Wednesday 30 September 2015
Tuesday 29 September 2015
Monday 28 September 2015
Psychiatrists can get compassion fatigue
Psychiatrists can get compassion fatigue
12:00 AM CST on Sunday, November 8, 2009
Maj. Nidal Malik Hasan had never set foot in Afghanistan or Iraq when he allegedly pulled out a semiautomatic pistol and began shooting his comrades at Fort Hood.But as an Army psychiatrist, caring for soldiers scarred by both wars, Hasan had experienced the conflict almost as if he had been in the combat zone for the past six years, psychiatrists and traumatic stress experts said.
"Many of the soldiers you evaluate and treat talk to you about horrific events," said Dr. Daniel Amen, a former Army psychiatrist who, like Hasan, once worked at Walter Reed Army Medical Center. "Psychiatrists can develop something called compassion fatigue. You just get worn out by the trauma."
At its worst, compassion fatigue becomes secondary trauma – a condition similar to post-traumatic stress, mental health experts said.
"They may not see combat themselves ... but they see the outcome of it and they hear the stories of it day in and day out," said Rep. Tim Murphy, R-Pa., a psychologist in the Navy Reserves. "It can be very real when you are dealing with people's difficulties every day."
An uncle of the 39-year-old shooter said Saturday that the work clearly weighed on Hasan.
'Tears in his eyes'
"I
think I saw him with tears in his eyes when he was talking about some
of [the] patients, when they came overseas from the battlefield," Rafik
Hamad told The Associated Press from his home near the West Bank town of Ramallah.Hasan also was torn between his religion and his military service, officials and acquaintances have said, and stressed about his imminent deployment to Afghanistan – a place "where all these terrible things he had heard about had taken place," Amen said.
While it's not yet clear what might have factored into Hasan's alleged attack on fellow soldiers Thursday, secondary trauma has been sparingly addressed in the military and civilian worlds, experts said.
"There have been a lot of cases and stories of those who just couldn't take it any longer and were transferred," said Charles Figley, a traumatic stress expert and former Marine who consults on the subject for the Pentagon. "And for those who are active duty, your career is over in that area if you transfer."
Emotionally drained
An
acute shortage of trained mental health workers in the military has
left these therapists emotionally drained and overworked, with limited
time to prepare for their own war deployments.A military mental health task force in 2007 expressed concern about the stress on nondeployed mental health personnel because of the shortage, which it said was leading to high attrition rates. "A vicious cycle has formed that will probably continue to worsen before it improves," the report said.
Dr. Layton McCurdy, a psychiatrist and dean emeritus at the Medical University of South Carolina who served on the task force, said the shortage is compounded by the thousands of troops suffering combat-related stress. "The psychiatrists are working with more people than they have time to work with," McCurdy said.
Post-traumatic stress is in essence a memory-management problem – an "inability to effectively manage the frightening experiences they've had," said Figley, who has conducted pioneering research on secondary traumatic stress at Tulane University. "It comes out in flashbacks, sleeping problems, being on edge."
Secondary trauma causes similar symptoms: sleep disruptions, nightmares, depression and jumpiness. Sufferers may avoid situations that remind them of past stresses. A mental health practitioner also may feel guilty about not having done more to help a patient or may obsess about individual patients – particularly those with whom they identify.
One noted study found that social workers who treated survivors, victims' families and first responders at the World Trade Center after 9/11 were most susceptible to secondary trauma if they lacked social support.
Suicide risk
Doctors generally have relatively high suicide rates, with psychiatrists having the highest rates. Both male and female physicians are significantly more likely to commit suicide than the rest of the population, according to a 2004 article in the American Journal of Psychiatry. Among all physicians. Psychiatrists are considered to be at greatest risk for suicide, according to the 2007 version of Kaplan and Sadock's Synopsis of Psychiatry.
Secondary stress poses more potential risks for military personnel – especially psychiatrists, said the study's principal investigator, public health researcher Joseph Boscarino of the Geisinger Health System in Danville, Pa.
"They are at high risk," said Boscarino, a Vietnam veteran and defense consultant.
No pleas for help
In
2008, the trend of military suicide rates being historically lower than
the civilian population reversed, according to the National Institutes
of Mental Health. In the first nine months of 2009, the Army reported
117 confirmed or suspected cases of suicide among active-duty
personnel, compared with 103 over the same period in 2008.If Hasan was suffering from the stress of secondary trauma, he told no one, military officials said. That would not be unusual for the medical profession, according to the experts.
"Doctors are the No. 1 profession for suicide," Amen said, but "doctors don't ask for help."
The Associated Press contributed to this report.
gjones@dallasnews.com;
lhancock@dallasnews.com
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Saturday 26 September 2015
WSIB lawsuit: Fired hospital worker details struggles after losing his claim | Toronto Star
WSIB lawsuit: Fired hospital worker details struggles after losing his claim | Toronto Star
"
"
WSIB lawsuit: Fired
hospital worker details struggles after losing his claim
hospital worker details struggles after losing his claim
Doctor's lawsuit claims she was pressured to
reverse her medical opinion in worker's favour.
reverse her medical opinion in worker's favour.
- Share on Facebook
FRED
THORNHILL
THORNHILL
Shawn
McCabe at his home in Courtice, Ont.
McCabe at his home in Courtice, Ont.
By: Jacques Gallant Staff Reporter, Published on Sat
Sep 26 2015
Sep 26 2015
An
injured hospital worker who says his claim was denied by the Workplace Safety
and Insurance Board — despite backup from a doctor who allegedly provided a
medical opinion in his favour — is going public with how he
struggled to earn a living after losing his job.
injured hospital worker who says his claim was denied by the Workplace Safety
and Insurance Board — despite backup from a doctor who allegedly provided a
medical opinion in his favour — is going public with how he
struggled to earn a living after losing his job.
Shawn
McCabe, a 46-year-old father of two, says he worked as a security guard at
Rouge Valley Centenary hospital in Scarborough for 17 years until he was
terminated in September 2014, a year after being injured on the job.
McCabe, a 46-year-old father of two, says he worked as a security guard at
Rouge Valley Centenary hospital in Scarborough for 17 years until he was
terminated in September 2014, a year after being injured on the job.
Dr.
Brenda Steinnagel, a Hamilton-area physician who was working as a medical
consultant to WSIB at the time, claims she wrote a medical opinion on his case
that concluded his emotional issues could be related to the head injury he
sustained.
Brenda Steinnagel, a Hamilton-area physician who was working as a medical
consultant to WSIB at the time, claims she wrote a medical opinion on his case
that concluded his emotional issues could be related to the head injury he
sustained.
Steinnagel
is alleging in a $3.2-million lawsuit, which does not name McCabe, that she was
terminated last April over the case. Her suit against the WSIB and her former
employer, Vaughan-based Workplace Health and Cost Solutions, claims that she
was repeatedly pressured to change her opinion on the case, and that the two
organizations tried to force her to participate in a “fraud upon the public.”
is alleging in a $3.2-million lawsuit, which does not name McCabe, that she was
terminated last April over the case. Her suit against the WSIB and her former
employer, Vaughan-based Workplace Health and Cost Solutions, claims that she
was repeatedly pressured to change her opinion on the case, and that the two
organizations tried to force her to participate in a “fraud upon the public.”
Steinnagel
alleges she was fired after her employer provided a different opinion to the
WSIB, “thereby providing WSIB with the false and fraudulent opinion it needed
to deny the hospital worker his benefits,” according to her statement of claim.
alleges she was fired after her employer provided a different opinion to the
WSIB, “thereby providing WSIB with the false and fraudulent opinion it needed
to deny the hospital worker his benefits,” according to her statement of claim.
None of
the allegations has been proven in court, and both the WSIB and WHCS deny any
wrongdoing. They have not yet filed statements of defence.
the allegations has been proven in court, and both the WSIB and WHCS deny any
wrongdoing. They have not yet filed statements of defence.
Steinnagel’s
lawsuit has highlighted concerns about the WSIB’s practices that some lawyers
and paralegals say they have been expressing for years.
lawsuit has highlighted concerns about the WSIB’s practices that some lawyers
and paralegals say they have been expressing for years.
“The
issue that has risen to the top is that the single-minded focus of the WSIB
seems to be to save costs no matter what the consequences are,” said
Uxbridge-based paralegal Hilary Balmer, who deals exclusively with injured
worker cases. She was speaking generally and is not involved in McCabe’s case.
issue that has risen to the top is that the single-minded focus of the WSIB
seems to be to save costs no matter what the consequences are,” said
Uxbridge-based paralegal Hilary Balmer, who deals exclusively with injured
worker cases. She was speaking generally and is not involved in McCabe’s case.
McCabe,
who says he’s actively looking for work, had been living off of employment
insurance until it ran out in August. He says he’s now looking at having to
cash in his pension, a decade before he planned to retire.
who says he’s actively looking for work, had been living off of employment
insurance until it ran out in August. He says he’s now looking at having to
cash in his pension, a decade before he planned to retire.
He
described Steinnagel as brave in an interview with the Star, and said he
decided to come forward after reading her story in Wednesday’s newspaper, in
which he was not identified.
described Steinnagel as brave in an interview with the Star, and said he
decided to come forward after reading her story in Wednesday’s newspaper, in
which he was not identified.
“I’m
without any benefits. I’m without any care,” said McCabe, who is appealing the
WSIB’s decision.
without any benefits. I’m without any care,” said McCabe, who is appealing the
WSIB’s decision.
“When I
got this letter saying I was turned down, I said I didn’t understand. My (WSIB)
case manager told me that a third consultant had ruled against my claim and
that was the end of the story.”
got this letter saying I was turned down, I said I didn’t understand. My (WSIB)
case manager told me that a third consultant had ruled against my claim and
that was the end of the story.”
Shortly
after being denied, he said he suffered a heart attack.
after being denied, he said he suffered a heart attack.
The WSIB
and the hospital declined to comment on McCabe’s case.
and the hospital declined to comment on McCabe’s case.
McCabe
said he suffered a number of injuries, including to his head, after trying to
restrain a patient in the hospital’s psychiatric intensive care unit on Dec.
20, 2013. He said he collided with a Toronto police officer when they both
tried to bring the patient under control.
said he suffered a number of injuries, including to his head, after trying to
restrain a patient in the hospital’s psychiatric intensive care unit on Dec.
20, 2013. He said he collided with a Toronto police officer when they both
tried to bring the patient under control.
After
that, McCabe said, he didn’t recognize himself. He would cry for no reason and
became increasingly irritable, while still trying to do his job on a modified
work plan. “I was suffering from this profound sense of sadness,” he said.
that, McCabe said, he didn’t recognize himself. He would cry for no reason and
became increasingly irritable, while still trying to do his job on a modified
work plan. “I was suffering from this profound sense of sadness,” he said.
Prior to
the incident, he said, he was always able to keep his cool.
the incident, he said, he was always able to keep his cool.
“After 17
years in the health care system and seeing the atrocities of what one human can
do to another, being able to compartmentalize that and do your job in a
professional manner has allowed me to keep my emotions in check,” he said.
years in the health care system and seeing the atrocities of what one human can
do to another, being able to compartmentalize that and do your job in a
professional manner has allowed me to keep my emotions in check,” he said.
Things
came to a head by fall 2014, McCabe said, when he got into what he described as
a shouting match with a manager. He said he was suspended with pay, and
ultimately terminated.
came to a head by fall 2014, McCabe said, when he got into what he described as
a shouting match with a manager. He said he was suspended with pay, and
ultimately terminated.
“This is
totally out of character for me,” he said. “You have no idea the months that I
spent asking my wife, asking other people: Am I violent? Do you perceive me as
violent, as threatening? Because God knows I don’t want to be that person. I
want to get help.”
totally out of character for me,” he said. “You have no idea the months that I
spent asking my wife, asking other people: Am I violent? Do you perceive me as
violent, as threatening? Because God knows I don’t want to be that person. I
want to get help.”
He said
he notified the WSIB of the incident and losing his job. He said his claim file
was sent to one medical consultant, and then to Dr. Steinnagel for a second
review in late 2014. (He said he only learned that she had concluded his mental
health issues could be related to his injury after his lawyer received the file
from the WSIB this year.)
he notified the WSIB of the incident and losing his job. He said his claim file
was sent to one medical consultant, and then to Dr. Steinnagel for a second
review in late 2014. (He said he only learned that she had concluded his mental
health issues could be related to his injury after his lawyer received the file
from the WSIB this year.)
An
ex-employee of WHCS, Steinnagel’s former employer, said Steinnagel was the
busiest consultant at WHCS, closing 40 files a week on time. The employee, who
has also worked at WSIB and asked to remain anonymous because she still has a
professional relationship with the agency, alleged that Steinnagel was not the
first consultant to lose her job at the request of the WSIB.
ex-employee of WHCS, Steinnagel’s former employer, said Steinnagel was the
busiest consultant at WHCS, closing 40 files a week on time. The employee, who
has also worked at WSIB and asked to remain anonymous because she still has a
professional relationship with the agency, alleged that Steinnagel was not the
first consultant to lose her job at the request of the WSIB.
The
company also previously removed from its roster an independent contractor, who
had apparently had a confrontation on the phone with a WSIB physician over a
medical opinion, the employee claimed.
company also previously removed from its roster an independent contractor, who
had apparently had a confrontation on the phone with a WSIB physician over a
medical opinion, the employee claimed.
“I cannot
comment because we have no knowledge of any of this,” said WHCS lawyer, Greg
McGinnis.
comment because we have no knowledge of any of this,” said WHCS lawyer, Greg
McGinnis.
“To me,
it’s really wrong what they did to Brenda,” the employee told the Star. “The
only person besides Brenda who got screwed out of this is the worker.”
" it’s really wrong what they did to Brenda,” the employee told the Star. “The
only person besides Brenda who got screwed out of this is the worker.”
Paul Murphy Mental Health Advocate Contact Information
Facebook---https://www.facebook.com/Fattertainment
Twitter @fat411
Email pauljmurphy22@gmail.com
Youtube https://www.youtube.com/channel/UC9BcyHhfTn-7bi4WENIaHqw
I am doing my utmost to offer support and guidance under the umbrealla of Health and Health Equity. Public speaker and presentor and I welcome you to contact me in the hope to offer support for your staff and your workplace.
Twitter @fat411
Email pauljmurphy22@gmail.com
Youtube https://www.youtube.com/channel/UC9BcyHhfTn-7bi4WENIaHqw
I am doing my utmost to offer support and guidance under the umbrealla of Health and Health Equity. Public speaker and presentor and I welcome you to contact me in the hope to offer support for your staff and your workplace.
Thursday 24 September 2015
WSIAT | Workplace Safety and Insurance Appeals Tribunal - Ontario
WSIAT | Workplace Safety and Insurance Appeals Tribunal - Ontario
"The current policy that restricts entitlement goes against Sec 15 in the Charter of Rights and Freedoms in Canada. Ontario First Responders and frontline staff deserve to be protected . Many workers and students are unaware of this issue and they continue to face Trauma and Vicarious Trauma in the workplace. You can help , or dismiss mental health issues as a sign of weakness , which carries a large measure of Stigma." Paul Murphy
" The Panel concluded that s. 13(4) and (5) of the WSIA, and related Board policy, infringe the worker's right to equality as guaranteed by s. 15(1) of the Charter of Rights and that the infringement was not justified by s. 1 of the Charter. Accordingly, the Panel declined to apply s. 13(4) and (5) of the WSIA and the related Board policy to the appeal. As previously concluded in Decision No. 2157/09I, the worker's appeal would have succeeded but for s. 13(4) and (5) of the WSIA and the related Board policy. Accordingly, the worker had initial entitlement for mental stress. In reaching this decision, the Panel noted that the Charter challenge only pertained to the limitation of entitlement to mental stress that is an acute reaction to a sudden and unexpected traumatic event. The further provision of s. 13(5) of the WSIA that excludes entitlement for mental stress caused by the employer's decisions or actions was not before the Panel in this appeal. The appeal was allowed. "
http://www.wsiat.on.ca/NoteworthyDecSummary.asp?lan=E&dec_decid=58670
"The current policy that restricts entitlement goes against Sec 15 in the Charter of Rights and Freedoms in Canada. Ontario First Responders and frontline staff deserve to be protected . Many workers and students are unaware of this issue and they continue to face Trauma and Vicarious Trauma in the workplace. You can help , or dismiss mental health issues as a sign of weakness , which carries a large measure of Stigma." Paul Murphy
" The Panel concluded that s. 13(4) and (5) of the WSIA, and related Board policy, infringe the worker's right to equality as guaranteed by s. 15(1) of the Charter of Rights and that the infringement was not justified by s. 1 of the Charter. Accordingly, the Panel declined to apply s. 13(4) and (5) of the WSIA and the related Board policy to the appeal. As previously concluded in Decision No. 2157/09I, the worker's appeal would have succeeded but for s. 13(4) and (5) of the WSIA and the related Board policy. Accordingly, the worker had initial entitlement for mental stress. In reaching this decision, the Panel noted that the Charter challenge only pertained to the limitation of entitlement to mental stress that is an acute reaction to a sudden and unexpected traumatic event. The further provision of s. 13(5) of the WSIA that excludes entitlement for mental stress caused by the employer's decisions or actions was not before the Panel in this appeal. The appeal was allowed. "
http://www.wsiat.on.ca/NoteworthyDecSummary.asp?lan=E&dec_decid=58670
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