Addressing Mental Distress Before It Becomes a Critical Incident
WorkReady Podcast Episode 27
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Speakers
Mark Veldkamp
Dr. Kevin Rindal | Vimocity -
View The Transcript
You've been trained to spot physical hazards, falls, electricity, equipment failures, but there's one category of risk nobody trained you to see. You can see it physically how they're carrying it. Physiologically, right? Something's not right. Today, mark Veldkamp tells us how to recognize the signs that you or someone on your crew is struggling before it becomes a crisis and what you can do about it.
Because mental state isn't separate from safety, it is safety. There's a whole lot of signs that somebody was not okay long before an incident happened. This is the WorkReady podcast.
So Mark, most incidents do not come out of nowhere. The signals were there, we just didn't know how to read them. In your experience, how often were the warning signs visible beforehand, and what did they actually look like? It didn't just happen, right? When there's an incident, when somebody's having a mental health crisis, there's signs that something was going on.
And I think in the workplace, especially in these high stress environments, the work is hard and there's long days, right? There's signs that there are days that are really difficult, but there's a difference between a hard day and someone who's truly struggling.
Like you said, most of these things that compound come from a lot of different directions. It could be relationally, it could be from a family perspective, it could be someone who's sick, it could be financial stress. What are some of the things that you've experienced that lead to that compounding?
Yeah, so I like to look at it from a perspective, and I'll do this in my practice when I work with clients, is risk and protective factors. So risks being things like isolation, substance use, lack of support, lack of identity outside of work, so work being the sole identity. And protective factors are close relationships at work, outside of work, family, a sense of purpose that could come from work but also outside of work. So I think with the lack of protective things that support us, we have concerns without those.
And what are some of those early indicators that someone on a crew may be struggling? And it's not the obvious ones, it's the ones that most people look at and they just kinda rationalize away. I like to think of it as you can see it, right? You can experience it with somebody who's increased in agitation. Maybe we had a hard day, a long day, but they're not able to turn it off.
So you can see it physically. If I see a client in my practice, I can kind of tell when they're coming in. Something's not right today. How they're carrying it physiologically. And you know, in these settings you might have somebody who it also might come through anger or agitation or kind of extreme reactions.
And again, going back to those signs, sometimes people working on a crew may be spending more time on a day-to-day basis with the people that they work with than their own families. And so you start to identify different behaviors, reactions to certain things.
When somebody does see a coworker and you know, somebody on their crew, just their behavior has changed, what are the best things that they can do to ask questions or to be curious? And there's a good chance they're spending more time, especially in a work week, with their coworkers than their family outside of work. So there's a good chance that they know their coworker very well.
And one of the things that's really important to remember is that these conversations can be low stakes. It's also helpful to know who's the best person to have a conversation with the employee who may be in distress, right? Maybe there's a close friend on the team who can actually talk to them side by side and say, hey, I noticed this. So it doesn't come from a place of criticism, it comes from a place of observation and concern.
And I think you're not gonna fail, no matter what language you use, as long as you're coming from that place. So I think people are afraid because if I say the wrong thing, that means they're gonna do something or I'm gonna upset them, or they won't tell me. So I think it's also how you express it, that you're not critical, that you're really concerned because you see them maybe acting differently than they usually are.
Yeah, absolutely, because I think there's a lot of fear of what the repercussions are gonna be when you do ask those questions because maybe somebody feels agitated to start out with and it's like, man, I just wanna keep my distance with this person.
But the thing that they may need is just somebody to lean into them. How does somebody assess that situation? What are some other tactics that people can use? I like the idea of a side by side conversation, right? Less formal when you're starting out. It doesn't have to be coming into somebody's office, but a coworker who can say, hey, how's it going? This has been a hard day, how are you doing? Even those simple check-ins. Or even how a lead manages after a long day. If it's even, hey, let's get some coffee together guys, something to just kind of turn it down.
And I think the other thing that's really important is preserving a person's dignity, right? To not make them feel like they're in trouble. But if they need to, take a moment aside, or wait till everybody's left the site to have a conversation, take a walk with them. So it's really, I think we get worried about what we say, but it's really just turning the knob down also for ourselves when we have those conversations.
And we've focused so far on this conversation on thinking about somebody else on the crew, but this might actually be the person who's listening to this conversation who's struggling. And so in the trades, pushing through is kind of part of that culture. Where does that stop being a strength and start to become a safety risk?
Yeah. And I think that is a strength, right? Because you have to be able to focus for hours on end. You have to get the job done. But it also can, I think the flip side of it is it creates a culture sometimes where it's not okay to struggle, or to be burnt. And you know, you just have to grind through. We keep going, we keep going. That's the culture. And that's there for a reason, right? Sometimes that job has to get done. So there are strengths to that. But I think it all comes down to leadership and understanding your people and what's going on for them and what they may need. And that'll differ from person to person. So it can create a culture where saying something isn't okay as well.
There are typically a few different times over the course of the day where people huddle together. One of them is usually the pre-job safety brief, or it could be like what we call a tailboard, where we talk about the work that's gonna be done during that day. So what are some signs that a leader who is facilitating that meeting can look for in their crew? It might be body language, it might be the response in people's face when they say certain things. What are some things that people can be aware of in those group settings?
Well, I think that's a really interesting time to assess where your crew is at. Looking at their body language within that, are people engaging with the supervisor? Are they responding? Are they acknowledging? Are they looking down? Are they folding their arms, shaking their heads? Those might be signs that somebody is burnt, or they need to reset. So those moments are really good also as a team to check in with each other. It doesn't just have to be the leader. There's the opportunity for people to talk about how they're doing, where we're at. This has been a long week. A bit of a debrief. And those don't have to be long.
And during that pre-op brief, I noticed that my teammate was just folding their arms, they seemed disengaged. And now it's just me and that other person and I'm walking out and I can tell something's wrong, but I don't know what to say, what I should avoid. What are some conversation starters that somebody could maybe use as cues?
I think a simple question of, are you okay? How's it going? And on the flip side, to not say, I know how it is, because you don't necessarily know what's going on.
And what should that person do if they try to engage and the person's like, I'm fine, and you just get that one word answer? But then when you observe them out there doing the work, you're like, this person is not fine. They don't want to talk to me. No one wants to be a tattletale. No one wants to go to the supervisor and feel like they're riding someone out. But there is a time where it is a safety risk if somebody's head's not in the game. What are the steps you would recommend for somebody to navigate that?
Yeah, I think this is the big challenge, right? People don't wanna tattle, they also don't wanna get somebody in trouble. On the flip side, the person who may be in distress really may not reach out because there are perceived and potential consequences of saying you have a problem. And so I think that's real. You're at your job, this is your livelihood. If there are signs that maybe things aren't going okay, or there might be a mental health problem, that might mean, am I gonna be able to do my job?
So I also think if there are signs, or if they're really agitated and they're making safety mistakes, it may be time to enlist the lead a little bit. I don't know how to, I'm concerned, and I don't know how to have a conversation with this person. They kind of blew me off. And it's clear, I'm worried about our crew right now because it's high stakes if we make a mistake.
That's something where other peers can help too, right? Is it a leadership issue or is there somebody who's better to have a conversation with the person? It doesn't always have to be the manager or leader. If there's one person saying something, there's probably everybody else experiencing that as well.
And you know, in these type of environments, I talk to frontline workers all the time and they tell me, hey, I'm trained on how to perform the job. I have all the OSHA training. But nobody ever taught me about crew dynamics. Nobody has talked to me about how to actually work in these type of situations and manage them. And it's a huge part. This impacts communication and it impacts safety.
You know, those risks can be just from day-to-day stuff, but it could even be a crew that goes through a critical incident. Maybe there's an injury or a serious injury or a fatality that happens on that crew or on the job. What's happening to them psychologically, and what type of support needs to happen in those situations?
The first thing is fear. They're afraid. And if it's a fatality or a serious injury, everybody there wants to get home at night and see their family. And so to have that happen on site, it becomes, well, this could happen to me. It's very scary. And then there's all the loss involved in that. Or even if they witnessed it, they could be traumatized just by witnessing that experience.
So this becomes not just the incident where we responded to it and we're investigating it, but now we need to look at what's going on with our people as a result of that. Because they are going to be struggling. And not everybody will develop mental health symptoms. Coming back to what I said earlier about risk and protective factors, if we have a lot of protective factors or support, we may have a better recovery. What we do know is that exposure to any traumatic event increases our risk of mental health disorders. However, the sooner the intervention, the less likely those symptoms are prolonged.
Okay Mark, we oftentimes talk about firsthand trauma, when somebody experiences something firsthand, they're the first on the scene or they're on the crew that had an injury. But what about the secondary trauma? How is that something that we should think about and identify and then support those people?
So I like to look at this almost like a visual. You have the people who are first exposed, the first responders. Your intervention needs to happen right away with those folks because they saw it, they witnessed it. But then you have a layer of the organization. Maybe they weren't there, or they hear about it, or they're coming in after the fact. Those are really both first responders in a sense. And as you go out, there are layers of the impact of an event.
So within an organization, then it might be the staff who are backing up, or the supervisors, because they're managing the incident, the frontline, the foreman. And in a community, if this is a critical incident, there's beyond that. Then you have families of those impacted. If there's a loss in the workforce, who are those folks and how does the organization respond?
We can incur trauma from being exposed directly to it, but also from witnessing or incurring emotional labor as a result of hearing about an event. And sometimes even things in the news can trigger that response. I had a situation that I'd been part of and worked on, a critical incident, and I hadn't thought about it in 10 years, and it came up in the news and I remember having a very physiological reaction to that.
And so that's why when you look at an incident, it's not just those who were there, but those who heard about it within your organization. Absolutely. Because I think about that, like maybe you're an organization of 5,000 people and John and Dave worked together for 20 years. Dave moved to a different part of the organization and then John gets injured. But those two were super tight for years. There's no way to identify the secondary impact within the organization. What are some additional things that organizations can do to just be sensitive to those connection points that they may not even realize?
I think that also can come down to communication, the broader communication to the organization. Probably everybody knows about the event. And to have the communication out to the organization, out to the company, we're aware of this, to acknowledge it. You can have that direct intervention with the folks who were there, but also to the broader community, because you don't know who it impacts or how it impacts them. To even just simply say, we have resources. And even if they're not many, to just name that so that folks see from a communication standpoint that this is being acknowledged.
Because I think that's the other part. These incidents happen. Everybody knows it happened. There are people who are affected, but it feels like, why didn't they do something? It seems like they did nothing. So the communication can be really helpful.
And I think that's why, at the organizational level, it's so important that you have a system in place. Every organization, when they meet in person, they say, here's where all the emergency exits are, here's where the AEDs are, here's where the fire extinguishers are. They have those plans. But when it comes to mental health support, we should probably have a similar type of plan laid out so that if this happens, these are the steps that we take.
So another situation that we hear unfortunately fairly frequent is threats from the public. Somebody's out turning off someone's gas or electric and somebody comes out with a gun or threatens them. That's a whole different type of trauma that people encounter. And there aren't systems to necessarily support somebody through that, but that can be a pretty scary situation. What are some things that leaders can think of in terms of supporting their teams when it comes to those external threats?
Yeah, and I think they really need to have a formal threat assessment program. That's a little bit different than what we're talking about in terms of the trauma response. These are legitimate threats to your employees. And there's crossover in these teams, because you need your risk management arm, your security arm, your HR, your legal team, disability services. A behavioral threat assessment management team to manage those threats and if needed, escalate them to outside law enforcement. And they need to have connection to law enforcement as well, and have mental health professionals within those teams to provide input around what may be going on and how to get this person the support they need immediately.
And one thing I like about this definition of trauma is that it's something that overwhelms our capacity to cope. I think it was Dr. Dan Siegel who said that. Another one, is it something that impacts our nervous system and overwhelms our nervous system's ability to respond, Dr. Bessel Van Der Kolk, who's a psychologist. So this idea that it's something unexpected. You could be trained to go out and do your job as a first responder or someone in the trades, you do that every day, but it's something that you're not prepared for that overwhelms your capacity to cope.
I think we need to double click on that. Because a lot of times people don't think about the nervous system playing a role in our ability to manage this. Can you expand on that? Because I think that's a really key component here. Think about people's reactivity at work, the agitation. It's their nervous system reacting. Not being able to manage whatever's going on. And they might not even be cognizant of it or able to understand what's happening. They might have so much input that it's spilling out, showing up at work in the ways they're responding to people or the ways they're talking and communicating. So that's a huge component of when we're concerned about folks. There's impulsivity, reactivity. And that might be their nervous system being overwhelmed.
Yeah. And I'm really glad we're talking about this because the episode right before this with Rich Ganley is about what we call recharge rooms. These are meant originally for first responders and it's all focused on trying to balance out the nervous system in recovery. It's that whole idea that you've got the parasympathetic, which is rest and digest, and the sympathetic side of the nervous system, which is fight or flight. And when we experience trauma, we tend to have that heightened state of fight or flight, and our nervous system can get stuck in that.
I think it's been mentioned on previous episodes, the concept of mindfulness, and what that really is is being present with whatever's going on. The recharge room allows yourself to slow down so your body can catch up with what's happening. But if we cannot turn it off, we're gonna feel anxious, we're gonna feel distress. And that's our body's way of telling us we need to turn it off.
I'm a big fan of those types of exercises, whether it's grounding, breathing, 30 seconds, just to sit there and notice your body. Whatever it is that's going on is something we really need. And it's not in the training, it's not in the manual, it's not in the safety checklist. But it goes a long way to continuing to be able to do that work in a healthy way.
Yeah. And I say this every episode, but I can't emphasize enough that these are workforce athletes. The way that they're pushing their bodies on a day-to-day basis is two to three times the amount of time per day physically that a typical athlete would perform. Zero off seasons. And being able to take care of the body and have that time to support that recovery is so important. Because if you don't, the body has a certain level of capacity, and when you constantly are overloading it, its ability to handle additional stresses just becomes less. And it's not a sign of weakness. It's physiologically what the body is capable of.
What are your thoughts around the industrial athlete concept and the way that people can leverage those principles to support themselves?
I think that's a great way to look at it. There's no break, there are no off seasons. So how do you incorporate these principles into your day to day? And it's not fluffy stuff. It's really stuff to help you be able to do your job, be able to also go home at night and feel calm around your family, and do whatever it is you wanna be doing outside of work. And it doesn't have to be a huge lift. If you don't have time, doing a brief breathing exercise, a slowdown, or recharge room, things like that can help you. They go a long way. And then when you're off, be off. To not be hooked into work. And that's hard for many of us. But when you're working that much, it's already taken up a lot of mental space.
Mark, I wanna go through some myth busting here, some rapid fire questions. Myth number one is mental health is personal, it's not the company's role. What would you say to a leader who genuinely believes that?
I would argue it's a safety issue. I would say that it's like any other injury or body part, that you need healthy workers and the brain is part of the body. And there's a real cost to not having your workforce healthy. If you talk about a physical injury, the cost of having somebody out. If you have somebody who has to go on leave for mental health, there's a cost to that. Or if they burn out and they don't leave, there's a cost, because they're phoning it in, they're not able to do their job. And it makes your teams perform better if folks are able to dial in.
Myth number two, if someone needs help, they'll ask for it. Why is this assumption so often wrong and what does it cost organizations that rely on that mindset?
I think that's a huge myth, especially in the workforce. Because of the dynamics. This is their livelihood, and what we talked about is the tough it out mentality. You suck it up and keep going. And if you show weakness by saying you need help, that's not acceptable. So it's really unlikely for an employee to go to a supervisor about a concern because there's good reason to feel worried. And that's why peer-to-peer support and these types of conversations are really important. It's very unlikely that somebody's gonna come out and say, I'm depressed or I'm struggling, given the dynamics, especially at the workplace.
Myth number three is bringing it up might make things worse. What actually happens when you address it early rather than waiting and hoping it resolves on its own?
That is such a common myth, this idea that I'll make it worse if I bring it up. Or that if I talk about suicide or worry about that, it will cause it. And nothing could be further from the truth. Because just the very nature of feeling distress, having a mental health diagnosis or just a symptom, is isolating. So by someone asking, it actually allows an opening, versus making it worse. It names it for a person.
Would you say that a majority of the time, just addressing it, somebody actually asking the question, the person on the receiving end actually feels a lot of relief that they're just able to get it off their chest?
Yes. I would say that it's more likely. Now there may be shame associated with it, but like we talked about earlier, how you ask matters. A check in, a low stakes conversation, a caring response. Hey, let's go grab something to eat. Just to show that that person cares. It's like pulling them out of that isolation, because it's all internal.
When it comes to a supervisor, what is one skill or tool that they should have in their toolbox when it comes to the mental health of their crews?
One thing is they don't have to be the expert. They don't have to feel like they have to be the counselor. That's not your job. But your job is, you do have a responsibility as a leader to the folks. Being able to simply have a conversation and not worry that you're gonna cause more problems, and come from a caring perspective. Simple language, not accusatory language, supportive language is helpful.
One of our other podcast interviews was John Harrison. He talked about leadership and he said one of the most important characteristics of a leader is being approachable. And when you're approachable, it changes the dynamic of the relationship between the supervisor and teammates. What would you say about that characteristic of approachability playing a role in mental health of a team?
Yeah, there has to be an ability for folks to talk with a supervisor. I like that word, approachable. They don't have to be the counselor, it's just that they can talk with them, they can resolve issues, they can have direct conversations. There's a trust and psychological safety that they are able to talk about issues that are going on on the team without a strong reaction or blame. Someone who's actually willing to take a bird's eye view of what's going on and not make assumptions is really important.
You've mentioned psychological safety a few times. How would you define psychological safety?
The ability, especially in the context of work, for folks to feel that they can work without toxicity or stress. This ability to feel that they can go and do their job and also grow. That they feel comfortable bringing ideas or communicating needs, especially in these high stakes environments, being able to feel safe. Because sometimes you do have to have a direct conversation. We need this, we need that. And to feel that others trust that is really for the betterment of the team and the job.
And what can a leader do to be thoughtful about building psychological safety on a crew?
I think it comes with this idea of, if we've had a hard week, how do we regroup? There could be moments, there could be tough times or tough conversations. Is it that we get some food at the end of the week together? We grab lunch on Friday. So that we turn the dial down, that there's time for folks to even have fun, to keep it light. Because the work could be really serious and at times traumatic given what they might be exposed to. And a leader who, it doesn't have to be hard. These softer things, like hey, we're gonna get some pizza, we're gonna get the crew together. There are the formal ways of debriefing, but also just that time where people have the opportunity to chill within that structure.
And a lot of crews like to poke fun at each other. They like to tease, which in some ways is a sign of affection. Being able to do that, but also maintaining a level of psychological safety so that people are not constantly scared of being ridiculed.
What are some things that crew members can do to build psychological safety amongst each other?
Yeah, that stuff is normal. A team that can poke fun, but I think there's a line where it becomes toxic or critical, hurtful. And you can see it. People experience it. Oh, this is no longer fun. And so as a team, it's recognizing what's going on with my teammate. You know them probably best, you're around them all the time. What do they need? Do they just need a break? He just needs to chill out for a bit on his own. That's normal. That's part of the day. Recognizing those things within your team. Because you are at work, you do need to have time. These aren't your family members. Sometimes you're very close, sometimes you may not always like the people so much. Being able to recognize that it's okay to take a break by yourself. It doesn't mean that there's something necessarily wrong. Some people need that. We're built a little differently around that social battery.
One final question. What common mistakes do leaders make in the immediate aftermath of a critical incident?
A couple things that really stick out to me is not following up. This incident happens and not keeping the focus on the employees that are responding to the incident. Knowing that even these small check-ins matter. Put it on a calendar. I needed to follow up with this person, especially if it's the loss of a coworker. They're gonna be impacted for a while. That might've been their partner for years.
One common thing I hear from employees is, it seems like they've forgotten that this happened. It seems like they've forgotten that so and so had just passed away and we're just moving on business as usual, or they've moved into investigative mode and forgotten that we were all part of this.
That follow up needs to happen. Going back to the job without any follow up increases that risk.
And what are the implications of not talking about it? A critical incident may have happened and there's an active investigation, so people are worried about even talking about it and everyone just goes into suppression mode. What impact can that have on a crew?
I think there's a lot of impact in terms of their feeling of psychological safety. Because they don't feel safe to talk about it or have a reaction because, oh, this could be part of the investigation. And yes, all that has to happen. But not being able to have a moment, that's why peer groups are really helpful. Because then you get into unaddressed symptoms, potentially people having mental health issues as a result of their exposure because there's been no follow up, no debrief, no intervention. And they suffer in isolation without any intervention.
Mark, for the workforce athletes listening, maybe they're driving home or just finishing a shift, if they only remember three things from this conversation about recognizing risk and taking care of the people on their crews, what should those three things be?
Number one, you can have conversations about mental health. It doesn't even have to be called that. But you can have conversations. Leadership can do this. It is possible. And organizations that invest in the mental health and wellbeing of their employees are going to reduce costs, they're gonna retain employees. It is really important and is just as important as any other injury. And maybe more important, because it could also cause safety issues. So it really is possible and it requires investment and it requires a culture of care from the organization.
Well thank you so much Mark. This has been really helpful to talk through some really practical things that people encounter on a day-to-day basis. But it's something that is not necessarily talked about day-to-day on crews and in the workplace.
We spend a lot of time training people to recognize external hazards, but some of the most common risks are internal. In how someone is thinking, what they are carrying into the job on a day-to-day basis, whether the people around them feel safe enough to say something when something is wrong.
If we ignore that, we're missing a significant part of the safety equation. Physical readiness matters. Recovery matters. Psychological safety matters just as much. And these are all part of the same system. And like we talked about, it's even at the nervous system level.
So Mark, what you help organizations do is see what was previously invisible and respond in a way that actually protects people. And that's where the future of workforce safety is going. So thank you for being here.
And I just want to highlight, if you want to learn more about Mark's work in threat assessment, trauma response, and building psychologically safe organizations, Mark's website is markveldkamp.com.
Do you want to share a little bit more about how people can reach out to you? Yeah, you can also email me, that's on the website, mark@veldkampco.com. I'm also on LinkedIn. I share a lot of insights into workplace trauma, which is kind of the area I focus in now. So folks on LinkedIn can follow along there. Feel free to reach out with any questions. I do a lot of training for organizations, especially first responder organizations. There's a lot of talk about it, but not a lot of folks doing the work. And I'm excited to talk with you Kevin about this and it really aligns with what I'm trying to do as a clinician, bringing that knowledge into the workforce.
Well awesome. It was so great to have you on the WorkReady Podcast. And for those listening, if this changed how you think about safety and the people around you, make sure to share it with a supervisor or crew lead. Also make sure to subscribe to the WorkReady Podcast on YouTube, Apple Podcasts, or Spotify. And until next time, take care of yourself, take care of your people, and stay work ready.
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