Sunday, July 24, 2011


Unseen risk


The recent kidnapping, murder, and dismemberment of a young boy in one of New York's boroughs reminds me that a post-event condition oft-ignored deserves to be included in the "recovery" portion of holistic risk management plans.

That condition is mental trauma, often called "post traumatic stress syndrome."

We no longer are a people accustomed to being told to "suck it up and get on with your life."

Now we need a therapist to guide us back to an even keel. Perhaps we always did, but just didn't know it.

Whenever an event occurs at a school or involves a school's student, the therapists are called out. It's routine.

Stress, however, is not limited to students.

It can happen to any of us given the right circumstances.

  • Loss of home or loved one.

  • Loss of a place to work and fear of losing a job.

  • Job site terrorism (someone "going postal")

  • Dislocation and sometimes simply relocation.

The psyche is a fragile thing.

In order to provide therapeutic assistance to staff and close relatives following an event, there are several things that need to be in place "pre event."

  1. Therapist
    An agreement should be in place with a therapist or group of therapists to be available to personnel on a need basis (the "need" to be determined by the personnel).

  2. Where will mental health professionals meet with employees?
    Typically this will be the provider's office, but other options may be necessary.

  3. Visits
    Is there a maximum number of visits or will this be set based on the level of the event that caused the trauma?

  4. Policies and procedures
    All personnel at all levels need to know the organization's policies regarding mental health providers.

    • How will provider-patient confidentially be guaranteed.
      Will the organization be able to identify the patient?

    • Who is covered?
      Employee, spouse, people residing with the employee?

    • How will the provider be compensated?
      What will the patient be expected to pay, when can the provider expect payment from the organization if that is arranged?

    • How many visits are allowed
      Is a set number appropriate or should the number be determined by the magnitude of the event or the event's impact on the individual?

  5. What are the procedures

    • to access the providers

    • pay the providers (is this covered by employee insurance, the organization, or will the employee be expected to fund all or a portion of the costs?),
    • will the employee be required to report visits to the providers; how will this be done while protecting the employee's privacy?

Organizations must be aware of all local, state, and national laws relating to provider-patient privacy and care, as well as laws relating to releasing personnel no longer able to function in their job - is a job transfer possible, is there a union involved with its rules?

The risk management practitioner's role is not to answer any of the questions presented above, but to lead management - in conjunction with HR, Legal, and internal or external mental health practitioners, as well as union leaders if a union if involved, to review the issue of post-event trauma.

Failure to attend to event-related mental health issues before an event can result in chaos, reputation damage, and possibly legal action.

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