What We Heard Wrkers Cmpensatin Act PTSD Presumptin and Supprt fr amendments t the Occupatinal Health and Summary f public cnsultatin June 5 30, 2017
Backgrund The Yukn Gvernment cmmitted t amending the Wrkers Cmpensatin Act t include a pst-traumatic stress disrder (PTSD) presumptin fr emergency respnse wrkers. On behalf f the gvernment, Yukn Wrkers Cmpensatin Health and Safety Bard (YWCHSB) recently cnducted a public cnsultatin t cllect public input n the fllwing tw issues: 1. The Wrkers Cmpensatin Act will be amended in 2017 t prvide a PTSD presumptin fr emergency respnse wrkers which will apply t firefighters, paramedics and plice fficers. The gvernment wants t knw what ther ccupatins the public thinks shuld be cnsidered in the future. 2. The gvernment als wants t knw if the public wuld supprt amendments t the Occupatinal Health and t prmte the develpment f regulatins aimed at preventing mental injuries at wrk. A tw-questin survey was published n the YWCHSB website. Interested Yukners culd respnd using a frm n YWCHSB s website, via email, r in print frmat. YWCHSB advertised the survey thrugh the Yukn gvernment staff newsletter, in newspaper and radi advertisements and nline. YWCHSB s regular stakehlder grups were directly invited t prvide submissins. The cnsultatin perid ran frm June 5 t June 30, 2017. In ttal, 206 Yukn citizens and rganizatins respnded t the survey. One hundred and ninety-fur respnded t the n-line survey and 12 prvided written submissins. This dcument prvides an verview f what we heard. Page 2 f 12
What We Heard Questin One The Wrkers Cmpensatin Act will be amended t prvide a PTSD presumptin fr emergency respnse wrkers which will apply t firefighters, paramedics and plice fficers. Are there ther ccupatins yu think shuld be cnsidered in the future and why? See appendix fr a breakdwn f jb titles included in ccupatinal grups. Overview f respnses 76% f respndents 157 f 206 suggest applying the PTSD presumptin t a brader grup f ccupatins. The three ccupatins r ccupatinal grups mst cmmnly suggested fr inclusin were nurses, scial wrkers and ther scial care staff, and crrectins fficers. Abut 16% f respndents suggested the presumptin shuld apply t all wrkers. Three respndents felt that the prpsed amendment shuld be limited t the ccupatins currently Page 3 f 12
included in the definitin f emergency respnse wrker (firefighters, paramedics and plice fficers). Nurses Many f thse in favur f applying the presumptin t nurses recgnize the ften frnt-line nature f nursing, such as prviding emergency services in rural Yukn. We heard that flight nurses frequently fly int trauma situatins, and that emergency rm nurses may develp PTSD frm prviding frnt-line emergency care. Numerus submissins indicated that nurses are regularly expsed t direct and vicarius trauma in treating traumatic injuries and being victims f vilence. Here is ne cmment: Nurses must be included frm the utset, as their wrk expses them t direct and vicarius trauma regularly. In hspitals and ERs, Nurses are regularly expsed t vilence frm patients and traumatic injuries they must treat. Studies have fund that nurses experience high frequency f PTSD and cmpassin fatigue. Scial wrkers As an ccupatinal grup, scial care staff include many jbs such as child prtectin wrkers, yuth-at-risk wrkers, mental health and addictins cunsellrs, and therapists. (See the Appendix fr a cmplete list). We heard frm thse in favur f adding such wrkers t the presumptive legislatin that these wrkers are regularly expsed t direct and vicarius trauma, thrugh remving children frm their hmes, being victims f assault, and cnstantly hearing abut traumas suffered by their clients. A cmpunding factr mentined by several respndents is that many f these wrkers are alienated within their cmmunities, as their jbs make them vulnerable t criticism and even persnal attack. Sme expressed cncerns that islatin and lack f cmmunity supprt cntribute t the ptential develpment f mental health injuries. These excerpts reflect thse pinins: Anyne wrking with at risk ppulatins. Fr example, grup hme wrkers, prbatin fficers etc. We are all affected by vicarius trauma. Our clients are harmed, die, victims r ffenders f hrrific situatins. Hearing these traumatic stries day in and day ut becmes a burden n ur wn mental health. I think that scial wrkers wrking within child prtectin shuld be included in the changes. I say this as the nature f the wrk can expse wrkers t situatins that are traumatic in and f themselves, such as, remving children frm the care f their parents. They als are expsed t ther peples traumas regularly. Generally, like Page 4 f 12
plice fficers they d nt deal with peple n their best days. T the cntrary, these interactins are ften part f the wrst days f the clients lives. Gender equity This submissin identified a pssible gender equity issue related t the prpsed PTSD presumptin: Varius research indicates that wrker ccupatins generally cnsidered fr presumptive PTSD prvisins tend t be male-dminated. Occupatins that tend t be female-dminated, such as nursing and child prtectin / scial service wrk, where there is regular (direct r vicarius) expsure t trauma and vilence, are nt being recgnized fr the degree f trauma risk and ptential harm assciated with the wrk. This cncern is heightened by the fact that gender appears t be a predictr f PTSD incidence rates, with mre wmen than men meeting criteria fr bth full and partial PTSD 1. A similar respnse invited the gvernment t cnsult with the Wmen s Directrate befre making a decisin n the definitin f emergency respnse wrker. Crrectins fficers One respndent in favur f adding crrectins fficers suggested: Crrectinal fficers shuld be cnsidered. As a crrectinal fficer I witnessed and experienced many traumatic incidents during my emplyment. After 12 years f wrking this jb with nly limited EAP hurs available and n ther supprt, I had t quit my jb. I believe if this psitin was included in the abve mentined grup, perhaps the emplyer wuld address the mental well being f their wrkers t a greater extent and it wuld als give the wrker an ptin ther than quitting and experiencing hardships t aid in recvery. 1 Van Ameringen, M., Mancini, C., Pattersn, B. and Byle, M.H. (2008), Pst-Traumatic Stress Disrder in Canada. CNS Neurscience & Therapeutics, 14: 171-181. Di: 10.1111/j.1755-5949.2008.00049.x Page 5 f 12
A brader apprach The fllwing excerpts suggest the gvernment is taking t narrw an apprach:...simply apply the PTSD-presumptin prvisin t all persns prviding emergency services, withut specifically identifying them by prfessin r ccupatin....restricting this easier access t three grups f emergency respnse wrkers and then nly t thse wh demnstrate the mst serius mental trauma, PTSD, n the cntinuum f medically recgnized mental injuries t which emergency respnse wrkers are mre susceptible t than ther wrkers is t small a step in Yukn s emergency respnse cntext....we must take a made in the Yukn apprach t defining emergency respnse wrkers. The amendments must g beynd the ccupatins listed in the questin t include ther Yukn wrkers wh regularly respnd t emergencies because f the unique aspects f living in the nrth. The respnses t this questin indicate that many peple misunderstand the cncept f a PTSD presumptin. While PTSD cverage extends t all Yukn wrkers, many respndents believe that YWCHSB s current psychlgical injury cverage either des nt extend t their ccupatin r is inadequate in sme way. T sum up In summary, three f the 206 respndents (abut 1%) believe n ther ccupatins shuld be cnsidered beynd the three prpsed by the gvernment (firefighters, paramedics and plice fficers). The majrity f respndents 76% want mre ccupatins cnsidered fr inclusin. The mst cmmnly suggested additins are nurses, scial wrkers and ther scial care staff, and crrectins fficers. Abut 16% f respndents believe all wrkers shuld be cvered by a PTSD presumptin. Page 6 f 12
What We Heard Questin Tw Wuld yu supprt amendments t the Occupatinal Health and t prmte the develpment f regulatins aimed at preventing mental injuries at wrk? What are the benefits and disadvantages f this apprach? As shwn in the pie chart, 69% f respndents supprt amendments t the Occupatinal Health and (OHS Act) t prmte the develpment f regulatins aimed at preventing mental injuries at wrk. A few dminant themes emerged in supprt f amendments t prmte preventin: Preventin is mre effective than treatment. Many respndents believe that treating mental health cnditins is difficult and cstly. Preventing the develpment f disrders in the wrkplace wuld be mre cst effective ver the lng term. Mental health issues have far-reaching effects that g beynd the wrkplace. Page 7 f 12
Yukn has a small wrkfrce and difficulties are ften encuntered in replacing wrkers. These cmments fcused n the cst benefit f retaining emplyees vs. use f sick and disability leave fr mental health issues. Regulatins supprting preventin wuld help reduce the stigma attached t mental illness. The fllwing excerpts utline why sme respndents believe these amendments are imprtant: These amendments are critical t health and safety f Yukn s wrkers. While presumptive legislatin is imprtant t assist wrkers in at-risk jbs, preventin is even mre critical. It is better t ensure that wrk is psychlgically safe, with prper supprts t prevent r mitigate mental injuries, than t nly help sufferers after the fact. Preventin is essential, therwise these kinds f claims are ging t spiral ut f cntrl. Emplyers must have a psychlgical health and safety management system/plan/standard lking at preventin f mental injuries at wrk. Yes, I wuld supprt this, as sme f these injuries culd be prevented with early interventin r immediate supprt prvided nce a wrker expresses that they are struggling and/r expsed t a particularly difficult event fr them. These regulatins may assist the emplyer t gain further knwledge and respnd in a mre timely manner. Many respndents were nt sure whether they wuld supprt amendments t the act. They wanted mre infrmatin n what the regulatins wuld lk like befre cmmenting n whether they wuld supprt them. One ffered:...it wuld be helpful if the Bard culd ffer stakehlders further details n the specific legislative amendment prpsals it has in mind t address mental health injury preventin. This wuld enable stakehlders t prvide better-infrmed and fcused input n the cntemplated amendments. Page 8 f 12
A minrity f respndents d nt supprt legislative amendments. Amng the reasns given were: Ptential expense fr emplyers t implement preventin prgrams. Ptentially higher assessment rates. Cncern that new regulatins wuld be ineffective, given the perceived lack f cmpliance with existing regulatins. Lack f cnfidence that mental health injuries can be prevented in certain ccupatins due t the nature f the wrk. Sme cmments frm respndents nt in favur f OHS Act amendments: N. Any regulatins yu draft will never be implemented. As it is, there are regulatins that are never fllwed. Why wuld these be? A huge disadvantage wuld be the cst. This will increase csts fr gvernments, which everyne pays. NO!!! I wuld be supprtive f amendments which wuld prvide REMEDIES and SUPPORTS t thse affected by wrk-place mental health injuries withut the affected individuals having t g thrugh ridiculus hps and feeling the stigma assciated with mental health issues. It is NOT realistic t say we can prevent them given the nature f the wrk that is dne. Get real! Using OH&S as a medium t fight r prevent mental illness will nt wrk. T many peple will "cry wlf" and devalue legitimate claims. Page 9 f 12
Overall Summary With respect t prpsed amendments t the Wrkers Cmpensatin Act, the majrity (76%) f Yukn citizens and rganizatins wh respnded t the survey recmmended expanding the scpe f the presumptin t mre ccupatins than the nes prpsed (firefighters, paramedics and plice fficers). The tp three suggested additins are nurses, scial wrkers and ther scial service prviders, and crrectins fficers. Abut 16% f respndents believe the presumptin shuld apply t all wrkers. Abut 1% believe the presumptin shuld be limited t the three ccupatins prpsed by the gvernment. With respect t supprt fr amendments t the Occupatinal Health and, the majrity f respndents (69%) are in favur. Many expressed supprt based n the human and financial csts f mental health injuries and their far-reaching effects in wrkplaces and the brader cmmunity. The few ppsed expressed cncerns abut ptential csts fr emplyers, scepticism that new regulatins wuld be fllwed, and the unrealistic belief that mental health injuries can be prevented given the nature f certain ccupatins. Page 10 f 12
Appendix Occupatinal Taxnmy: A structured taxnmy fr use in categrizing ccupatins in the PTSD presumptin cnsultatin reprt A. Medical Occupatins Nurses Emergency rm nurses Emergency Medical Services nurses Cmmunity nurses Medevac nurses Dctrs Emergency rm dctrs Other medical staff Admitting staff Family supprt staff Medevac persnnel First aid vlunteers Midwives Dispatchers Emergency Rm staff Crners B. Enfrcement Occupatins Crrectins fficers Enfrcement fficers RCMP fficers RCMP auxiliary fficers Sheriffs Animal prtectin fficers Occupatinal Health and Safety fficers Husing and Public Wrks fficers Rangers Bylaw fficers Search and rescue wrkers Cnservatin fficers Page 11 f 12
C. Scial Care Scial wrkers Other scial care staff Therapists Cunselrs Grup hme wrkers Nursing hme wrkers Child welfare wrkers Outreach wrkers Yuth-at-risk wrkers Mental health and addictins wrkers D. Miscellaneus Other Caretakers Military persnnel Gvernment wrkers Retail wrkers Teachers Office wrkers Legal prfessinals Security guards Page 12 f 12