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PTSD or post-traumatic stress disorder can occur as an acute disorder soon after a trauma or have a delayed onset in which symptoms occur more than 6 months after the trauma. It can occur at any age and can follow a natural disaster such as flood or fire or a man-made disaster such as war or imprisonment, or assault or rape.
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workdays and millions of dollars in lost wages. In addition, victims of violent crime may suffer undiagnosed post traumatic stress disorder (PTSD) for many years at great cost to their health and the healthcare systems.40
According to Dean Kilpatrick, Ph.D. and Sherry Falsetti, Ph.D. in a report from the annual meeting of the Anxiety Disorders Association of America in May, 1995, titled Stress signs often missed in victims of violent crime, "Violent crimes like physical assault, homicide, and rape touch the lives of millions of Americans each year and produce persistent emotional effects, such as PTSD, which can last for many years."41 Drs. Kilpatrick and Falsetti stated that the most common diagnosis that they found after a traumatic event was PTSD. They also found that 80% of patients coming in for treatment reported four or more physical reactions occurring at the same time which were diagnosed as panic attacks.
According to NIOSH, homicide is the second leading cause of death on the job and homicide is the leading cause of workplace death for women. However, men are at three times the risk of becoming victims of workplace homicides that women. Homicide is also the leading cause of death for workers under 18 years of age. The majority of workplace homicides are robbery related crimes (71%) with 9% committed by coworkers or former coworkers. Moreover, 76% of all workplace homicides are committed with a firearm.
EMPLOYERS' ORGANISATION
Although there are numerous employers' organizations, two stand out in terms of their work on employment and mental health issues as well as their partnerships with governmental agencies.
Washington Business Group on Health (WBGH)
WBGH is a non-profit organization of approximately 300 employers. It was established in 1989 to assist employers with workplace strategies and health system practices that reduce the economic impact of depression and other mental disorders. The program is advised by a council of corporate leaders in human resources, employee assistance, medical, health and disability, health promotion, and work/life programs. WBGH has worked closely with the National Institute of Mental Health National Worksite Program in developing programs for employers that will reduce the impact of mental disorders, particularly depression, on both employer and employee42
The U.S. Office of Technology Assessment provides the following description of WBGH's mission and activities:43 "...to provide information and technical assistance to employers, advocates, service providers, unions, and others to assist in achieving voluntary compliance with Title I of the ADA. Among the project's goals: The creation of widespread awareness among employers about their responsibilities under the ADA; the establishment of a WBGH/ADA Resource Center consisting of a database of effective employer's best practices and resource individuals and materials; the provision of information and technical assistance; the production and wide dissemination of a series of ADA mental health information briefs; and the production of an employer's guide to accommodating individuals with mental disabilities in the workplace"
The Washington Business Group on Health has been an important resource for this document. Please refer to the bibliography for a complete list of its publications pertinent to depression and the workplace.
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