Picking up the pieces post-disaster

The 29-year-old Edmonton man is currently standing trial for several charges related to the incident. Meanwhile, his co-workers — and employer — are forced to cope with the aftermath of the brutal attack. A violent incident in the workplace creates shockwaves on many different and complex levels, according to Glenn French, Toronto-based president of the Canadian Initiative on Workplace Violence.

"There is an environmental impact, there’s witness and bystander impact, and of course there’s the impact on the individual (victim) — and the individual’s family, for that matter," he said.

"It’s really complex. It’s much simpler when you look at the individual target — the individual who’s actually been assaulted… However, we tend to focus only on that individual target and we don’t look at all the other people who were there as well."

Post-traumatic stress disorder (PTSD) is a major concern for victims and witnesses alike, said French. But it’s not always a black-and-white diagnosis.

"PTSD is not categorical all the time. It’s dimensional, meaning that one can have various elements of the diagnosis of post-traumatic stress disorder," he said. "Someone may not have the diagnosis, but may have elements of (PTSD)."

Some of those elements might be quite striking, but others may not be so outwardly obvious, according to Hannah Rockman, clinical supervisor at The Trauma Centre, based in Sharon, Ont.

"Social withdrawl, inability to focus, making more mistakes, drinking, calling in sick much more often than usual, avoidance — sort of coming in, sitting in your corner, not going out for lunch with the people they usually go out for lunch with, like a social isolation — depression, panic attacks. But sometimes those are things you cannot see from the outside," she said.

And it’s important to be aware that those symptoms may not develop immediately, said French.

"This kind of acute impact may not always happen at the time. For example, the individual might be the subject of an assault, and then comes back to work right away. And the impact doesn’t hit them until a week later or two weeks later — and sometimes even longer," he said.

A key thing to look for is changes in a worker’s behaviour or personality, said Kevin Kelloway, Canada research chair in occupational health psychology at Saint Mary’s University in Halifax.

"People experiencing PTSD will often go through very marked behavioural changes. (Maybe) they used to be really good and produce reports on time and now they seem sort of scattered, they’re not getting stuff done. They may used to be really outgoing and now they’re sort of withdrawn — things like that," he said. Often, employees will be afraid to return to work at all.

"They have the feeling that nowhere is safe — even going to work," said Rockman. "People start to feel out of control. The one place they thought they could do their job, they have a safe place… suddenly, that place becomes somewhere that is in a sense a threat to them."

In French’s experience, one of the most difficult aspects of the aftermath comes in the form of two little words: "What if?" — "A lot of questions come up in (people’s) minds like ‘What if I didn’t do this? What if I didn’t go to work that day?’" he said.

"Quite often for victims in those cases, the flashbacks, the self-doubts come in: ‘What if I had been there earlier? Could I have done something?’ People often have great regrets because they could’ve done more but they didn’t. So a lot of self-recrimination happens for people."

There’s also the issue of assigning blame toward others for missing "warning signs" that shouldn’t have gone unnoticed.

"With incidents like this — for instance, after the Edmonton tragedy that just happened — everyone comes out of the woodwork and says ‘Well, there were signs,’" he said. "Quite often, individuals… may start to blame others for not picking this up or not doing something earlier. So that’s one thing that often gets overlooked, that causes tremendous difficulty."

And for those who did notice warning signs but failed to flag them, the trauma will likely be even more severe, said French.

"There is a special class of individuals who are bystanders (which is) those people who were aware that there was the potential for the assault," he said, citing the 1999 OC Transpo shooting in Ottawa that left five people dead, including the shooter, and two others injured. A co-worker had some insight to the shooter’s plans but did not take it seriously. That co-worker committed suicide a few months later.

"There can be a greater price to pay for those individuals who felt they could have done something more," he said.

That’s why it is so critical for employers to review their procedures around workplace threats, said Kelloway.

"It’s almost like in the public schools around bomb threats: You just treat every one as if it’s absolutely deadly serious. You’re going to overreact 99 times out of 100."

In the immediate aftermath, offering some form of debriefing to everyone who’s been affected is crucial, said French.

"That debrief is critically important. And even though people may say, ‘I’m fine, I’m OK,’ it’s important that people understand what the organization is doing to mitigate any future risk. But it’s also critically important to provide people with an opportunity, when they want, to discuss their particular reaction, or to at least know what some of the signs and symptoms might be in the future," he said.

"Some employers don’t want to do that, because they’re afraid that if they talk about it, people might get more upset and they won’t come back to work, when actually the (opposite) is true. If it’s done skillfully, it’s not an invitation for people to stay off work, but it is an opportunity to make sure people are a little bit more educated as to what to expect."

Organizations should have a comprehensive policy in place for dealing with a violent incident — particularly organizations that work with the public, said Kelloway.

"The other thing organizations should be doing is — because of this heightened level of fear that people experience — to be reviewing your security procedures and maybe beefing them up… and even if that results in no change, I think you need to go through that to signal to your employees that this actually concerns us, we care about this and we’re trying to make this as safe as possible," he said.

Upgraded security can help make employees feel more comfortable.

"If I know that we used to work in an environment that was open to the public, but something tragic happened, and now we have a secured entry — we have a swipe card or something and only authorized people can get in — that’s going to help relieve some of the anxieties for people," said Kelloway.

But employees may still have difficulty returning to the scene of the crime.

"Sometimes people are not able to come back to the place where the incident happened, and then it becomes a question for the employer of accommodation — especially if they have a bona fide psychiatric diagnosis such as PTSD, it becomes a human rights issue at the same time," said French.

There’s no ideal timeline, and everyone will respond differently, said French.