c e /f i r e t r u c k s , s i r e n s /t o n e s , f l a s h i n g l i g h t s , h e a r i n g d i s p a t c h c a l l s , h e a r i n g o r r e a d i n g d e t a i l s o f t r a u m a t i c c a l l s

INCORPORATING EXPOSURE INTO RETURN TO WORK PROGRAM

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E m p l o y e r s h a v e a d u t y t o a c c o m m o d a t e e m p l o y e e s w i t h d i s a b i l i t i e s (r e c a l l d e f i n i t i o n ) u p t o t h e p o i n t o f u n d u e h a r d s h i p

ONTARIO HUMAN RIGHTS CODE

Determine if the employee can

perform his/her original job

Determine if the employee can

perform the job in a modified form

Explore other jobs in their existing form that the

employee may be capable of performing

Explore whether the employee can

do another jobwith modifications

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• P h y s i c a l o r m e n t a l h e a l t h i n f o r m a t i o n , i n c l u d i n g h e a l t h h i s t o r y o f t h e i n d i v i d u a l ’s f a m i l y

• T h e i d e n t i f i c a t i o n o f t h e p r o v i d e r o f h e a l t h c a r e t o t h e i n d i v i d u a l

• A p l a n o f s e r v i c e w i t h i n t h e m e a n i n g o f t h e L o n g -T e r m C a r e A c t , • P a y m e n t s o r e l i g i b i l i t y f o r h e a l t h c a r e , o r f o r c o v e r a g e • T h e d o n a t i o n o f a n y b o d y p a r t o r b o d i l y s u b s t a n c e o f t h e

i n d i v i d u a l , o r t h a t d e r i v e d f r o m t h e t e s t i n g o r e x a m i n a t i o n • T h e i n d i v i d u a l ’s h e a l t h n u m b e r a n d s u b s t i t u t e d e c i s i o n -m a k e r

WHAT IS PERSONAL HEALTH INFORMATION

55

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Accommodations

• D u t y t o a c c o m m o d a t e t o t h e p o i n t o f u n d u e h a r d s h i p

• Q u e s t i o n s w h e n a c c o m m o d a t i n g W h a t i s w o r k e r e x p e r i e n c i n g a n d w h a t a r e

l i m i t a t i o n s ? D o l i m i t a t i o n s i m p a c t w o r k t a s k s ? W h a t a c c o m m o d a t i o n s c a n a d d r e s s

l i m i t a t i o n s ?

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