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Following Up Distressed Personnel
Following Up--Checklist
I. Overview
General Considerations
The purpose of this section is to orient leaders and other unit members to the importance of following up after an individual has received assistance with a difficult life event or distress. This is particularly important following an inpatient psychiatric hospitalization, Alcohol and Drug Abuse Prevention and Treatment Program, or referral and treatment at the Life Skills Support Center (LSSC).
For many problems, such as depression, support needs to occur throughout the course of treatment. Some episodes of mental health problems can return after previous improvement. Effective follow-up by unit leadership can help prevent relapse and ensure that further assistance is given if problems do reoccur. Unit leaders and members see affected individuals more often than counselors and usually know more about their life circumstances. As such, they are in a better position to give preventive messages, spot indications of relapse, and support individuals during their recovery.
The most powerful and helpful message unit leadership can send to a distressed individual is to say, "We care about you and will assist you in any way we can." That message continues to be powerful and helpful throughout an individual’s recovery.
The Role of Leadership after Evaluation and Treatment
As the member’s level of distress diminishes, it is important to reevaluate the plans and supportive measures that have been put in place by peers, leaders and helping agencies. Leaders should contact helping agencies and relate any concerns about risk for self-harm or other job related safety issues, including managing potentially dangerous tasks such as operating heavy machinery or weapons bearing duties. If an individual is hospitalized, periodic visits by members of the unit are usually very helpful, if the person consents to these visits, as they show that people care.
Supportive Measures When Following Up
● Be aware:
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● Provide frequent inquiries about the member's well-being.
● Ensure time is provided for appointments with helping agencies.
● Support their participation in self-care activities, even if it means some reasonable lost time at work.
● Consult with mental health providers if appropriate.
Supportive measures also differ depending upon the individual’s circumstances. For instance, the type and intensity of support should differ for a person just released from a psychiatric unit following a serious suicide attempt versus a person who is seeking counseling for an ongoing marital problem. Because of those differences, specific suggestions are given below for common follow-up scenarios.
Following Up if a Member is Hospitalized
If the member is hospitalized:
● Visit (if they consent to having visitors).
● Contact family to offer support.
● Express caring/concern and encourage member to cooperate with caregivers (providers).
● When the member is released from psychiatric hospitalization:
● Consult with LSSC provider about aftercare plan.
● Identify key personnel to check in with member.
● Report concerning behaviors to LSSC provider.
● Continue support to individual’s family.
Following Up When a Member is Being Treated at the LSSC
If the member is being seen at LSSC but difficulties or distress is not apparent in the workplace:
● Respect member’s privacy.
● Support their choice to get help.
If the member is being seen at LSSC and difficulties and distress are apparent in the workplace:
● Consult with mental health providers (providers will be limited in details they can reveal but may be able to offer suggestions for enhancing support in the unit).
● Discuss with LSSC provider ways in which you might collaborate in treatment.
● Encourage ongoing use of LSSC services.
● Inquire as to how work demands may be contributing to difficulties.
● Provide concrete feedback about work tasks.
● Arrange for extra supervision, if needed.
The Importance of Peer Support during the Follow-Up Phases
Coworkers may notice job performance problems before such problems become evident to supervisors. Encourage select coworkers to proactively reach out to support the unit member during their period of recovery.
Supporting Individuals with Longer Term (Ongoing) Distress
● Follow-up with helping agency personnel and relay any observations that may be helpful for continued support or treatment.
● Participate in periodic treatment team meetings that include providers, patient, commander, first sergeant, and supervisors to discuss status and ongoing support.
● Keep in mind that individuals who have a history of significant behavioral health history including depression and suicide attempts may be at risk for problems down the road. It is crucial to emphasize compliance if they are in treatment.
● For helping with continued problems, including dealing with personnel life stressors, follow-up by asking if further support is needed, since this provides an opportunity to assess if the member's situation has improved or has deteriorated.
● Given that suicidal states vary over time, it is essential for the leaders to continually monitor, and assess the general status of the unit member.
LSSC providers can stay involved in the member’s management and provide ongoing support to the unit in an appropriate way even when formal treatment is not desired. Examples of non-treatment involvement by LSSC staff include:
● Collaboration to develop a means for ongoing monitoring of risk in the workplace.
● Guidance in responding to different types of problem behavior or issues of concern.
● Regular contact with the first sergeant or supervisor to discuss an individual’s behavior.
● Collaboration to increase support and decrease factors that may contribute to risk for suicide.
● Telephone checkups.
II. Relevant Policy
Relevant policy in community suicide and violence prevention is in AFI 44-154.
III. Suggested Resources
National Institute of Mental Health website: http://www.nimh.nih.gov/
IV. References
1. Lukens, E. P. (2002). Promoting community awareness to enhance mental health. Health and Social Work, 27, 83-88.
2. Mead S. (2001). Peer support; a theoretical perspective, Psychiatric Rehabilitation Journal, 25:134-141.
3. Mechanic, D., Bilder, S., & McAlpine, D. (2002). Employing person with serious mental illness. Health Affairs, 21, 242-53.
4. Riffer, N. W. (2000). Working responsibly with employees with a psychiatric disability. Psychiatric Rehabilitation Journal, 23, 281-284.
5. Roman, P. M.,& Blum, T. C. (2002). The workplace and alcohol problem prevention. Alcohol Research and Health, 26, 49-57.
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