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17 CHAPTER 2 Recommendations The research team encourages any mental health professionals Throughout the aviation industry, there are many different to read the project in its entirety to glean the most up-to-date management structures in place at airports and air carriers. information pertaining to Employees Coping with Traumatic Delineating factors between such structures include size, re- Events. sources, and number of employees. Clearly, a large organiza- tion with several thousand employees will have different State-of-the-Art Model resources available than smaller operations with an employee for Disaster Management or two. Irrespective of an organization's scope, there are several critical planning tasks common to all operations that should Seven steps will be introduced and explained that will be completed as part of critical incident response plans. guide an organization through the development of a mental recovery plan. There are also five very important intervention principles that are essential for a manager to instill when an Step 1. Awareness and Cultural Integration employee has been involved in a traumatic event. The seven The first planning task of all organizations should simply steps are the following: be making all employees and any affected individuals aware that the organization will now be implementing an MHRP. 1. Awareness and Cultural Integration. Ideally, this should be stated in an employee manual or AEP. 2. Assessment of Mental Health Resource Availability. The concept should be introduced and emphasized via sev- 3. Embedding Mental Health Practitioners. eral communication channels including verbal, signage and 4. Preparations of the Mental Health Provider. written policy. By engaging in such emphasis, the concept of 5. Employee Training Program. an MHRP can become interwoven with the organization's 6. Establishment of a Mutual Aid Assistance Program. culture. In addition, this emphasis may help alleviate (but 7. Assimilating the MHRP into the Critical Incident Response probably not eliminate) some of the well-documented phe- Training or Airport Emergency Plan. nomenon wherein some individuals are resistant to receiving mental health assistance. Introduction to the Planning Stage In spite of the many defensive strategies and sound operat- Step 2. Assessment of Mental Health ing techniques employed, catastrophic aviation-related di- Resource Availability sasters occur. As any industry practitioner knows, it is vital to prepare for such events. Most preparation is aimed squarely on In any disaster planning endeavor, it is critical to determine loss-of-life mitigation, scene preservation, and ultimately sce- exactly what resources are available and which employees will nario reconstruction. However, an aspect that often gets over- be responsible for each of the necessary tasks. As previously looked involves the mental health monitoring, maintaining, discussed, most planning efforts focus on loss-of-life mitigation and resilience of air carrier and airport employees. As with any and scene preservation. As part of an MHRP, determining critical incidence response, maintaining functional employee who will be responsible for overseeing the psychological mental health is a vital component, and should be given due monitoring of the plan is equally important. Ideally, a licensed consideration prior to the occurrence of a catastrophic event. mental health practitioner who is employed by the organization
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18 would be the key person; however, it is very unlikely any or- and a peer may be unqualified to help? In order to overcome ganization would have the luxury of having such a person both obstacles, it is recommended that the employer embed on staff. licensed mental health professionals, preferably from the However, almost all organizations have access to Employee organization's EAP, as part of the internal team involved in Assistance Programs (EAPs) or other mental health providers. a crisis. These professionals should literally "walk the scene" An EAP is a program in which employees have confidential with all of the employees as everyone goes about their business access to mental health providers to help them through psy- of dealing with the catastrophe. Using this model as a compo- chologically stressful events, like chemical dependence issues nent of an MHRP has proven to be effective and accepted by and traumatic personal events. Usually, these programs are most employees. accessed when an employee needs help and is willing to make first contact. In the case of implementing an MHRP, it is rec- Step 4. Preparations of the Mental ommended that a mental health care provider take more of a Health Provider proactive status and actually seek out employees as part of the organizational team. Federal, state or locally governed orga- The embedded mental health provider should acquaint nizations may be able to utilize a government-sponsored EAP themselves with all of the available assessment and therapeu- (at least for the purposes of use during catastrophic events). tic techniques recognized as efficacious when treating PTS or Even if an organization does not currently have access to an other associated trauma. EAP, it is highly recommended that the organization contracts with some mental health entity for the purposes of imple- menting an employee MHRP during critical incidents. Step 5. Employee Training Program As part of the planning activities, all employees should be Step 3. Embedding Mental taught basic crisis management techniques and how to rec- Health Practitioners ognize symptoms. While peer-to-peer counseling should be limited, knowing how to recognize some symptoms in Many current mental health monitoring programs in place co-workers and advising the embedded mental health team make use of peer-to-peer sessions, often termed "debriefings" member of such signs could prove helpful. In addition, a basic or "defusings." Without a doubt, sound operating practices description of the cause, prognosis if left untreated, and long- dictate that logistical and progress briefings be made so as term care principles regarding traumatic stress should be to ensure all personnel maintain the appropriate levels of aware- emphasized. ness and situation status. However, with regard to mental health assistance, there is mounting evidence that peer-to-peer counseling sessions may be ineffective for some individuals Step 6. Establishment of a Mutual Aid and even harmful for others. At issue is the possibility of Assistance Program an employee experiencing Post Traumatic Stress (PTS). The Some airports participate in mutual aid groups whereby current evidence indicates that unless an employee experienc- in the event of a natural crisis (hurricane, flood, etc.) other ing PTS is evaluated and treated by a licensed mental health airports not affected will send personnel to staff critical func- provider, an untrained peer counselor could potentially exac- tions. Certainly, this gives the ability for the airport to function, erbate the stress levels (albeit unintentionally) of the employee and, often airports are a vital asset during natural disaster and prolong the episode. It is important to note that some recovery efforts. However, there is also a mental health com- employees report they greatly desire a peer-to-peer model, and ponent to participating in a mutual aid pact. Employees who believe such models have helped them in the past. However, work at an airport experiencing a natural disaster are often the findings from the present study seem to belie this notion affected by the same disaster in their personal lives. They may with some people and certainly demonstrate the requirement be caught in a dilemma between continuing to work so as to for more investigation into whether or not peer-based inter- support the airport's function or abandoning their posts so ventions should become the preferred treatment method. that they can deal with their own families and personal situ- In some cases, there is a stigma attached to seeking out pro- ations. By participating in a mutual aid group, an organiza- fessional mental health support from licensed providers. Given tion could help enable employees to deal with their personal that the efficacy of peer-to-peer counseling is questionable at situations and not make a difficult, stress-inducing decision best, there seems to be a conundrum; how does an employer between work and family. provide mental health assistance for their employees during a There are two groups in existence at present. They are the crisis when there is apprehension about seeking a professional Western Airports Disaster Operations Group (WESTDOG)