Limits to the access and use of support and help
This section summarizes the factors that may limit use of help by crew members after a critical incident.
Fear of lost income
- Some crew members do not “book on trauma” because they fear the 3 month delay it automatically induces before they can return to work (see medical rules). They feel forced off work and feel doubly victimized by the loss of income that comes with time off work.
- Even if it is changing, there is still a strong masculine culture within the railway industry. Men who strongly adhere to strong masculine values and stereotypes tend to “bottle it up”, repress their feelings and deny their difficulties.
- These men do not tend to use available resources to help them cope with critical events. The railway industry can play a role in promoting help seeking in it values and codes of conduct, encouraging their employees’ perspectives to evolve.
Fear of negative consequences at work
- Some people fear that if they take time off work, use medication, consult with a therapist or express emotional difficulties, they will be judged by their peers, by their managers and that this will have a negative on their work relationships.
Pre-existing work relations difficulties
- Seeking help implies that people admit to experiencing difficulties. This can only be done in a context of trust. Difficult relations with colleagues or especially with managers may prevent crew members from expressing a need for support and care.
Misunderstanding who can help
- People do not always understand the role of the professionals they meet. There are misunderstandings leading to frustrations, unexpected consequences and grievances.
-The role of the company medical officer appears to be particularly ambiguous to employees.
- People do not always understand the difference between a doctor, a psychiatrist, a psychologist, a social worker and a therapist. They do not always contact the right professional and may feel frustrated by the response.
- These misunderstandings may lead to multiple referrals and an increased riss of discontinuing care seeking.
Prior unmet expectations
- The desire to seek support depends largely upon previous experiences. Negative experiences in the past will discourage people to seek help again.
- Having had arguments with the employer about a previous leave of absence will increase pressure when the time comes to take some more time off work
- Having a poor experience with a mental health professional can lead people to think that these resources are useless