Trauma & Stress After a Serious Incident

A serious injury, a death, a near miss or a violent event at work can affect people long after the physical danger is over. Strong reactions are normal. Most people recover with time, rest and support, but some need more help. Knowing what to expect, and how to help yourself and others, matters as much as first aid does.

• All Workers
• Supervisors
• First Responders

Who is affected

• The injured worker and anyone who was directly involved.
• Witnesses who saw it happen, and coworkers who helped with first aid or rescue.
• Supervisors and managers who feel responsible.
• Coworkers and friends who weren’t there but knew the person.
• First responders and safety staff, who see traumatic events repeatedly.
• Family members of the injured or killed worker.

Construction and industrial work carries a high risk of traumatic events, and the trades also have high rates of suicide and substance use. See Suicide Prevention and Substance Use & Recovery.

Normal reactions

After a shocking event, many people have some of these, usually for days or a few weeks:

• Physical: trouble sleeping, nightmares, fatigue, headaches, stomach problems, a racing heart, being easily startled, changes in appetite.
• Emotional: shock, numbness, fear, anger, guilt, sadness, irritability, anxiety, feeling overwhelmed, or feeling nothing at all.
• Thoughts: replaying the event, trouble concentrating, confusion, intrusive images, blaming yourself or others, thinking “it could have been me.”
• Behavior: avoiding the site or reminders, withdrawing from others, drinking or using drugs more, being less careful at work or more careful than usual, arguments at home.

These are normal reactions to an abnormal event. They don’t mean you’re weak or broken.

Warning signs that you need more help

• Symptoms that last more than about a month, get worse, or stop you from working, sleeping or caring for yourself and your family.
• Constant flashbacks, nightmares, or feeling like the event is happening again.
• Heavy use of alcohol, drugs or pills to cope.
• Severe depression, hopelessness, panic attacks, or feeling cut off from everyone.
• Thoughts of hurting yourself or ending your life. Call or text 988 (Suicide & Crisis Lifeline) right now, or call 911 in an emergency.
• Trouble doing safety-critical tasks, such as running equipment, because of fear or panic.

Post-traumatic stress disorder (PTSD) and other conditions are medical issues that respond well to treatment. A doctor, counselor or mental health professional can help.

Taking care of yourself

• Get safe and take a break. After a serious event, ask for time before going back to the scene or the same task, if you need it.
• Talk about it with people you trust, such as family, friends, a coworker who was there, a mentor, or a clergy member. You don’t have to tell the whole story, and you don’t have to talk right away.
• Take care of your body. Eat regular meals, drink water, move around or walk, and rest even if you can’t sleep well. Limit caffeine and avoid using alcohol to calm down. See Stress Management and Sleep for Shift Workers.
• Keep routines as much as you can, and do small things that help you feel steady.
• Limit exposure to repeated reminders, such as watching videos or reading news about the incident over and over.
• Be patient with yourself. Healing takes time, and it isn’t a straight line.
• Use professional help. Counselors, your doctor and peer support can help, and getting help early is a sign of strength.

Helping a coworker

• Check in in person, simply and kindly: “How are you doing? I’m here if you want to talk.” Listen without judging or fixing.
• Don’t push someone to talk, or say “at least it wasn’t worse.” Avoid blame, and don’t share gossip or graphic details.
• Offer practical help: a ride, a meal, covering a task, or going with them to see a counselor.
• Keep in touch over time. Many people feel alone after the first few days.
• Watch for the warning signs above, and encourage professional help. If someone talks about suicide, take it seriously and get help. See Suicide Prevention.
• Respect privacy, and don’t share their story.

What employers and supervisors should do

1. Take care of people first. Give first aid, make sure the injured person has care, and notify family respectfully. See How OSHA Investigates Fatalities for what comes next.
2. Provide immediate support: a quiet place, water, time to call family, a ride home, and a chance to stop work. Don’t pressure people to return to work the same day.
3. Offer psychological first aid: be calm, practical and caring, and connect people with help. This is more helpful than forcing people to talk about the event in a group right away.
4. Provide resources: an Employee Assistance Program (EAP), counselors, a crisis line, medical care, and information on what reactions to expect. Tell workers it is confidential and free.
5. Be careful with debriefings. Research doesn’t support mandatory, single-session “critical incident stress debriefing” right after an event. Offer voluntary support instead, and let people choose.
6. Support peers. Trained peer support teams can help coworkers who relate to the experience.
7. Follow up days and weeks later, and watch for signs that someone is struggling. Make sure supervisors are cared for too.
8. Plan the return to work. Allow flexible duties, a gradual return and a chance to talk about concerns. See Return to Work and Light Duty.
9. Learn from the incident through a fair, non-blaming investigation. See Incident Investigation and Preserving an Incident Scene.
10. Plan ahead: include mental health support in your emergency action plan. See Emergency Action Plans.

Workers’ compensation and time off

• In some states and situations, psychological injuries from a workplace event may be covered by workers’ compensation, though the rules vary widely. Ask your employer, a workers’ comp lawyer or your state agency. See Filing a Workers’ Comp Claim.
• You may be able to use sick leave, family and medical leave or other leave to recover. See Leave Laws and Disability Accommodations.
• Employers can’t retaliate against you for reporting an injury or seeking help. See Whistleblower Protection.

Where to get help

• 988 Suicide & Crisis Lifeline: call or text 988, 24 hours, free and confidential.
• SAMHSA Disaster Distress Helpline: 1-800-985-5990, or text TalkWithUs to 66746.
• SAMHSA National Helpline for mental health and substance use treatment referrals: 1-800-662-4357.
• Your employer’s EAP, your doctor, a counselor, a union assistance program or a faith leader.
• Veterans can reach the Veterans Crisis Line by dialing 988 and pressing 1.

After an incident: quick guide

• I know that strong reactions are normal and usually fade
• I’m eating, resting and talking to someone I trust
• I know the warning signs that mean I need professional help
• I know the EAP and crisis line numbers, including 988
• Supervisors have offered voluntary support and a fair plan to return to work
• I check in on coworkers in the days and weeks that follow

Last updated: October 4, 2026