In a purely hypothetical case, a careless factory employee makes a mistake that results in the death of a fellow worker. Others in the same area are splashed with blood as they helplessly stand by and witness the death of their workmate.
Who in the group may suffer from post-traumatic stress disorder?Any or all of them, according to Barry M. Richards, a specialist in the field.
Richards, president of the Salt Lake-based National Institute for the Prevention of Post-Traumatic Stress Disorder, is alerting insurance claims adjusters, law enforcement officers and others to the potential for on-going psychological problems related to trauma.
The emotional effects can last long after a violent event, resulting in decreased productivity and ongoing medical costs to employers if they are not dealt with, he said. Recognizing the potential and dealing with it in a preventive mode can be cost-effective for insurers.
"We haven't been very good at addressing the emotional aftermath of trauma," said Elliott Morris, vice president of claims, Workers Compensation Fund of Utah. "We've looked primarily at physical healing and haven't adequately addressed the emotional side. These people need some tender, understanding care."
Morris and approximately 40 co-workers recently attended a training session conducted by Richards. The group included supervisors, managers, claims adjusters and staff, he said.
The agency handles about 45,000 claims a year. Of that number, about 10 percent absorb more than three-fourths of the money paid out in claims, Morris said. They usually represent the most severe injuries - the ones that may result in post-traumatic stress.
"From our standpoint, PTSD manifests itself in bizarre, strange manners," said Morris. "If it is not adequately addressed, we see people trying to prolong the physical effects. They are unwilling to return to work - literally terrified at the prospects of having to relive the accident.
"With training, we can recognize the symptoms and provide help for them. This training was long overdue."
Over the next few years, the state agency will provide help to the companies it insures to help them recognize and deal with the disorder, both for victims and witnesses, he said. The assistance will begin with the largest companies that have the most claim exposure.
Some accident victims are receiving copies of "Thriving After Surviving," a book written by Richards on the subject. It identifies symptoms that might indicate post-traumatic stress and suggests sources of help.
The workplace may feel the brunt of the disorder when hospitals fail to administer to the emotional needs of patients who have suffered serious trauma, Barry said. Often, medical attendants don't alert patients or their families to the likelihood of an emotional response that can linger after physical problems have been resolved.
In conjunction with the awarding of certificates to the Workmen's Compensation group who took Richards' training seminar, his institute will announce availability of a publication called "Management Guidelines for the Prevention of Post-Traumatic Stress Disorder Following a Workplace Accident."
The publication is a response to a 1990 directive by the federal Occupational Safety and Health Administration, which omits the post-traumatic stress issue altogether, he said.