Trauma and stress: Supporting workers' families

Author: Jo Faragher

We explore the potential impact of workers' exposure to traumatic events and other stressful environments on their families and look at some of the measures that employers can take to support those families.

Introduction

What amounts to a "stressful day at work" will vary hugely depending on the sector in which an employee works. There is no doubt that certain situations have the potential to take a tough mental toll on employees.

An extreme example would be firefighters' exposure to the horrifying scenes at the Grenfell fire in 2017. However, many other workers face challenging situations every day, including police officers and other emergency services workers having to deal with traumatic events, City workers under pressure to work long hours and deliver results, and employees in the service sector facing abuse from the public.

The impact of this exposure can extend to their families, with poor sleep patterns or "bringing work home" causing arguments or guilt. What support can employers offer to ensure that workers and their families are protected?

"After some form of traumatic, shocking or stressful event, most people will feel shocked, numb, and unable to accept what has happened. People react differently and take different amounts of time to come to terms with things. It's common to have feelings of fear, helplessness, shame, anger, guilt," explains Christine Husbands, managing director of corporate wellbeing company RedArc.

"All of the above symptoms will naturally impact the mood and ability of an individual to relate normally to their family. Coupled with long hours at work and no one to offload to, this can often mean that family relationships become strained and add to the difficulties."

Difficult challenges at work tend to fall into two camps: external pressures from exposure to traumatic situations (for example serious accidents, violent crime, injury and abuse) and internal pressures such as deadlines, unsocial hours and having to deal with intense public scrutiny.

Impact of trauma

An extreme potential impact on employees exposed to traumatic situations is post-traumatic stress disorder (PTSD), which can develop immediately after the traumatic event or months or years after it.

Other outcomes from stressful situations might include increased sickness absence due to anxiety and/or depression and poor sleep quality leading to reduced performance at work and irritability with colleagues and family.

Employees might also experience flashbacks, vivid memories and recurring bad dreams, and may choose to "self-medicate" with alcohol or drugs, which in turn can have an impact on the family.

Birgit Lundgren, head of clinical services at employee assistance provider Validium, says it is important to note that the definition of trauma will be different for both the role and the individual.

"Is it a train driver seeing someone on the track? An armed robbery in a bank? An IT issue where people in the call centre get abuse from customers? Or where the IT person has to work long hours for days to work out why there was a security breach? This in itself will lead to unsocial hours," Lundgren says.

"The family may not see someone for days or weeks because they're dealing with an incident. Or there could be an unexpected death at a hospital and someone has to deal with an investigation or press scrutiny."

Workers may not feel that those who have not been close to the trauma, or experienced the stress, will understand. Emergency services workers such as firefighters and police officers will typically have rehearsed how to react in those situations, adds Lundgren: "The people closest to the trauma may have practised reactions, but the family are one step away and have not. They may then get angry at the workplace."

Some symptoms of exposure to trauma will be most prevalent in those who work in emergency services such as the police, ambulance, fire, and search and rescue services. Research from mental health charity Mind has shown that more than one person in four (27%) had contemplated taking their own lives due to stress and poor mental health while working for the emergency services.

Support for families

In 2017, the Home Office announced that it was investing £7.5 million in a new national police welfare service, which it is due to launch later this year. There is recognition that, while the mental wellbeing of officers and other police staff is of central importance, extending support to their families is important in their engagement at work and rehabilitation after traumatic events.

Chief constable Andy Rhodes, who leads Oscar Kilo, an organisation set up to deliver wellbeing support in the police, says family outreach will be an area of focus as the national wellbeing service is rolled out. "This is a really important issue and the response to which is one that we have found varies around the country," he says.

"We will continue to signpost to charities and staff associations who are already providing some excellent support for families but there is work for us to do to ensure that we can embed a nationally consistent approach to this, to support our people from recruitment to retirement and beyond."

One of the common issues where families may feel unsupported is in knowing how they should react themselves to traumatic events. This is where it can be helpful to signpost family members to useful mental health and wellbeing resources.

Mental health charity Mind runs the Blue Light Programme for emergency services staff and volunteers, and has produced a series of booklets that detail how friends and family can help. It is also worth police employers and family members contacting charities such as the Police Dependants' Trust.

The Police Federation runs a welfare support programme, which is accessible to police officers' immediate family members, partners and dependants and any person living in the same household with a police officer.

Extending EAPs

For employers that run employee assistance programmes (EAPs), one option is to extend access to families or those close to affected workers. Chieu Cao, co-founder of employee engagement company Perkbox, says doing this provides another avenue to support employees' wellbeing.

"Left untreated, family problems can impact your employees leading to poor performance, absenteeism and workplace injuries that cost you money in terms of support and compensation," Cao says. "Our responsibility towards employees shouldn't end in the workplace. We should be looking to cater for their entire employee experience."

This approach could also apply to employee benefits such as income protection and critical illness cover. While these products may be associated with financial support for employees and their families after a life changing accident or medical diagnosis, they can also provide mental health support to workers and their families.

Katharine Moxham, a spokesperson for GRiD, an organisation that raises awareness of group risk protection, explains that mental health support could include critical incident support, wellbeing drop-in days, bereavement counselling, medical services and online resources. "Support can also be extended to family members but not all providers offer the same benefits, so it's always a good idea for employers to talk to their advisers about the additional benefits that can be attached to the products," Moxham says.

"Although not all the support an employer makes available in this way is extended directly to families, a well-supported employee is better able to support their family and less distracted at work if they are empowered to make things better at home though the help that they, themselves receive."

Impact on home life

While trauma is often imagined as exposure to a horrific event, high stress can also have an impact on employees within the confines of their own workplace, through unsocial hours, high levels of scrutiny from managers, or having to make difficult decisions on a near constant basis.

A 2012 survey by Unison found that, in call centres, 38% of respondents had experienced aches and pains at their desk sometimes and 23% often, and 16% were never able to take breaks from work when needed.

Shift working can also be difficult to cope with: therapist Sally Baker argues that any point where individuals are working before 8am in the morning and after 7pm can impact family life. "When a partner works long hours, the burden of parenting falls to the person at home," she says.

"They feel like single parents, unsupported and under pressure. They can become demoralised and depressed. The person working the long hours, meanwhile, may be really stressed and hypercritical when they come home, because it's hard for them to shrug off the working day. They come in and 'delegate' or lay down the law to their family."

Employers can overcome this by helping workers find ways to separate their home and work personas and create clearer boundaries between work and family life, adds Baker. However, technology frequently blurs those boundaries. Those in high-stress roles or where there are expectations of long hours often feel like they must be seen to be "always-on".

A spokesperson for the City Mental Health Alliance, which supports employees in London's financial centre, says: "The connected world of work has an effect on almost every aspect of life, but a healthy work-life balance is key to a mentally well culture."

Many of the organisation's members try to redress that balance by ensuring they respect annual leave entitlements, and not contacting employees on holiday so they can return to work well rested and mentally focused.

Flexible approach

It is also important to recognise both for managers and families that work can be a form of therapy in itself.

"For some people work can be an important coping mechanism. It brings routine when their life might feel like it's in disarray," explains Dr Amy Armstrong from Ashridge at Hult International Business School. She says this is where having flexible policies can help.

"Policies can be rigid and people may feel backed into a corner. Should they go onto sickness pay for a fixed amount of time or take compassionate leave? If someone has been bereaved, there may be no physical signs but it doesn't mean the worker is not suffering psychologically. There needs to be an acknowledgement that they may not perform to the same level for weeks or months."

Management training rarely covers issues such as handling traumatic situations or breaking difficult news, Armstrong adds, so in certain industries this may be worth considering.

Establishing a way for employees to be heard at work can also prevent trauma or stress bleeding into their family life. "On the one hand, employees' ability to contain their emotion will be affected so they may be snappy at home," adds Lundgren from Validium. "Or they might want to avoid discussing [stressful events] with their family altogether, and the place where they should feel most safe they feel most vulnerable."

In the NHS, many trusts employ a mechanism called Schwartzrounds, a forum for nurses and other medical staff to talk about a traumatic event such as an unexpected patient death.

For other employers, providing similar help could be as simple as managers taking a greater interest in employees' home life so they can spot when stress is beginning to have a detrimental impact. However, not all employees feel comfortable with questions about home life, says Dr Armstrong. "We don't know staff intimately enough - talking about this requires a degree of trust and psychological safety."

Armstrong suggests that one strategy could be to use team meetings to table one item of conversation that is non-work related, where people can talk about what's going on with them personally. This normalises talking about "our whole selves" at work.

There is a growing recognition that employees who are experiencing problems at home are unlikely to be able to give their best at work. Whether through opening up existing support mechanisms or building specific initiatives for relatives and loved ones, employers can help to reduce the likelihood of workplace stressors having an impact on employees' families, with the knock-on benefit of employees' enhanced morale and productivity.