Post-traumatic stress disorder in occupational settings: anticipating and managing the risk.
BACKGROUND
Post-traumatic stress disorder has had a substantial impact on employer liability for workplace psychological injury. The emergency services are an example of high-risk workforces that demand clear policies and procedures within an organization. The challenge is to minimize the injury to individuals and lessen the cost to organizations through the optimal application of preventative strategies.


METHODS
This field is not well represented in standard keyword searches and Medline was examined with linked fields of practice and research. Consensus guidelines that refer to this domain were also utilized. Few conclusions can be reached from the literature which directly examined occupational settings.


RESULTS
Organizations need to anticipate the possible traumatic exposures that may affect the workforce and have strategies to deal with the effects in the workplace, particularly the negative mental health outcomes in some personnel. This domain is relevant to all employers as accidents and violence are possible in most workplaces. Screening should be considered for high-risk individuals, particularly following a major traumatic event or cumulative exposure, such as in the emergency services. While psychological debriefing has no demonstrated benefit, the benefits of early intervention necessitate ready access to evidence-based treatments that have minimum barriers to care. Employers should be aware that distress may present indirectly in a similar way as conflict with management, poor performance and poor general health.


CONCLUSIONS
The knowledge about the impact of traumatic events obliges employers to have an active strategy to anticipate and manage the aftermath of such events as well as cumulative traumatic exposures.
McFarlane
Alexander C
AC
Centre of Military and Veterans Health, University of Adelaide, 122 Frome Street, Adelaide, South Australia 5000, Australia. alexander.mcfarlane@adelaide.edu.au
Bryant
Richard A
RA
D004632:Emergency Medical Services; D006801:Humans; D008403:Mass Screening / Q000379:methods; D009784:Occupational Diseases / Q000209:etiology / Q000517:prevention & control*; D009786:Occupational Health Services / Q000379:methods; D018570:Risk Assessment; D012308:Risk Management / Q000379:methods; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology / Q000517:prevention & control*