Work-related stress – violent or traumatic events

Psychosocial hazards

Psychosocial hazards are factors in the design or management of work that increase the risk of work-related stress and can lead to psychological or physical harm. Examples of psychosocial hazards might include poor supervisor support or high job demands.

Employees are likely to be exposed to a combination of psychosocial hazards. Some hazards might always be present at work, while others only occasionally. There is a greater risk of work-related stress when psychosocial hazards combine and act together, so employers should not consider hazards in isolation.

Psychosocial hazards do not necessarily reveal the causes of work-related stress. Causes are likely to be specific to the employee, work or workplace. Senior management should identify which psychosocial hazards negatively affect employees' health and well-being and take appropriate action to control the impact of those hazards.

Violent or traumatic events

Work-related violent or traumatic events are incidents that can cause fear and distress and involve exposure to abuse, the threat of harm or actual harm. The fear and distress from violent or traumatic events can lead to work-related stress, psychological injury and physical injury. The impact of traumatic experiences can arise from a single distressing event, or from the cumulative impact of many events over time, including direct or indirect exposure.

Some industries have a higher risk of employee exposure to potentially traumatic incidents, especially with repeated or prolonged experiences. Examples include emergency services, first responders, disaster management, customer service, defence, transport, justice personnel and health and community services.

Traumatic experiences in these types of roles can involve threats to life and witnessing or experiencing serious injuries. Examples include:

• being involved in or witnessing serious motor vehicle or transport accidents
• being verbally, physically or sexually assaulted
• acts of violence such as an armed robbery, war or terrorism
• being bitten, spat at, scratched or kicked
• being threatened with or without a weapon
• stressful events such as death, suicide, accident or injury
• ongoing bullying
• natural disasters such as bushfires, earthquakes or floods
• severe or life-threatening weather events
• needle-stick injuries
• workplace incidents, injuries or deaths
• repeated exposures to aversive details in reports

A person is more likely to experience an event as trauma when the person considers the incident to be:

• unexpected
• something they were unprepared for
• unpreventable
• uncontrollable
• the result of intentional cruelty

Types of trauma risk

Direct or indirect exposure to violence or traumatic events can cause trauma. Vicarious trauma, also known as secondary trauma, refers to the negative effects of indirect exposure to potentially traumatic events during the course of one's work. For example, helping others cope with traumatic events, witnessing a fatality, reviewing distressing information or investigating a serious injury or fatality.

While single exposure to violence or traumatic events can result in a risk of trauma, multiple exposures also pose a risk of trauma. Cumulative trauma refers to the impact associated with repeated exposure to potentially traumatic events. Exposure can occur directly from violent and aggressive behaviours or indirectly during the course of one's work, such as through counselling an assault victim or reading details relating to an assault. For example, as part of their work, some employees, such as child protection workers, lawyers, police officers, forensic scientists, journalists and custom officers, may need to repeatedly listen to or view material containing detailed descriptions or images of distressing and traumatic events experienced by others.

Risks of violent or traumatic events

While exposure to traumatic or violent events may be difficult to predict, it is possible to identify situations leading to increased risks and to implement appropriate risk controls. Work situations that have greater risks of violence or trauma include:

• handling cash, drugs or valuables
• working alone, working in isolation, working in the community and working at night
• providing services to distressed, highly agitated or incarcerated people
• enforcement activities
• responding to emergencies
• working in areas where you or others may be exposed to distressing or traumatic events, for example, health care, community work, counselling, funeral services, protective services, legal services, high-risk work where injuries may occur

Where repeated exposures to violence or trauma are a part of normal work role additional risks of cumulative trauma experiences need to be considered.

Implementing controls for violent or traumatic events

Effective systems, processes and training can help reduce the risk of violent events. It is also possible to prevent the effects of exposure to trauma by adequately preparing employees. Preparation includes both the ability to respond in the moment and access to coping strategies and social support to help after an incident.

Violent events

The following are examples of risk control actions to prevent violent events:

• Ensure the physical work environment and security are well designed –
  • the building is secure, well maintained and fit for purpose
  • secure on-site parking or escort to private means of transport is available
  • security measures such as closed circuit television (CCTV), timer safes, anti-jump screens are in place
  • employees are separated from the public where possible
  • access to work areas is limited by electronic security passes, door locks, or remote locking doors
  • visibility of those entering and exiting the premises
  • communication and alarm systems are functioning and monitored at all times, and that is known by employees
  • regular checks and risk assessments are carried out
  • Crime Prevention Through Environmental Design (CPTED) is considered
• Implement strategies to reduce client or customer frustration, for example –
  • clearly visible instructions and service level expectations
  • readily available directions and assistance
  • alternative strategies to queues, such as buzzers or numbers
  • providing entertainment in waiting areas
• Develop a culture of low tolerance of aggression towards employees through management commitment, policies and processes.
• Conduct awareness campaigns highlighting expectations of acceptable behaviour as well as the rights, responsibilities and consequences of inappropriate client or customer behaviour.
• Provide skill-based training to employees in –
  • violence prevention measures
  • situational risk assessment
  • positive behaviour strategies
  • de-escalation and emotional regulation
• Develop and regularly review work systems and procedures in consultation with employees, including –
  • procedures for working in isolation
  • procedures for opening and closing the business
  • monitoring employees working in the community or away from the workplace
  • processes to assess client needs and provide appropriately skilled employees
  • management plans for clients or customers known to have a history of aggression, complex or challenging behaviours
  • identification systems which clearly identify employees and authorised visitors
  • systems to map and record areas of concern for safe entry and exit
  • procedures in the event of crime

Traumatic events

The following are examples of risk control actions for management of traumatic events:

• Implement processes for employees exposed to potentially distressing situations or content. Processes could include –
  • employee assistance programs
  • peer support programs
  • reporting systems where employees, as a matter of course, report exposure to distressing circumstances and where managers or others can check in following exposure to such situations
  • working in pairs or teams
  • rotating roles or activities to have adequate breaks from roles which are likely to involve exposure to distressing events
  • implement file flagging processes on potentially distressing files or cases to avoid inadvertent exposure to distressing content
  • ensure there are guidelines and processes in place following a traumatic event in the workplace
  • ensure workload allows sufficient recovery time
• Ensure there are procedures in place to respond to critical incidents, for example, a Critical Incident Stress Management (CISM) plan. At a minimum there should be –
  • practical support provided to employees following a violent or traumatic event
  • counselling and professional support services available to employees and supervisors following a violent or traumatic event
  • appropriate information provided to employees, including the availability of resources
  • regular monitoring of employees' wellbeing following exposure to violent or traumatic events and encouraging access to employee supports such as counselling and professional supervision
• Ensure managers are trained in appropriate responses to violence and trauma.
• Ensure employees are trained in normal responses following a traumatic incident.
• Ensure recruitment and selection practices incorporate a realistic job preview so applicants are aware the role has the potential to expose them to trauma.
• Implement professional supervision among peers and supervisors.
• For organisations that frequently provide services to clients who have experienced trauma, consider becoming a trauma-informed employer through the introduction of specific training and practice changes.
• Redesign work wherever possible, particularly in situations where work roles involve repeated exposures to traumatic experiences.
• Where repeated high-risk exposure to distressing experiences is a necessary part of the role, additional risk controls could include reducing workload, increasing breaks, and recovery time, implement systematic health screening to identify trauma stress responses, and implement annual health assessments.

Work-related stress and your legal duties

The Occupational Health and Safety Act 2004 (OHS Act) requires employers to provide and maintain a working environment that is safe and without risks to health, so far as is reasonably practicable. This responsibility includes providing and maintaining safe systems of work and an obligation to consult with employees and HSRs on matters that directly affect or are likely to affect their health or safety, including hazards and risks associated with work-related stress.

Employees also have duties under the OHS Act to take reasonable care for their own health and safety, the health and safety of people in the workplace and to co-operate with their employer.