Vilko-Goldfarb Medical Group

NYBGH Newsletter article by Naomi Vilko, MD
Moving Past Trauma: Coping with the Aftermath of 9-11 in the Workplace

We have not yet recovered from the tragedy of 9-11. It is estimated that as many as 40,000 survivors, eyewitnesses, family members of those killed, and emergency workers will suffer from post-traumatic stress disorder and/or alcoholism, depression and anxiety disorders as a result of the attacks. Getting psychiatric treatment for employees are not only the right thing to do, but is good business. The wall street Journal estimated that untreated depression cost industry $70 billion last year. Post-traumatic stress disorder results in an annual productivity loss of $3 billion. One in 5 Americans experiences a mental disorder every year. Mental illness is the second leading cause of disability. Depression and PTSD result in healthcare costs that are at least double that of other employees. These costs can be reduced with early intervention and easy access to quality psychiatric care.

Since 9-11 have your employees had increased absenteeism, reduced productivity, increasing medical costs, more workplace accidents, increasing use of alcohol and nicotine? Have your employees been depressed, angry, irritable, and tired? There is data from Oklahoma bombing, Vietnam and the Holocaust which shows that trauma adversely affects victims ability to be productive in the workplace. What are the signs that an employee needs psychiatric attention?

Stress sets off a cascade of hormonal disturbances that are commonly referred to as the ?fight or Flight? response. People who have been repeatedly traumatized or who have experienced extreme trauma often stay in a prolonged state of hyper-arousal called post-traumatic stress disorder or PTSD. An employee would be irritable, have an exaggerated startle response, lose interest in his work, be unable to concentrate, would try to avoid reminders of the trauma, and would look anxious or depressed. People with PTSD also have physical complaints such as stomach and intestinal problems, headaches, back pain, and insomnia.

Employees who suffer from PTSD often are also depressed and anxious. Fifty percent of these employees also suffer from Alcoholism and Substance Abuse, which are also very costly to industry. Stress adversely affects our cardiovascular system causing heart attacks, strokes and increased blood pressure. People who suffer from Depression and PTSD often have exacerbations of other medical illnesses, since stress decreases the effectiveness of our immune systems.

Psychiatric disorders are nor difficult to diagnose or treat. Like other medical disorders, early intervention leads to early recovery. PTSD, Depression, Anxiety Disorders and Alcoholism all have treatment protocols. They include the combination of medication and psychotherapy. The medications used for these conditions are among the safest and most effective pharmaceutical agents in medicine. However, studies have shown that few patients are diagnosed, and of those treated, few are treated properly. Those employees who are able to exercise, remain socially active, and who are connected to community resources recover more quickly from the aftermath of trauma. Wellness programs have been helpful.

There is still a stigma associated with psychiatric illness. Many employees resist getting treatment because they think that it is a sign of weakness. Many employers don?t know that effective treatment exists for the most common psychological consequences of 9-11..

What can employers do? Educational programs that link employees to mental health treatment have been studied and have been shown to be effective. Managers can be trained to recognize the early signs of trouble and to refer employees to EAPs, psychiatrists, or their managed care providers. There are psychiatrists who provide education, evaluation, and confidential treatment for employers. Unfortunately the ?Domenci-Wellstone Amendment to the Mental Health Act?, proposed to provide more parity in health coverage, died in Congress. However, industry may not need this mandate. It costs industry $113 billion annually in lost productivity, paid disability, medical bills, and early death to ignore mental illness and substance abuse in the workplace. In these difficult economic times, we cannot afford not to treat the victims of 9-11. Let us use the crisis that we are in to do the right thing for our employees and ourselves. We can provide employees with the quality psychiatric care that they deserve. It is good business.