Psychological Support After a Workplace Accident: Managing Trauma in the Team and Psychological First Aid

How do you plan psychological support after a workplace accident? Read this guide to psychological first aid, team trauma, legislation and return to work.

When a serious workplace accident happens in a factory, the first hours pass with ambulances, reports, machine safety and official notifications. All of these are necessary. But something is also shaken in the inner world of the employees who witnessed the moment of the accident, gave first aid to their injured colleague, or have to return to the same workstation the next morning. Psychological support after a workplace accident is the structure set up to notice this invisible impact early, to help the team feel safe again and, when needed, to refer people to specialist support. In this article, for employers, HR managers and occupational health and safety (OHS) specialists, I look at what works in the days after an accident, what is not recommended, and the framework the legislation offers on this subject.

Why Is Psychological Support After a Workplace Accident Necessary?

In Turkey, a workplace accident is not an exceptional event but, unfortunately, a regular reality of working life. According to SGK (Social Security Institution) data, in 2025 766,039 workplace accidents were recorded under coverage 4-1/a (insured employees), and 1,931 employees lost their lives as a result of workplace accidents (SGK Statistical Yearbook, 2025). In the same year, workplace accidents caused a total of 4,639,930 days of temporary incapacity for work. About 41% of accidents took place in the manufacturing sector. Independent observers also stress that the real numbers may be higher than the official records.

Behind each of these figures there is not only the person who had the accident, but also shift colleagues who saw the incident, foremen, the first aid team and families. The mental effects of an accident can be reflected directly in work outcomes:

• Drop in attention and concentration: An employee who keeps reliving the incident in their mind may be less attentive at the machine, and this can raise the risk of a new accident.
• Absenteeism and difficulty returning to work: Avoiding going near the accident site, longer sick leave or decisions to leave the job may be seen.
• Loss of trust within the team: The thought "Will it be my turn next time?" can shake the team's trust in the safety rules and in management.
• Blame and anger: A tendency to look for someone to blame in the aftermath can damage communication and reduce the reporting of near misses.

So the post-accident process is not only a technical root cause analysis but also a human process of recovery.

What Reactions May Be Seen in Employees After an Accident?

After a serious incident, people being shaken is not abnormal but expected. The following reactions are common in the first days and weeks:

• Images of the incident coming to mind involuntarily, nightmares and difficulty falling asleep
• Avoiding the accident site, particular sounds or machines
• Being constantly on guard, startling, tension and irritability
• Guilty thoughts such as "If only I had responded faster"
• Emotional numbness, describing the incident as if it had never happened, or excessive joking
• Physical complaints such as headaches, stomach problems and tiredness

Most of these reactions settle with appropriate support and time. However, in some employees the signs can continue and impair daily functioning. In a systematic review examining occupational post-traumatic stress disorder, prevalence rates were found to vary widely between studies, from 8.4% to 41.1% (Lee et al., 2020). The width of this range shows that there is no single "post-accident trauma rate"; the outcome varies according to the severity of the incident, working conditions and the person's previous mental state. You can find detailed information on what can be done when signs persist in the article on post-traumatic stress disorder.

There is an important line here: a manager's or an OHS specialist's task is not to diagnose. These signs alone do not mean a disorder; the aim is to notice the person who is struggling and to connect them with the right resource.

Risk Factors: Who May Need More Support?

Not everyone exposed to the same incident is affected in the same way. When planning after an accident, it is useful to pay special attention to the following groups:

• The employee who had the accident and was injured: Research shows that as the severity of injury increases, the risk of mental impact also increases. One study reported that return-to-work rates were lower among employees who had post-traumatic stress symptoms together with a musculoskeletal injury (Lin et al., 2016).
• Those who closely witnessed the incident: Employees who saw their injured colleague, helped, or were present at an accident that ended in death.
• Those who feel responsible: The person who operated the machine that day, handed over the shift or gave the instruction.
• Those who have had a traumatic experience before: For example, employees who lived through the 6 February 2023 earthquakes or were involved in another accident in the past.
• Those with weak social support: Employees who live away from their family, live alone or have just started a new job.

This list is not a labelling tool but a guide that helps set follow-up priorities. Imagine that a serious hand injury has occurred on a press line. Alongside the injured employee, the maintenance technician who set up the machine that day, the two operators who ran to help and the shift supervisor may all have been affected to different degrees. A good plan makes sure that each of these people is gently asked how they are at least once in the days after the accident.

Legislative Framework: Law No. 6331 and Risk Assessment

Occupational Health and Safety Law No. 6331 places on the employer the obligation to ensure employees' health and safety in relation to work (Art. 4). The phrase "psychological support" does not appear directly in the law; but there are some provisions related to the post-accident process:

• Article 15 (Health surveillance): On return to work after repeated absences following a workplace accident, a medical examination is carried out if the employee requests it.
• Article 17/4 (Training): Additional training is given to an employee who has had a workplace accident before they start work again. This training can be thought of together with a return-to-work plan that also takes into account the mental effects of the accident.
• Risk Assessment Regulation, Article 12: When a workplace accident, occupational disease or near miss occurs, the risk assessment must be renewed.
• Article 8 of the same regulation: Alongside physical and chemical hazards, psychosocial sources of hazard are also required to be identified and recorded.

Therefore the risk assessment renewed after an accident can address not only machine guards but also the psychosocial effects of the incident on the team. For details of this subject, you can look at the article on psychosocial risk assessment.

What Is Psychological First Aid? Look, Listen, Link

The World Health Organization's psychological first aid guide for field workers summarises how to approach people in and immediately after a crisis in three basic action principles: Look, Listen, Link (WHO, 2011).

• Look: Ensure safety, and notice those with urgent needs and those who are clearly shaken.
• Listen: Approach the person, ask about their needs, and if they want to talk, listen without judgement; do not force them to tell their story.
• Link: Help with practical needs such as water, rest, reaching their family and transport; if needed, direct the person to health services and specialist support.

The guide specifically stresses that psychological first aid is not professional counselling and is not something only specialists can do. Trained foremen, OHS specialists and workplace physicians can apply these principles.

The hardest thing in the field is what to say. Some sentences said with good intentions can leave a person alone. The statements best avoided are:

• Words that quickly shut down the feeling, such as "Get well soon, come on, pull yourself together, back to work"
• Blaming comments such as "If you'd been careful, this wouldn't have happened"
• Pulling the subject towards yourself by saying "I've been through things too"
• Sharing unverified information or guesses about the accident

Instead, short, calm sentences that leave choices open, such as "You're safe now", "What do you need?" and "I'm here if you want to talk, and I understand if you don't", are more supportive. In many production settings in Turkey, especially in male-dominated teams, showing that you are shaken can be seen as weakness. So when a manager says, "It's completely normal to be affected after an incident like this," it opens the way for the team to voice their feelings instead of hiding them.

In the first hours after an accident, what an employee needs is often not an analysis; it is to feel safe, to rest and to be able to reach their loved ones.

A practice that is not recommended: mandatory psychological debriefing. For many years it was a widespread practice to gather everyone in a room after an accident and have each person recount the incident in detail. However, the WHO strongly recommends that psychological debriefing not be offered to people recently exposed to a traumatic event with the aim of reducing the risk of post-traumatic stress, anxiety or depression (WHO, mhGAP). Instead, psychological first aid, monitoring and, when needed, referral to trauma-focused cognitive behavioural therapy are recommended. An operational briefing meeting that explains how the incident happened and which measures will be taken is different from this and is useful to hold; provided that no one is forced to talk about their feelings.

A Step-by-Step Plan for Employers: Psychological Support After a Workplace Accident

It is hard to make the right decision in a moment of crisis. So having the psychological support plan for after a workplace accident prepared before an accident happens makes a big difference. The following steps offer a framework:

The first hours

• Ensure physical safety and medical response; close off the site of the incident.
• Take employees who witnessed the incident to a quiet, calm area; if necessary, do not expect them to continue production on that shift.
• Assign people who have had psychological first aid training; apply the "Look, Listen, Link" principle.
• Handle communication with families through a single responsible person, in careful language.

The first days

• Give the team a short, clear operational briefing on the incident and the measures to be taken, one that prevents gossip.
• Avoid blaming language; state clearly that the root cause analysis examines the system, not the person.
• Offer a voluntary, confidential option for individual conversations.
• Give a short briefing on normal reactions such as sleep problems, anxiety and poor concentration; for those who have trouble sleeping, the article on how to overcome insomnia may be a guide.

The first weeks

• Hold regular, short check-in conversations with affected employees through the foreman or HR.
• Refer people whose signs are not easing, whose functioning is impaired or who mention thoughts of self-harm for specialist assessment without losing time. If there is an urgent risk, 112 (emergency services) should be called.
• Prepare a gradual return-to-work plan for the employee who had the accident; combine the additional training under Article 17/4 with this plan.

In the long term

• Renew the risk assessment and record the psychosocial effects too.
• Remember that anniversaries of the incident and similar incidents can bring old feelings back to life.
• Develop a culture that encourages, rather than punishes, near-miss reports.

How to Start in Your Organisation

Post-accident support is not something that can be improvised in a moment of crisis. Thinking of the preparation in three stages makes your work easier:

Needs analysis: Your facility's hazard class, shift pattern, past accident and near-miss records, number of employees and existing health unit are examined. Who will do what in a crisis, which communication channels will be used, and the need for external support are determined.

Programme: Psychological first aid training for foremen, OHS specialists and workplace physicians; a written critical incident response procedure; a confidential individual conversation option after an accident; and a return-to-work protocol are the core components of the programme. It is important that the procedure is short, understandable and simple enough for shift supervisors to carry in their pockets; in a crisis no one reads a long file. Reviewing the procedure at least once a year with a drill or a tabletop scenario exercise lets you see possible problems in advance. You can look at how such services can be designed on the corporate services page.

Measurement: Indicators such as post-accident absenteeism, return-to-work times, the number of near-miss reports, resignations and the rate of use of the support service are monitored regularly. These indicators are the most concrete way of knowing whether the programme is really working.

Frequently Asked Questions

When should psychological support start after a workplace accident?

In the first hours, basic needs should be met using a psychological first aid approach, and in the first days a voluntary conversation option should be offered. Not everyone needs therapy straight away; what matters is monitoring and referring those whose signs are not easing to a specialist in good time.

Is it right to gather the whole team after an accident and have them talk about the incident?

An operational briefing that explains the incident and the measures to be taken is useful. However, psychological debriefing sessions in which everyone is pushed to recount their experiences in detail are not recommended by the WHO. It is more appropriate to offer a confidential and voluntary space to those who want to talk.

How should the employee who had the accident return to work?

A gradual, planned return, prepared by talking with the employee, is the healthiest way. By law, additional training must be given before starting work; this process can be designed to support the person in getting used to the accident site again.

In which situations is specialist support needed?

If the signs are not easing after weeks, if the person cannot come to work or their family life is seriously affected, specialist assessment is recommended. If there are thoughts of self-harm, professional help should be sought without waiting, and 112 (emergency services) should be called in an emergency. In this process it can also be reassuring to know that getting support is always possible for your organisation and your employees.

• #workplace accident
• #psychological first aid
• #trauma
• #occupational health and safety

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Eda Erkan Alapala

Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.

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