PTSD at Work: How to Support with PTSD in the Workplace
KEY POINTS
PTSD can deeply affect employees’ well-being and performance at work.
Both pre-existing and work-related trauma require understanding and structured support.
Training, adjustments, and open communication help create safer, more resilient workplaces.
*article revised by Konstantin von Vietinghoff-Scheel, Founder and Managing Director of CCS
Post-Traumatic stress disorder (PTSD) is a mental health condition that can significantly affect individuals and their ability to function in everyday settings, including the workplace.
Through this article, we aim to emphasise how important it is for employers to have a comprehensive understanding of PTSD in the workplace. This knowledge enables them to support their staff effectively in times of need. Being informed about mental health challenges fosters a more engaged and prepared workplace, benefiting both employees and the organisation as a whole. We also aim to understand how you can support employees from work related PTSD and pre-existing PTSD.
What is PTSD?
Post-Traumatic Stress Disorder (PTSD) is a mental health condition triggered by experiencing or witnessing a traumatic event. Such events might include natural disasters, serious accidents, terrorist acts, war/combat, rape, or other violent personal assaults.
PTSD was first formally recognised in 1980 when it was included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) by the American Psychiatric Association. However, the condition has been known by various names for much longer. During World War I, it was called "shell shock," and during World War II, it was referred to as "combat fatigue." Over time, the understanding of PTSD has evolved, acknowledging thatit can affect anyone, not just combat veterans. This evolution in understanding has broadened the criteria for diagnosis and improved the methods for treatment.
PTSD is a complex mental health struggle that involves a range of symptoms. These symptoms can be severe and debilitating, including flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the event. They can affect every aspect of a person's life, from their ability to work to their relationships with others. PTSD is not just a response to a single traumatic event; it can also result from prolonged exposure to stressful situations, such as long-term abuse, warfare or chronic illness.
Getting diagnosed with PTSD is the first step toward effective treatment and management. Early intervention can significantly improve outcomes, making it essential for individuals experiencing symptoms to seek professional help. Through a combination of psychotherapy, medication, and support from family, friends and workplaces, many people with PTSD can manage their symptoms and lead fulfilling lives.
For a person to be diagnosed with PTSD, they must be seen by a trained mental health professional, such as a psychologist, psychiatrist, or clinical social worker. The diagnostic process typically involves a comprehensive evaluation that includes a discussion of the person's symptoms, medical history, and any relevant traumatic events. This assessment is guided by criteria set forth in the DSM-5 (the latest edition of the Diagnostic and Statistical Manual of Mental Disorders). These criteria include the presence of certain symptoms such as re-experiencing the traumatic event, avoidance of reminders of the trauma, negative changes in thoughts and mood and heightened reactivity.
According to the National Institute of Mental Health (NIMH), PTSD affects approximately 3.5% of U.S. adults every year, with an estimated 1 in 11 people diagnosed in their lifetime. In Europe, PTSD prevalence varies across countries, but studies indicate that it affects around 1-2% of the general population annually. For instance, two comprehensive studies on mental health in Europe from 2008 and 2009 found that PTSD affects approximately 1.1% of adults in Germany and around 2.9% of adults in the UK over their lifetimes. [1,2] However, these numbers could be different nowadays due to changes in societal awareness and access to mental health diagnosis and treatment. Increased understanding of PTSD, along with improved diagnostic tools and greater accessibility to mental health services, may result in higher reported prevalence rates as more individuals seek and receive appropriate care.
PTSD vs. PTS
Post-Traumatic Stress (PTS) and Post-Traumatic Stress Disorder (PTSD) are often confused, but they are distinct conditions. PTS is a common, often short-term response to experiencing or witnessing traumatic events. Symptoms of PTS can include irritability, difficulty concentrating and sleep disturbances. These symptoms typically resolve over time without requiring clinical intervention.
PTSD, on the other hand, involves more severe symptoms that persist for months or even years and require professional treatment. The key difference lies in the duration and intensity of symptoms, as well as the degree to which these symptoms interfere with an individual's ability to carry out daily activities.
Given the serious nature of PTSD, it is crucial for individuals experiencing symptoms to seek professional help rather than relying on information found on the internet. Consulting a mental health specialist is essential for an accurate diagnosis and appropriate treatment. Self-diagnosing or ignoring symptoms can lead to worsening conditions and can hinder effective recovery. Mental health professionals, such as psychologists, psychiatrists, and licensed counselors, are trained to distinguish between PTS and PTSD and can provide the necessary support and interventions to facilitate healing and improve quality of life.
PTSD from work
PTSD in the workplace can be categorised into two primary scenarios: employees who suffer from PTSD and need support at work and employees who develop PTSD as a result of workplace incidents.
Employees with pre-existing PTSD
Employees may enter the workplace already dealing with PTSD from unrelated events. These individuals might struggle with triggers within the work environment that exacerbate their symptoms, such as loud noises, confrontational situations, or even specific tasks that remind them of their trauma. Triggers can vary widely and may not always be immediately obvious, making it crucial for employers and colleagues to foster an understanding and supportive atmosphere.
Recent research highlights the growing prevalence of PTSD among younger individuals, particularly college students. Diagnoses among college students more than doubled between 2017 and 2022, with rates rising from 3.4 percent to 7.5 percent. This increase was most pronounced during the COVID-19 pandemic, which significantly disrupted the lives of young adults. The study, which analysed responses from over 390,000 participants in the Healthy Minds Study, underscores the need for workplaces to be particularly attentive to the mental health needs of younger employees who might be entering the workforce with pre-existing PTSD.
For these employees, the workplace can be a source of additional stress. Symptoms such as heightened anxiety, flashbacks, or panic attacks can be provoked by seemingly benign events. This not only affects the employee’s productivity and job performance but can also impact their overall well-being and interpersonal relationships within the workplace. For veterans returning to work, the challenges of navigating the workplace with PTSD can be particularly daunting. These individuals may already be grappling with PTSD symptoms stemming from their time in service.
It's essential for employers to recognise that employees with pre-existing PTSD may require specific accommodation to thrive in their roles. This can include providing a quiet workspace, allowing for flexible work hours, or offering additional support through Employee Assistance Programs (EAPs). Open communication and a non-judgmental approach are key in identifying and mitigating potential triggers. Moreover, awareness and education about PTSD within the workplace can help colleagues better understand and support their peers who might be struggling.
Work related PTSD
Work related PTSD is a significant concern that employers must address to ensure the well-being of their employees. These incidents can encompass a range of traumatic events, from accidents and violence to harassment or the persistent strain of a toxic work environment. The aftermath of such experiences can leave a lasting impact on individuals, manifesting as work related PTSD symptoms that interfere with their ability to function both professionally and personally.
Research underscores the heightened risk of PTSD in the workplace among certain professions where exposure to traumatic events is an inherent part of the job. First responders, including police officers, firefighters and paramedics, often confront harrowing scenes of accidents, disasters, and violence. According to the University of Cambridge, almost 1 in 5 police officers and staff suffer from PTSD or complex PTSD. Moreover, it is believed that two-thirds of those dealing with symptoms are unaware.
Healthcare workers, particularly those in emergency rooms or critical care units, frequently witness human suffering and trauma. Studies conducted by Hernandez Bojorge and his team analyzed a cohort of over 40,000 nurses across 55 research projects spanning 26 nations. Their findings revealed that approximately 29% of these nurses experienced symptoms of work related PTSD during the peak period of the COVID-19 pandemic, spanning from 2020 to 2023.
Similarly, military personnel endure intense combat situations and the stress of deployment, which can leave lasting psychological scars. According to a study from 2018, PTSD ranges from 11% to 30% among veterans. [3]
Employers must recognise the unique challenges faced by employees in high-risk professions and take proactive measures to support their mental health. This includes implementing trauma-informed policies and practices such as Critical Incident Management (CIM), which provides structured frameworks for responding to and supporting employees after traumatic events in the workplace.
Providing access to counseling and support services is also essential for employees who have experienced workplace-induced PTSD. By offering confidential counseling sessions, peer support groups, and resources for coping with trauma, employers can help individuals navigate their symptoms. By addressing the root causes of workplace-induced PTSD and offering comprehensive support to affected employees, not only helps mitigate the impact of PTSD but also empowers employees to respond appropriately to negative factors, reducing the overall risk of trauma and enhancing workplace resilience.
PTSD symptoms to look for
Identifying PTSD symptoms in employees is crucial for providing timely support. Employers should be aware of the following signs:
- Withdrawal from social interactions or self-isolation
- Experiencing depression, feelings of hopelessness, or despair
- Difficulty concentrating or lack of focus
- Engaging in avoidance behaviors
- Hypervigilance and heightened reactivity
- Apathy or emotional numbness
- Anxiety or experiencing panic attacks
- Persistent exhaustion or fatigue
- Developing cynicism, detachment, or a sense of purposelessness
- Fluctuating moods or mood swings
- Feelings of self-blame or self-hatred
- Engaging in substance use or misuse
- Physical complaints or health issues
How to support employees with PTSD in the workplace
Supporting employees with PTSD involves creating an inclusive and understanding work environment. Employers have a duty to ensure the well-being of their employees, which extends beyond just their physical health to include their mental and emotional health as well. This responsibility is not only a moral imperative but also a legal one in many jurisdictions, where workplace health and safety regulations mandate employers to provide a safe and supportive work environment.
Employers must recognise that PTSD can significantly impact an employee’s ability to perform their job and interact with colleagues. Therefore, it is essential to foster a workplace culture that values psychological safety and encourages open dialogue about mental health issues without fear of stigma or discrimination. This includes being vigilant and responsive to the needs of employees who may be struggling and ensuring that policies and procedures are in place to address these challenges.
Here are key strategies for providing this support:
1. Provide Training to HR
HR personnel should receive training to recognise and respond to PTSD symptoms appropriately. This training should include understanding the nature of PTSD, identifying symptoms, and learning how to approach affected employees with empathy and confidentiality. Providing HR with the right tools and knowledge can help them support employees more effectively. To facilitate this, we offer on-demand corporate training and webinars on a variety of topics such as mental and workplace health.
2. Make adjustments
Reasonable adjustments to the workplace can significantly aid employees with PTSD. These adjustments might include flexible work hours, allowing remote work, providing a quiet workspace or accepting that employees are accompanied by a service animal. Small changes can create a more accommodating environment that helps reduce stress for affected employees. Additionally, it is crucial to listen to what affected employees have to say. By engaging in open and empathetic conversations, employers can better understand the specific needs and challenges of their employees, allowing for tailored adjustments that truly support their well-being. This collaborative approach not only empowers employees but also fosters a more inclusive and supportive workplace culture.
3. Offer regular psychosocial assessments
Regular psychosocial assessments can help monitor the mental health of employees, identify early signs of PTSD, and provide necessary interventions. These assessments can be part of routine health check-ups or offered through wellness programs. Regular monitoring helps in taking timely actions to support mental well-being. Incorporating Psycho-Social Risk Assessments (PSRA) can further enhance this process. PSRA has over 100 items of analysis and involves systematically evaluating potential psychosocial hazards in the workplace. By identifying these risks early, employers can implement strategies to mitigate them, thus fostering a healthier work environment and preventing the escalation of mental health issues like PTSD.
4. Offer support through EAP services
Employee Assistance Programs (EAPs) are a valuable resource for employees dealing with PTSD. These programs provide confidential counseling services, mental health resources, and support for personal issues that might affect work performance. When dealing with workplace trauma, EAPs are a good starting point in providing support for those experiencing post-traumatic stress from work-related incidents. By actively promoting EAP services and ensuring that employees are aware of how to access them, organisations can create a supportive environment where employees feel empowered to seek help when needed. This not only fosters employee well-being but also contributes to a healthier and more resilient workforce.
In conclusion, understanding and addressing PTSD in the workplace is not only a matter of compassion but also a necessity for fostering a healthy, productive work environment. By recognising the symptoms, causes, and impacts of PTSD, employers can take proactive steps to support affected employees and mitigate the risk of workplace-induced trauma. From providing education and training to implementing trauma-informed policies and support services, organisations have a crucial role to play in creating a workplace where individuals feel safe, valued, and able to thrive. By prioritising the mental health and well-being of their employees, employers not only fulfill their legal obligations but also contribute to a culture of empathy, resilience, and inclusivity in the workplace. Together, by raising awareness, offering support, and fostering understanding, we can create workplaces where individuals affected by PTSD feel supported, empowered, and able to reach their full potential.
FAQs about PTSD from work
What does PTSD look like in the workplace?
Work related PTSD can manifest differently in the workplace depending on the individual and their specific experiences. However, some common signs and behaviours may indicate that an employee is struggling with PTSD from work:
Difficulty concentrating: Employees may find it challenging to focus on tasks or maintain attention to detail due to intrusive thoughts or memories related to their trauma.
Increased anxiety: Individuals with PTSD may exhibit heightened levels of anxiety, especially in response to triggers or reminders of their trauma. This can manifest as nervousness, restlessness, or panic attacks.
Avoidance behaviours: Employees may actively avoid certain tasks, situations, or people that remind them of their traumatic experiences. This avoidance can hinder productivity and limit their ability to fully engage in their work responsibilities.
Irritability or aggression: Work related PTSD can lead to irritability, mood swings, or outbursts of anger, which can negatively impact workplace relationships and collaboration.
Physical symptoms: Some individuals with PTSD may experience physical symptoms such as headaches, nausea, or fatigue, which can affect their ability to perform job tasks effectively.
Withdrawal: Employees may withdraw socially, isolating themselves from colleagues and avoiding interactions in the workplace. This isolation can further exacerbate feelings of loneliness and disconnection.
Decreased productivity: PTSD symptoms may impair an employee’s ability to meet deadlines, complete tasks efficiently, or contribute effectively to team projects.
Emotional distress: Employees with PTSD may display signs of emotional distress, such as frequent crying, mood swings, or expressions of hopelessness or despair.
What happens when PTSD is triggered at work?
When PTSD is triggered at work, an employee may experience intense symptoms such as flashbacks, panic attacks, or severe anxiety. This can lead to decreased productivity, increased absenteeism, and strained relationships with colleagues. Employers should be prepared to provide immediate support and adjustments to help the employee manage these episodes.
Can you be signed off work with PTSD?
Yes, employees can be signed off work with PTSD. If an employee's PTSD symptoms are severe and impair their ability to perform their job, a healthcare provider can recommend taking time off to focus on treatment and recovery. Employers should support this process by providing the necessary accommodations and ensuring a smooth transition back to work when the employee is ready.
References
- Maercker, A., et al. (2008). “Prevalence of traumatic events and post-traumatic stress symptoms in the community: An epidemiological survey in Germany.” Journal of Clinical Psychiatry, 69(3), 472-478.
- McManus, S., et al. (2009). “Adult psychiatric morbidity in England, 2007: Results of a household survey.” Leeds: The NHS Information Centre for health and social care.
- Kintzle, S., Barr, N., Corletto, G., & Castro, C. A. (2018). PTSD in U.S. Veterans: The Role of Social Connectedness, Combat Experience and Discharge. Healthcare (Basel, Switzerland), 6(3), 102. https://doi.org/10.3390/healthcare6030102