A critical incident is an event, or a series of events, that causes enough stress to overwhelm a person’s ability to cope and return to their normal state of well-being. The person can be directly involved in the incident or have witnessed it as a bystander. The critical incident stress can cause problems that interfere with that person’s ability to enjoy their life.
Examples of critical incidents include being directly involved or witnessing:
- The death of a coworker
- Fatal accidents
- Public emergencies and natural disasters
- The threat of injury or death
- Witnessing death, abuse, suffering
- Harassment, including discrimination and bullying
This list is not complete because it’s not specific types of incidents that make them “critical”, it’s their impact on people. If that stress is not addressed, then workers can have symptoms including:
- Insomnia or other problems affecting sleep
- Mood swings, irritability, withdrawal
- Heart palpitations, sweating, trouble breathing
- Feeling disconnected from the people and the environment around (dissociation)
If the stress that caused the symptoms is not addressed, then a person’s physical and mental health well-being can be affected, causing injuries, illness, and death. The impacts of these types of incidents should not be ignored, dismissed, or minimized.
Anyone experiencing any type of health problem after a critical incident should consult their health care provider. There are effective solutions that can help.
Critical Incidents in Work
Exposure to traumatic events in work is common. An estimated 1.5% of workers have experienced traumatic events at work, and that’s likely under-reported. CUPE members are frontline public sector workers whose work directly provides health or safety to the public. Many CUPE members are more likely to experience one or more critical incidents because of their type of service work.
Research tells us that working conditions and practices can be protective when they consider the impacts of critical incidents. That’s why it is important to have appropriate health and safety control measures in place.
The Joint Health and Safety Committee or the Health and Safety Representative are a good place to ask these questions. If there are critical incident exposures in work, there should be a psychosocial hazard prevention program. There is more information on this in the CUPE Mental Health Toolkit on www.cupe.ca.
There is a stigma associated with mental health problems and illnesses. That could mean that some people don’t feel comfortable talking about these kinds of problems. This could be for many reasons, including a lack of understanding, past experiences, or cultural and/or societal norms.
In some workplaces, there is a culture of not reporting these types of incidents. Some reasons workers do not come forward could include:
- They fear they will not be believed,
- They fear they will not be supported,
- They fear they will look weak or like they can’t handle the work, or
- They fear they will face negative consequences like ridicule, blame, or discipline if they talk about it.
Members of equity-deserving groups may have additional stressors to deal with, like violence or discrimination based on race, culture, origin, ability, gender, or sexual orientation. Generational trauma, like from colonization or racism, can cause mistrust of the health care or security systems we typically count on for help.
These are key factors to deliberately consider.
The employer’s responsibility for psychological safety
Some employers mistakenly believe that all workers should be able to deal with all critical incidents every time, without help. That does not consider the human needs of workers, and it ignores the employer’s responsibility for providing safe work. The report “Tracking the Perfect Legal Storm” by Dr. Martin Shane in 2010 outlines the legal frameworks that assign responsibility for psychological safety in work to the employer.
Unsafe work practices can lead to critical incidents in any workplace, like:
- A fall from a roof or death while working alone,
- Understaffing and poor safety procedures can increase the likelihood of violent outbreaks by clients,
- Poor working conditions,
- Excessive workloads and overtime can increase the safety hazards of lots of kinds of work.
Proper health and safety policies and practices in all workplaces will reduce the likelihood of critical incidents.
What can be done about critical incidents and critical incidents stress?
1. Identify the Problem
The first step is to recognize that critical incidents are a serious health and safety hazards. If a critical incident has happened or can happen in your workplace, critical incident stress is likely to affect CUPE members. Surveys and mapping techniques are excellent tools to identify critical incident stress. There is more information in Psychological Health and Safety in the Workplace on www.cupe.ca.
2. Preventative Actions
Where possible, the first goal should be to prevent critical incidents. For some occupations, critical incident stress is very hard to avoid or engineer away.
- Develop a critical incident prevention policy and program that puts the health and safety of workers first. The CSA Standards Z1003-13 - Psychological health and safety in the workplace and the Z1003.1-18 - Psychological health and safety for the paramedic service organization are good examples of what such programs should include.
- Refuse unsafe working conditions and unnecessary overtime.
- Conduct a full review of work organization and conditions that lead to critical incidents.
- Evaluate the exposures to psychosocial hazards at work.
- Conduct regular workplace inspections to evaluate the physical environment and controls measures where critical incidents may happen.
- Demand that employers act on improving working conditions and eliminating or controlling residual hazards that can cause critical incidents and critical incident stress.
3. Responding to critical incidents
Despite the best prevention plans, many CUPE members will face critical incidents during their work. The following are important considerations to respond appropriately:
- The safety of the individual comes first. Appropriate health care should be available as needed to help them deal with their reactions to the incident.
- People exposed to critical incidents can continue to react for days. New symptoms could take some time to appear. There should be multiple opportunities to check-in that are respectful of a person’s right to refuse assistance.
- Critical incidents should be discussed to understand how an incident happened. It’s important that the discussions not shift blame to the worker. This could cause self-blame in a person who has just experienced a traumatic event.
- Peer support programs can be helpful but should be carefully considered. The Mental Health Commission of Canada has resources that can ensure this is done well.
- Keep critical incidents and their management on the health and safety committee agenda until issues are resolved.
- Negotiate contract language where legislation does not provide for specific critical incident and critical incident stress controls, monitoring, or access to information about critical incidents and critical incident stress.
- Raise awareness of ongoing concerns with campaigns, education, and training.
The harm caused by critical incident stress is significant for CUPE members. It is hard to fully gauge the extent and effect of critical incident stress due to under-reporting, employers’ ignorance about critical incident stress, and a lack of employer support for critical incident stress programs. CUPE needs to lead the way by educating workers and employers on the effects of critical incident stress.
Employers have the responsibility to provide a healthy and safe workplace. Eliminating critical incident hazards and critical incident stress is an important part of maintaining a healthy workplace. Ending critical incident stress requires the participation of CUPE members. Through education and action, we can make our workplaces safe and healthy.