How to interpret Florida PTSD Law SB-376

 

 

Florida PTSD Law Kicks into High Gear

Credit is due to Florida’s Chief Financial Officer and State Fire Marshal! With the state’s new law expanding benefits to first responders who have work-related Posttraumatic Stress Disorder, Jimmy Patronis wasted no time in addressing one of the most important elements of the legislation: mental health training for employing agencies.

One provision of the legislation that took effect Oct. 1 requires those who employ affected workers to provide educational training on mental health awareness, prevention, mitigation and treatment. Patronis launched materials that can be used as a framework for the employers to develop their own programs.

The importance of this part of the law cannot be overstressed. It is critical for first responders to have access to this training to help prevent cases of PTSD. Our work with first responders in Canada over the last several decades has proven the effectiveness of this training in helping these workers return to function and work.

Background

 

Anyone who is exposed to a traumatic event will experience stress to some extent. A small percentage will develop full-fledged PTSD, which affects their occupational, social and family functioning.

First responders and other professionals who experience trauma are four to five times more likely to develop PTSD compared to the general population. When not properly addressed, the results can be tragic, as shown in a 2015 study out of Florida State University:

• Nearly half the firefighters – 46.8 percent – had thought about suicide.
• 19.2 percent had suicide plans.
• 15.5 percent had made suicide attempts.
• 16.4 percent made non-suicidal self-injuries.

Following the mass shootings of students at a Florida high school this past Valentine’s day, the legislature approved, and Gov. Rick Scott signed Senate Bill 376. It adds indemnity benefits to workers’ compensation coverage for first responders with PTSD.

Preventing PTSD

Pre-trauma training and post-trauma interventions are needed to protect these workers. What is especially gratifying about Florida’s efforts is that the materials released by Patronis include strategies for both.  

For example, the ‘pre-traumatic injury’ training states:

• Reduce or remove the stigmas associated with mental health within the service
• Provide pathways available to the employee to pursue mental health intervention
• Encourage ongoing peer support

For those exposed to a trauma, interventions include:

• Encourage ongoing peer support interventions
• Rapidly implement a mental health triage process and apply Psychological First Aid (PFA) concepts as needed
• Monitor, identify, modify, or avoid (if possible) or reduce stressors before they cause dysfunction
• Build stress coping skills within the individual

The materials correctly point out that single session debriefs after traumatic events do not prevent PTSD or reduce psychological distress and, in fact, can increase the risk. Instead, they advise PFA, which includes an assessment element to identify those workers who require more targeted interventions.

PFA involves a series of actions steps with the injured worker:

1. Contact and engagement
2. Safety and comfort
3. Stabilization
4. Information gathering of current needs and concerns
5. Practical assistance
6. Connections with social support
7. Information on coping
8. Linkage to collaborative services

For each step, there are descriptions of the goal along with recommendations for key activities and even sample questions to ask the first responder. PFA should be provided immediately after a first responder experiences a traumatic event.

Peer Counseling

Included in the Florida materials is information on Critical Stress Mitigation Elements. This is important for organizations that wish to implement peer counseling, something we strongly recommend and has been shown to be one of the most mitigating factors for PTSD Development.

Peer counseling is not a substitute for having a trained clinician, but a way to help first responders by relating to others in similar positions who have had similar experiences. PTSD creates feelings of loss of control and safety. Social interaction is necessary for recovery.

The role of the peer counselor is to help and observe colleagues who have been through traumas. A person who seems to be withdrawn and isolating himself may need assistance. The peer counselor can approach the worker and see how he can help. That may require the counselor to refer the worker to the EAP program or more professional counseling, for example.

First responders who volunteer for this typically receive several days of training on ways to support and encourage their colleagues who have been exposed to trauma. They themselves must be recovered enough from any traumas they have witnessed to be able to best support someone else.

They may work with colleagues in several ways.

• One-on-one support, such as mentoring and befriending
• Reaching out to colleagues who have recently been exposed to a traumatic event
• Participate in support groups that meet on a regular basis to provide mutual support
• Community resource and professional intervention referral
• Assistance with goal setting

Peer counseling has been used successfully in Canada for many years, and is starting to catch on in the U.S. We hope Florida employers of first responders will consider implementing this in their organizations.

Conclusion

PTSD can be either eliminated or present with decreased symptoms in nearly all cases, when the right treatment is provided as quickly after an incident as possible. Florida’s CFO has released an impressive array of materials that can truly make a difference in the lives of first responders. It is my sincere hope that affected employers will carefully evaluate and use these to every extent possible within their own organizations.

Ascellus – Integrated Medical Case Solutions – is the premier behavioral medicine network for pain and trauma response with evidence-based outcomes and a proven track record for transforming workers’ compensation cases. Ascellus makes intervention efficient with a national network of 1,500+ psychologists and psychiatrists in all 50 states.