Supporting You After a Distressing Event

Occupational Health and Wellbeing

Supporting you after a distressing event

What are acute distressing events (ADEs)?

Events that can cause colleagues to experience an acute stress reaction and that are potentially traumatic.

Any acute event where the circumstances are so unusual or the sights and sounds so distressing, resulting in high levels of immediate or delayed emotional response.

Experiencing a distressing event can affect people in different ways. For some, the impact may feel minor, while others find themselves overwhelmed with unfamiliar emotions. This leaflet aims to help you understand your feelings, provide selfhelp strategies and introduce you to the peer and professional support available to you.

Remember, you are not alone, and the reactions you may be experiencing are normal responses to an abnormal situation. How you respond will depend on many factors, including the circumstances of the event and what else was happening in your life at the time.

Trauma Risk Management (TRiM)

NHS Barnsley Talking Therapies NHS Practitioner Health

Mental Health Support Worker PNA / PMA Support

Interventions

Trauma Incident Briefing (TiB)

Team Immediate Meet (TIM) (Within the hour)

Stages / Aims

Acute Distressing Event

1. Demobilise & Communicate

External Mental Health Support

Occupational Health Mental health triage Individual counselling (in-person)

Line Manager Support

Employee Assistance Programme (EAP)

(e.g. wellbeing conversations)

Individual counselling (telephone)

Personal / Self-Care Resources (e.g. VIVUP website, Unmind app, Good Thinking: Coping with Trauma workbook)

2. Defuse & Support

3. Reflect & Restore

– Acknowledge the event (facts) – Reassure / normalise reactions – Signpost to support resources

– Talk about what happened (relate) – Appraise and monitor wellbeing – Identify / signpost further support

– Explore thoughts and emotions – Insight into reactions (meaning) – Stabilise and restore functioning

1st hour - Day 3

Day 3+

Day 28+

The graphic above summarises the pathway of interventions available to support you in the hours/days following an acute distressing event (ADE). Not every colleague will require the same level of support or move through every stage. Most people who experience an acute stress reaction will recover naturally within 4 weeks.

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How do people react to ADEs? Immediately after an ADE you may feel numb, shocked or detached, as if the event wasn’t real. Over time, emotions and thoughts may emerge, and it’s common to replay what happened or experience vivid dreams.

People respond differently, but common reactions include:

When to seek additional help Most people recover from acute stress naturally, but sometimes support is needed. Consider seeking help if you: ➔ Feel overwhelmed by intense emotions or physical symptoms ➔ Have persistent nightmares or flashbacks that interfere with your day-to-day activities or your ability to get restful sleep ➔ Struggle to maintain relationships or find yourself withdrawing from others

Emotional reactions: Sadness, guilt, anger, shame, fear or frustration

Physical symptoms: Fatigue, headaches, nausea, tightness in the chest and muscle tension

Mental effects: Difficulty concentrating, flashbacks, nightmares and feeling on edge

Changes in behaviour: Irritability, withdrawing from loved ones or avoiding reminders of the event

These reactions are natural and often subside with time. However, they can strain your relationships and daily routines. It’s important to be kind to yourself, allow your feelings to surface and seek support when needed.

➔ Notice changes in behaviours, such as drinking heavily, avoiding activities, or feeling detached ➔ Feel stuck, depressed or unable to move past an event ➔ Suicidal thoughts or thoughts of self-harm.

If you recognise any of these signs, it may be helpful to talk. Help is available, and reaching out is a sign of strength.

Talking to someone you trust – whether it’s friends, family or colleagues, can help you process your feelings.

Remember, you don’t have to go through this alone. Accepting help and support can make a big difference.

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Positive coping strategies

Avoid negative coping strategies

Taking active steps can promote healing and improve quality of life:

Some behaviours may seem helpful at first but can create long-term challenges. Try to avoid:

Connect with others – spend time with family, friends and colleagues

Isolating yourself from others Overworking or staying excessively busy to avoid feelings

Exercise regularly – even a short daily walk can boost your mood and energy levels Get involved – volunteering or helping others can provide purpose and build resilience Learn something new – developing new sills or hobbies outside of work can be fulfilling Limit technology use – take breaks from screens and social media to recharge Stick to routines – maintaining familiar activities can provide stability

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Relying on alcohol or drugs to numb emotions Bottling up emotions – express how you feel, whether through talking, journaling or another outlet.

What to Remember You are still the same person you were before the event.

It’s normal to have a range of emotions, but they don’t define you. Allow yourself to process what happened and remember that healing is possible with time and support.

Re-establishing routines and focusing on positive coping actions will help you regain balance. While you may not forget the event, you can learn to integrate it into your life in a way that it doesn’t overwhelm you.

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For family members, friends and colleagues After a traumatic event. Someone close may seem different. This change is usually temporary, and your support can help them return to their usual self.

Here are some helpful tips: ➔ Listen carefully and spend time with them ➔ Offer help and a listening ear, even if they don’t ask ➔ Assist with daily tasks but respect their need for private time

Final thoughts…

You are not alone. Support is available.

Be kind to yourself, take things one step at a time, and remember that recovery is a journey, not a race. With the right care and support you can find your way back to feeling stronger and more in control. ♥

➔ Don’t take anger or other emotions personally ➔ Avoid phrases like, “you’ll get over it” or “it could have been worse.” Instead reassure them and try to see things from their perspective. ➔ Your understanding can make a big difference.

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Helpful Supports Line Manager Support

Mental Health Support Worker (MHSW)

Your Line Manager will have regular 1:1s and wellbeing conversations with you, and it may be beneficial for the usual frequency of these to increase following the ADE. The BHNFT Health & Wellbeing Passport can help support and structure these conversations. Consider whether any workplace adjustments may help you in the short-term (e.g. opportunity to rotate from work areas of high to low stress).

The MHSW is available via Occupational Health and Wellbeing (OHWB) to provide peer support, welfare checks and signposting to/liaising with further support services (e.g. bereavement support).

Contact bhnft.occupationalhealthandwellbeing@nhs.net

PNA/PMA Support Professional Nurse Advocates (PNAs) and Professional Midwifery Advocates (PMAs) can provide peer support, mentoring and signposting, for NMC registered colleagues. They offer Restorative Clinical Supervision to address the emotional needs of staff and help develop resilience. Contact the PNA team bdg-tr.professionalnurseadvocates@nhs.net or the PMA team bdg-tr.barnsleypma@nhs.net

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Trauma Risk Management (TRiM) TRiM is an evidence-based approach whereby trained TRiM Practitioners within the organisation provide structured peer support and risk assessment to colleagues following an ADE. The intervention can be delivered 1:1 or in groups. Undertaking a TRiM assessment is voluntary and confidential. Colleagues who are found to present with risk factors indicating they may encounter difficulty recovering from their acute stress reaction and/or maybe a risk of developing mental health difficulties, are directed to professional psychological support. All colleagues are signposted to relevant self-care resources, other support available and a follow up TRiM assessment offered 4 weeks later.

You can access this service at bdg-tr.trim@nhs.net

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Personal Self-Care Resources

Occupational Health and Wellbeing (OHWB)

The following are links to useful self-care resources you can access directly or to signpost colleagues towards:

Mental Health Triage – expert advice can be provided around fitness to work, return to work, reasonable/ workplace adjustments and signposting to other (external) mental health support. Managers can refer individuals to the services and/or the individual can make a self-referral: for further details see OWHB Intranet Page.

Mind’s – Coping with trauma website and Trauma Guide Good Thinking – Coping with Trauma Workbook The Employee Assistance Programme (EAP) provider VIVUP – Resources page on the VIVUP website

Individual On-site Counselling – confidential talking therapy and trauma-informed counselling available at Block 9 Monday to Thursday 8:30am – 4:30pm. Telephone: 01226 43 4939; colleagues should complete a self-referral form via OHWB Intranet page or email bhnft.occupationalhealthandwellbeing@nhs.net Where Line Managers have concerns over staff with suicidal thoughts/a history of suicide attempts or recent selfharm, a fast-track referral to OHWB may be made. For severe mental health crises/emergencies contact the individuals’ GP or take them to A&E (see Mental Health Escalation Guidance).

Cumbria, Northumberland, Tyne and Wear – Stress Guide – Anxiety Guide – Depression Guide Health and Wellbeing Service Directory for BHNFT

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Employee Assistance Programme (EAP)

Other Helpful Supports:

VIVUP – provides confidential telephone counselling – as standard, they are open 24/7, 365 days a year.

Telephone: 0330 380 0658. Face to face counselling using trauma-focussed approaches (e.g. EMDR) is also available if needed.

The Samaritans offer confidential emotional support 24 hours a day.

External Support

CALM The Campaign Against Living Miserable is leading a movement against suicide. You can talk to CALM about anything.

NHS Barnsley Talking Therapies (formerly known as IAPT) – provides confidential telephone counselling (including cognitive behavioural therapy, CBT). Open Mon to Fri 9am – 5pm. Telephone: 01226 644900 barnsley.talkingtherapies@swyt.nhs.uk

Call 116 123 – it’s FREE or email jo@samaritans.org.uk SHOUT offers free, confidential support 24/7: text SHOUT to 85258

Call on 0800 58 58 58

– Online computerised CBT (cCBT) via the SilverCloud NHS Practitioner Health provide free and confidential mental health treatment for doctors, dentists and other primary/secondary care staff where they cannot access care confidentially through other routes (e.g. seniority in their role, or the team they work in).

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Barnsley Hospital NHS Foundation Trust Gawber Road, Barnsley S75 2EP Tel: 01226 730000 www.barnsleyhospital.nhs.net

Occupational Health and Wellbeing