Roles & Responsibilities

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.

Senior Leadership Roles

Senior Leadership should:

  • Understand the impact that PTSD, and other occupational stress injuries have on the organization
  • Identify what health and safety programs already exist and how a PTSD Prevention Prevention Plan & Program can be integrated into existing systems. This should consider:
    • Management Training,
    • Employee Engagement,
    • Anti-stigma Awareness,
    • Communication Strategies,
    • Civility and Respect,
    • Critical Incident Response and Management, and/or Peer Support, and
    • Employee Assistance Programs (EAP) or other benefits that support a mental health and wellness program. Provision of enhanced benefits for use of professional psychologist, or psychiatrist services with training in addressing Post Traumatic Stress Disorder
  • Train individuals in strategies for resiliency and health behaviour
  • Identify gaps that need to be addressed using an assessment.
  • Determine how the organization should monitor trauma exposures.
  • Establish policies, procedures, initiatives and services to support the plan and  program and monitor implementation.
  • Set the tone and lead by example, reducing stigma and encouraging conversations and take every reasonable precaution to protect workers.
  • Enforce the policies, procedures and program.
  • Maintain the program, evaluate it and look for opportunities to improve it.
  • Reduce stigma by participating in positive conversations.

Managers and Supervisors

Managers & Supervisors should:

  • Be involved in the workplace assessment and participate in identifying controls.
  • Participate in training to be aware and ready to address the day to day aspects of PTSD prevention and management.
  • Receive training on how to recognize signs and symptoms of PTSD and understand the causes and risk factors and understand how to support workers suffering from PTSD.
  • Participate and contribute to establishing policies, procedures, initiatives and services to support the program.
  • Provide advice on how to monitor/screen trauma exposures.
  • Identify individuals at risk of PTSD.
  • Be prepared through training, coaching or other means to engage workers in discussions about psychological health and safety.
  • Encourage active discussion with workers about mental health and psychological safety.
  • Implement processes to report concerns and provide support to workers in need.
  • Help identify control methods that support PTSD prevention such as workplace rotations for highly exposed individuals.
  • Enforce the policies, procedures and program.
  • Reduce stigma by participating in positive conversations.
Meeting

Health and Safety Committee

The organizations health and safety committee should be engaged in the development of a PTSD Prevention Program.3

To actively participate the committee should:

  • Understand the factors of the job that impact psychological health and safety, in particular PTSD. They should develop awareness about what it is, as well as the symptoms causes and risk factors.
  • Be involved in the workplace assessment.
  • Assist the organization in developing a process for identifying workplace mental health and wellbeing issues, and in particular PTSD.
  • Help identify controls that can be put in place to address psychological health and safety, in particular PTSD.
  • Help reduce stigma related to mental illness by participating in identify needs for education, training, and resources to address PTSD, and participating in delivering these to the organization.
  • Participate in training to enable support of the workforce as required.
  • Engage in the development of a communication plan and strategies.
  • Reduce stigma by participating in positive conversations.

Workers

Workers should:

  • Comply with policies, procedures and program.
  • Participate in training and education about PTSD, and resiliency.
  • Report concerns, incidents to that they can be investigated and addressed.
  • Listen to coworkers and encourage engagement in the program if needed.
  • Reduce stigma by participating in positive conversations.

Unions and Associations

Unions and Associations should:

  • Be consulted about policies and procedures.
Procedures to Support Your PTSD Prevention Program Policies

CSA Z1003.1-18 Psychological health and safety in the paramedic service organization

This Standard provides paramedic service organizations and other key stakeholders with guidance on good practice for the identification and assessment of hazards and management of psychological health and safety (PHS) risks for paramedic service organizations and the promotion of improved psychological health and safety. The Standard is an evidence-informed document that encompasses existing CSA Standards, government policy documents, peer-reviewed research articles, and non-peer-reviewed materials. The source materials are primarily from Canada, but a few from other countries have been included.

 

Download the Standard

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.

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.

PTSD Awareness Training Program

Sample Awareness Program

Peer Support Training Program

Sample Peer Support Program

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.

1. Mayo Clinic, 2016. National Institute of Mental Health, 2016.
2. National Institute of Mental Health, 2016.
3. Great West Life Centre for Mental Health in the Workplace, 2005.