September-October 2022

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Page 24 of 44 PalletCentral • September-October 2022 23 diagnosed mental illness is not enough to declare the person a "direct threat." A case-by-case analysis will be required, including consideration of what the illness is, what medications or treatments may be required and any side effects or adjustment period needed, and other relevant factors. For employers with 50 or more workers in a 75-mile radius, unpaid leave under the Family and Medical Leave Act may also be mandated for treatment of, or recovery from, mental health and addiction issues (or to care for a family member undergoing such a crisis). Too often, employers put blinders on to the mental health challenges impacting workers or tell them to "leave the personal stuff at home" when they enter the workplace. Of course, it isn't that simple. UPS was in the headlines in October 2022 when a pregnant employee who had sought mental health assistance at work was told she was "overreacting" – the worker then jumped to her death from a ledge as other workers were clocking in. No doubt many of those who observed this will be permanently traumatized. Employers must accept that total worker health is their concern. It is also the law. Under the Mental Health Parity and Addiction Equity Act, all health plans with 50 or more participants must apply similar rules to mental health and substance use disorder benefits as they do for physical health benefits. It is worth checking your company's health plans now as renewals for 2023 are underway, to make sure that your existing benefits plan meets the new legal requirements. In addition, how strong is your Employee Assistance Program (EAP), if you even have one? Do employees know of its availability as part of a benefits package, and that it can be utilized for things other than substance abuse issues? Many plans remain underused while workers suffer in silence. Establishing a Psychological First Aid So where does PFA come in, and what exactly is it? It is defined as a compassionate and supportive presence to mitigate acute distress and to assess need for continued mental health care. Because the goal is to stabilize the individual, it is not the PFA provider's role to be a diagnostician or therapist. It is more akin to physical first aid, where one might put ice on a bruise or a temporary splint on a suspected broken ankle. PFA is designed for employers and community volunteers, trainers, and disaster responders who must respond and provide initial care in the wake of adversity or when faced with a person in crisis. PFA intervention has been found to be more effective than multi-session psychotherapy post- disaster and should be considered where a workplace incident is the triggering event. ose impacted in terms of mental health after witnessing a workplace tragedy or violent event will normally be entitled to worker's compensation, in which case reduced need for treatment means reduced costs and insurance premium hikes. A work- related mental illness is OSHA-recordable if it results in reassignment, restriction, medical treatment or days away from work, and reportable if it results in immediate hospitalization. OSHA says: a mental illness will not be considered work-related (for reporting/recording) unless the employee voluntarily provides the employer with an opinion from a physician or other licensed health care professional with appropriate training stating that the employee has a mental illness that is work-related. Psychological First Aid rests on several key concepts: • Reflective Listening • Differentiating the benign, non-incapacitating psychological/behavioral crisis from potentially incapacitating • Prioritizing (triage) psychological/behavioral crisis reactions • Mitigating acute distress and dysfunction, as appropriate, and

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