Managing Trauma

With thanks to Dr Nicola Lester, Psychological Trauma Consultant  

When we are in our 'window of tolerance' – the optimal point of arousal or alertness – we are able to think clearly, solve problems, make decisions, take perspective, be curious, and generally perform at our best.  

However, when someone experiences trauma, such as witnessing or experiencing a collision, their window of tolerance becomes much narrower and they are more easily pushed outside of it into what's called a 'survival mode' because their brain thinks that they are in danger. This survival mode can take two different forms, either: 

  • hyperarousal (fight or flight) 
  • hypoarousal (freeze, collapse) 

These survival responses can impact their safety as drivers, affecting their confidence, situational awareness and judgement, capacity to make good decisions and lead to an increase in irritability, anger and impulsivity. Indeed, stress and adversity from other areas of life can also impact on a driver's ability; they are more likely to be distracted, struggle to concentrate and may experience anxiety which in turn may affect their confidence and judgement.  

It is important to remember these are normal responses to an abnormal event and they will often subside in the days and weeks following a traumatic incident. However, drivers can keep themselves safe by being aware of how they have been affected and thinking about what support they might need from those around them. In the event of exposure to a road traffic collision (either as a witness or a victim) it can also be worth thinking about ways to rebuild confidence. For example, advanced driver training can be a useful way of widening a Window of Tolerance to increase the driver's capacity to cope and respond to stress on the road.

The importance of reaching out 

However squeamish we may be about invading another's privacy, we must recognise that people experiencing mental health conditions often cannot ask for the help they need. It is essential then that colleagues and managers reach out to them – repeatedly if necessary. 

Stress 

The modern usage of stress refers to demands or pressures which exceed a person's ability to deliver or cope. People can feel overwhelmed and anxious. 

In biological terms, the stress response is triggered by the brain recognising a threat to wellbeing or safety. The hypothalamus informs the pituitary gland, which triggers the adrenal gland to release adrenaline. It raises your heart rate, sends blood surging through muscles, diverts blood from the digestive tract, and tunnels our perception to the immediate danger. Once, this burst of adrenaline would have given us the speed, focus and energy to run fast or fight hard to protect ourselves from an aggressor.  

Today, the dangers we usually face, especially in the road environment, require logic, calm rational responses, and a wide awareness of events unfolding around us – not the narrow perception and physical prowess our fight or flight response provides. 

If we are able to act to mitigate an immediate threat – eg grab the cat and flee a burning house – then our stress level can abate, because the adrenaline has done its job. However, when people are stressed in the workplace, or on the road, there is often no consequential action they can take to reduce their stress response, because the things they fear are not physical, but environmental, social and professional pressures.  

This adrenal response can also be cumulative, with many small incidents ramping up an individual's adrenaline levels as the day progresses. 

Driving is often stressful, especially in congested conditions, or if drivers must meet deadlines. 

Effect on road safety 

Stressed drivers are many times more likely to speed, fail to give way and generally demonstrate poor driving behaviours. Stressed drivers accelerate intensively six times more often than non-stressed drivers and brake harshly twice as often.  

In the driver stress study referenced above, stressed drivers were also 20% more tired after a driving test than non-stressed drivers. 

What you can do 

  • Under the Health and Safety at Work Act you have a legal responsibility to protect workers from occupational stress. 
  • Ensure that your scheduling does not cause undue stress to drivers. If delivery windows, routes or distances put pressure on drivers, consider changing them. Develop an understanding of how your drivers are performing against pre-set delivery schedules. If they are already 'running late' early in the day, then the schedules clearly do not align with the reality of what the drivers can deliver. 
  • Educate drivers in stress management. See the techniques below. 
  • Ensure that drivers know that if they are anxious or stressed, they should pull over when safe and take a break to calm down. This can seem counter-intuitive when up against a deadline, but they will perform better, with less risk, once they feel better.  
  • Ensure that drivers have time in their schedules for sufficient breaks. The Highway Code recommends at least a 15-minute break after every two hours of driving. Vocational drivers may have their breaks mapped differently. However, the regulations specify minimal breaks – there is no reason employers cannot allow their drivers to have longer breaks than specified. Rest breaks where no work is done do not count towards working time or driving time limits. 

Anxiety 

Anxiety and stress are closely related, but anxiety refers to a long-term state of stress arousal. Anxiety can be horrible to live with, exhausting, and is often disruptive to other normal functions like eating and sleeping.  

Anxiety may be related to specific worries, such as money or ill health, or a wide range of issues. 

Depression 

Depression is a serious mental health condition which requires professional support. It can seriously affect decision-making and it can be dangerous to drive with untreated depression. However, with treatment most people can continue to drive and work safely. 

What employers can do 

There are many other mental health conditions and illnesses than are mentioned here. It is not a manager's job to make a diagnosis of a mental health condition, any more than they would be expected to diagnose a physical condition. However, you can be aware of behavioural changes, such as people being more nervous, irritable, or withdrawn, not seeming 'themselves', being forgetful, or their driving or other performance deteriorating. 

  • Risk assess your workplace for causes of stress.  
  • Be aware that some individuals may be more vulnerable to concerns about their mental health than others, for instance if they are neurodivergent, socially isolated, a carer or have chronic or acute health conditions. 
  • Train managers in having supportive conversations in which drivers are invited to share their concerns. If they do not wish to talk to someone at work, suggest seeing an external professional or GP.   
  • In the UK, it's common for people to give automatic responses when asked if they're all right. To get a more genuine answer, it's helpful to ask twice. The second time, they're more likely to share how they really feel. 
  • Educate all staff about mental health issues, the importance of speaking to someone, the safety issues caused by driving while stressed, anxious or depressed, and the positive steps which can be taken to protect them at work and help their recovery. 
  • Once someone has a diagnosis, do not debate it or try to understand it. Simply accept the advice of the GP, medical support staff or occupational health adviser about what adjustments should be made and listen to the individual about their needs. 
  • Always ensure that any medications have been checked with a doctor or pharmacist for their compatibility with driving. 
  • The key terms for managing mental health in the workplace are open, positive supportive and judgement-free. 
  • Train mental health first aiders. Distribute the numbers of helplines and have a helpline sticker for the Samaritans or similar charity in each vehicle. 

Resources