At the 2018 PRIMA Annual Conference, Kimberly George, SVP with Sedgwick, discussed the diagnosis and treatment of post-traumatic stress disorder.
PTSD rarely stands on it’s own as a diagnosis. It is part of a larger issue around mental health. About one in five Americans will experience a significant mental health event this year. One in twenty-five people live with a significant mental health condition. There is over $193 billion in lost workforce productivity each year due to mental illness. Mental health is one of the top three reasons for disability across all spectrums and it is the top driver of pharmacy spending.
Seventy percent of adults have experienced a traumatic event in their lives. Up to twenty percent of those people will develop Post Traumatic Stress Disorder. It is estimated that in the age 18-54 population there are over 5 million people with PTSD. The prevalence of this is greater with women than men.
Leading Risk factors for PTSD:
- Physical assault (32% of victims develop PTSD)
- Serious accident with injury (17% develop PTSD)
- Witness to killing or serious injury (7% develop PTSD)
- Natural disaster (4% develop PTSD)
- Rape (49% develop PTSD)
It is normal for a person to have an adverse reaction to a severe mental trauma. This is not necessarily post-traumatic stress. A person commonly will suffer from acute stress for up to four weeks following the traumatic event. When you suspect post-traumatic stress it is important to rule out other diagnosis that may be causing symptoms including anxiety, depression or conversion disorder.
PTSD symptoms typically develop within three months of the incident, but not always that quickly. PTSD can develop years down the road because of a cumulative effect of multiple events. Something minor can happen to trigger the PTSD response.
Types of PTSD:
- Direct experience – The person directly experienced the traumatic event.
- Learned experience – A close family member or friend experiences a traumatic event that causes you anxiety.
Following a traumatic event, it is important to offer counseling to the employee. Again, it is normal to have a stress reaction following such events so the counseling can help the employee cope with the stress and move forward with little to no residual problems. Both individual counseling and group counseling have been shown to be effective. Peer groups can also be a very powerful counseling tool.
The optimal treatment will facilitate:
- The right care at the right time.
- Faster return to work.
- Increased productivity.
- Less repeat claims.
- Use of EAP services for long-term follow up counseling.
Before return to work following a traumatic event you should consider some type of fitness for duty testing. You do not want to have a first responder out in the field that is still dealing with severe anxiety issues as it could impact their job performance and put lives at risk.
Dealing with PTSD can be part of an overall culture of health and wellness in your workplace. Companies are deploying programs now to help their workforce have better resilience and coping skills. There are big opportunities to have your EAP program partner with your overall behavioral health approach. That can ensure continuity of care for patients rather than having to switch medical providers when they switch from the EAP to their other employee benefits.
Important ways to measure your mental wellness program:
- Incidence, how frequently are you experiencing these claims.
- Duration of disability
- Adequate providers/access to care
- Employee Satisfaction
A great resource on mental health issues is the National Alliance on Mental Illness: