Transcription:
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Patti Harman (00:06):
Hello and welcome to the DigIn podcast. I'm your host Patti Harman, editor-in-chief of Digital Insurance. The images coming out of California from the wildfire sweeping the state our nothing short of horrific. As thousands of homes and businesses burn and tens of thousands of people evacuate, knowing they may not have a home to return to as first responders work around the clock to get fires under control, the physical and mental impacts on them, their families and their residents affected will be devastating for insurers, agents, brokers, and claims and customer service professionals working with their policy holders. In the coming weeks, there will be many difficult conversations as damages and coverage are assessed. Joining me today to share some insights on the mental impact and event of this magnitude will have on so many individuals is Mark Debus, clinical manager of Behavioral Health at Sedgwick. Thank you so much for joining us today, Mark. I wish it was under different circumstances, but I think this is a really important conversation on so many levels.
Mark Debus (01:19):
Thanks Patti for having me. Yeah, you're right. As we're recording this now, it's still developing. So yeah, big stuff.
Patti Harman (01:30):
So I have covered disasters of all types for about 30 years, and watching the coverage in California hit me in a way that I can't even begin to explain. The sheer devastation in knowing that wildfires are generally unforgiving affected me in a way that truly surprised me. So I can't even begin to imagine what it's like for folks who are actually on the ground and experiencing it firsthand. So let's start with the impact on the residents of the areas that have been affected. They're watching this on television or on their home cameras and seeing their homes literally burning to the ground before their eyes, their communities, their schools and basically their way of life have changed forever. What is that process like for them? Do they go through the same stages of grief that someone goes through for other losses or is this grieving on a different scale? And part of my thought process is that it will also be a long process for them, so I'm wondering if that's going to be the case as well?
Mark Debus (02:44):
It's a really good question, and I think what we need to do is take a step back and think of this not just from a grieving perspective. Obviously, there's going to be a lot of grief and loss that they're going to be going through, but really right now it's trauma and trauma has a very different manifestation of symptoms. I mean, there's a lot of crossover, but what I think what they're going through right now is certainly a traumatic event in a collective traumatic event. I mean, we've certainly seen some of these in the past recently with the hurricanes and even going back a few years with the Covid pandemic. But what we're going through right now and what the individuals on the ground are going through right now is trauma and trauma is going to be really difficult for them. And then compound that with grief, you're looking at the effects of this are going to be very long term probably for a lot of them.
Patti Harman (03:44):
Okay. What kinds of behaviors might they experience or exhibit then as they go through this trauma and the grieving process and when should someone be concerned about the behaviors they're seeing and how should they even respond?
Mark Debus (04:03):
A really good question. Typical symptoms of trauma, someone who's been through a traumatic event will show things like hypervigilance first of all. And hypervigilance is when we are faced with a traumatic situation, our brain kind of kicks into high gear and looks for evidence of threat around us. And so when people are through a traumatic event, they have this thing called hypervigilance where it's hard to turn that part of your brain down and live kind of a normal life dealing with just stressors. So your brain is already kind of kicked into a high gear, so you're going to have hypervigilance. So you're always going to be on the lookout for threats around the corner even if you are in a safe space. So presumably someone's sought shelter, maybe they've evacuated in time and they're physically safe, but because they've been traumatized, they're not going to feel safe.
(05:00):
They're going to feel on edge and hypervigilant. Other things you're going to see immediately are sleep disturbances. People are going to have tremendous difficulty relaxing and getting good quality sleep after an event like this. Other things you're going to see with trauma reactions include ruminating thoughts just for lay people. Ruminating is having negative thoughts that you can't turn off. You may experience this during periods of intense anxiety where you can't turn the negative thoughts off. You're going to have catastrophizing thoughts as well. Examples of that would be even though you are physically safe, maybe your family's safe, your pets are safe, you're at a distance away from the immediate threat of the fires, but you can't turn off those thoughts that I could have died, my family could have died, and you kind of relive this worst case scenario in your head, even though physically you are safe right now. And so that is a really normal reaction to trauma. And then other things like difficulty calming down, as I mentioned before with sleep problems. And then overall just jumpiness and irritation are going to be very common symptoms of someone who's been traumatized.
Patti Harman (06:09):
So I ask when should someone be concerned then about these behaviors that they're seeing and how should they respond or what can they do at that point?
Mark Debus (06:21):
Well, I think the first part you need to realize is that this is going to happen. And so these types of reactions are very normal human reactions. We all go through them in various degrees. These are very common symptoms of trauma. So we don't want to quickly pathologize people who are going through this. This is a normal reaction now it's held to go through. I mean, you're going to feel terrible as you're going through this, and you're going to be worried about your loved ones who are also going through this. And you're going to see this manifesting in slightly different ways depending on the individual. Some people are more resilient to trauma than others, but at some point when you're dealing with such devastation in front of you, you're going to have some kind of reaction and that's normal and we expect that. So first thing we want to do is not pathologize.
(07:11):
This is a normal trauma response. There is help available and there's a lot of help available for this. The key thing though is to talk about it and talking about it helps normalize this and oftentimes will help relieve some symptoms if you just talk to someone about it. You can also do some things to help prepare with sleep, and we can probably talk about that in a little bit. But there's some practical solutions you can do to address some of this. But the key thing is to really recognize that you're going to go through this, recognize this is a normal response to trauma. There's nothing wrong with you because you're having hypervigilance. You're not going crazy. This is just what happens when people are traumatized. And then it's important to talk about it.
Patti Harman (07:54):
And I think it helps to know that it is a normal response that a lot of times people think, oh, I've never felt like this before, but to know that in this situation this is completely normal. It's not that unusual. It doesn't make it easier maybe to grasp it all, but it does make it a little bit easier to understand that this is all part of that process. There is a lot for the homeowners and the residents to process, but how can claims handlers and adjusters and first responders and others who come in contact with them, support them and maybe even empathize with what they're experiencing?
Mark Debus (08:40):
You hit the nail on the head. Empathy is key in these situations, but I would even take it a step further besides just empathy. And for our listeners, empathy, if you're not familiar with the term, is basically putting yourself in someone else's shoes or imagining their experience, their stressors and all of that. And it takes some level of imagination to kind of put yourself in someone else's position and experience what that might be like for them emotionally. The other piece of it though that takes a little further step is caring, and those are things that we also can do as claims handlers and adjusters is use caring responses. Now, the two together, you're going to say things like, first of all, you want to get to the emotions. You can name the feelings that you're hearing on the phone or you're seeing face-to-face. If you're interacting with someone during the claims process and you're meeting with 'em, you could see that they're upset likely.
(09:42):
But if you're on the phone, listen for emotional cues and then name it. And if you don't really know what they're feeling, ask them how they're feeling because people need to start talking about it. And again, we mentioned before that the key thing is to talk about these things to help normalize that these are normal reactions and people can start to feel better if they can name these feelings. So a couple phrases maybe to try would be like, I can't imagine how difficult this must be for you. You've experienced not only a huge loss, but the trauma and stress of it all. That's a lot for anyone to go through. I mean, something like that, simple goes a long way to express not only just empathy, but also caring.
Patti Harman (10:22):
I would totally agree. I had an incident where I had to file an insurance claim and I spoke to several different people as part of the claims process, and everyone's first reaction was, how are you? Are you okay?
(10:39):
And it just surprised me how much I appreciated someone caring and being concerned about my wellbeing in this particular incident. So you're right, I can see where that would really have a major impact. We think of first responders, police and firefighters in particular as being used to seeing devastation when there's a loss of this magnitude plus the long shifts and the sheer physical exhaustion involved with trying to bring these fires under control, are they in greater danger of mental exhaustion as well? And I mean, I'm thinking of how do they even regroup or take time away when it's almost impossible to take a break and how can they protect their mental wellbeing under such difficult circumstances?
Mark Debus (11:33):
Absolutely. Yeah. I mean, I don't even mean to chuckle, but it's overwhelming how much stress these first responders are going through in these life-threatening situations. Not only are they interacting with the public and people who are traumatized, but they themselves are putting themselves in danger. By flying over these scenes or on the ground with evacuation efforts and all sorts of things, they are putting themselves at risk, physical risk, risk of life even. And that is extremely stressful. Now, there are people that are kind of drawn to these fields that have different resilience than maybe I do, or you do, and they're kind of used to it, but it doesn't mean that they're immune to stress. Absolutely it doesn't mean they're immune to stress. And so it will take its toll on them. And we see this time and time again with the work comp realm where first responders do file claims for stress after awful situations like this, but also there are things that they can do, and one thing that's really wonderful about first responders is they often have this built-in support system among each other that there is this comradery that happens that they can support each other, have each other's back work together as a team, which can be really supportive not only from a practical standpoint and a safety standpoint, but an emotional standpoint.
(13:05):
They also have resources available to them through their possibly employee assistance program that they can turn to, or maybe there's a counselor that's part of their staff that they can talk to or someone in the occupational health department, they can talk to, reach out for help, but sometimes they're not always keen to do that. And so I would suggest if one of your loved ones is a first responder, police, firefighter, medical staff, be proactive in reaching out and offering them some support during this. Encourage them to talk about this. If they do get breaks or some down time, I mean they will get eventual breaks, but reach out to them during those times where they're not actually in dangers way so they can feel that support from the sidelines, even that can be a tremendous help to them.
Patti Harman (13:59):
Yes, that's really good advice. We're going to take a short break right now and we'll be back in just a few minutes.
Welcome back to the Dig In podcast.
We're chatting with Mark Debus, clinical manager for behavioral health at Sedgwick about the impact of the wildfires on our mental wellbeing.
So going forward, I'm thinking that technology is going to play a huge role in helping insurers assess and confirm much of the damage, but insurance adjusters will also have to walk these losses to confirm the scope of the claims, and the exposure to losses of this magnitude will have both physical and mental impacts. What are some steps that they can take to protect themselves and to maybe help them process what they will be seeing?
Mark Debus (14:51):
Well, first step is to be aware that there are real risks to mental health in investigating these cases cumulatively. This type of secondary stress can be a secondary trauma for individuals who are interacting with people who've been traumatized. And what's interesting about secondary trauma is that even though you aren't witnessing it firsthand where your life is threatened, assuming they're not going in and investigating while something's burning, but they're doing it after the fact,
(15:25):
So your life isn't immediately threatened in these scenarios. You are talking to people who've been through that and who are experiencing it again, and their trauma responses over time. Re-exposure to that, even from a helping perspective, does have a cumulative effect and does cause a secondary trauma response. That's very, very similar to if you are having a firsthand trauma response. The symptoms are identical, and so they can also develop post-traumatic stress disorder just like someone who's been immediately traumatized. And so it's important to be very proactive when you go into these situations and have a plan in place on how are you going to debrief yourself after investigating these scenes of complete devastation? Are you going to talk to your supervisor after that and have a debrief session? I think that's really helpful and be proactive about that. If you're managing claims managers or you're managing loss adjusters as a supervisor or a leader, be proactive about that and schedule follow up times with your team to help them normalize some of these feelings. They're going to have a lot of reactions themselves. You, yourself as a manager may have your own reactions to it, and it's important just to seek support within your own organization so people aren't alone in this. People don't take this home with them emotionally and ruminate over it themselves, and then that would lead to burnout. And so this is all things that you can do proactively to help address some of that because we know it's going to happen. We know this emotional impact is going to be there.
Patti Harman (17:10):
And you've mentioned it a little bit, but what are some of the short-term and long-term effects of being exposed to a major loss like that, and how do they actually manifest in people? I used to cover the disaster restoration industry and think they were a lot of those companies, they went in after all kinds of major disasters, and it really does start to have an impact at some point. So what does that look like?
Mark Debus (17:38):
Sure. Well, there's short-term effects and there's long-term effects. So let's cover the short-term first on a short-term basis, usually within the first few days, maybe the first week, so you're going to see sleep problems. People are going to have difficulty sleeping, and again, some of the rumination that happens is also going to be there. You're going to see people who are very agitated, maybe they don't seem like they can relax. You're going to see it in their bodies. If you're experiencing it yourself, you're going to feel on edge. That's what it's going to feel like. It's going to feel like maybe you've had a pot of coffee in an hour. That's going to be that type of edginess that you're going to feel. You're going to have a lot of worry. You're going to have a startle response. So one thing to remember, if you are encountering someone who's been traumatized, don't sneak up on them.
(18:29):
Don't come up from behind. Face them. Tell them if you're going to touch their arm or whatever, you need to be very vocal with them about any sudden movements because they will have a startle response that's going to, they're going to appear very jumpy. You're also going to see some health issues occurring on a short-term basis. Probably the first one you're going to see is your gastrointestinal disturbances, so diarrhea, nausea, vomiting, those types of things, maybe even constipation, but you're going to see some things where your digestion is going to be affected by stress. Longer term, what typically happens is anxiety symptoms or depression symptoms sort of set in. People are irritable. People will sometimes have flashbacks, and if you're not familiar with flashbacks, it's like reliving the event itself. So it's more than a memory. It's actually feeling like you are back in the event and being re-traumatized. So flashbacks are pretty common with people who've been traumatized, and then you're going to see some other health issues. Also, high blood pressure. Oftentimes, the companies see long-term stress, digestion issues as I mentioned before, but you might also start seeing some skin conditions like hives or rashes from ongoing stress. And then on interpersonal basis, long-term effects are you're going to have some conflicts in your personal relationships, maybe at work or family, marital conflicts. Those types of things are going to be more pronounced in people who've been traumatized on a long-term basis.
Patti Harman (20:06):
Wow, that's a great overview of different types of factors and behaviors to notice or be aware of. If a colleague or a family member sees something that concerns them, what should they do? Should they approach the individual? I'm sure some people are going to be like, okay, I'm noticing that something's not right. What do I do now?
Mark Debus (20:28):
The main thing to keep in mind is shed some light on it.
(20:34):
People are going to try to conceal what they're feeling. It's pretty normal. We get very protective when we're feeling overexposed, especially if you've been traumatized, hiding your feelings becomes almost a default because it's a self-protection thing. If you're experiencing the trauma, talk about it. If you're the loved one who's seeing your family member or colleague experiencing post-trauma symptoms, talk to them about it. Make sure that they know it's okay that you are safe person to talk about the feelings with, and the more you talk about, the less alone that person's going to feel, and they're going to feel less stigma about talking about these things. So you don't want to cover it up, you don't want to ignore it. You don't want to think it's going to go away on its own because it won't. Typically, trauma reactions don't get better on their own and will often have lasting effects.
(21:26):
So it's important to talk about it, talk about it as soon as you can. One thing to keep in mind though is when you do talk about it, and this is a reminder I think also for claims adjusters, is when you talk about the traumatic event, don't ask the person to give you details about the event because that can also retraumatize them. So you want to keep your questions more present focused, future focused. You've got some information you need to gather about loss of property, those types of things. That's fair. But don't talk about, oh, when you saw the fire coming at you, how did you feel? Don't do that. That's retraumatizing. So be careful with your words. You can talk about current feelings, understand that there's going to be loss and grief associated with that and talk about that, but don't talk about the event itself and what they experienced during the event.
Patti Harman (22:25):
Oh, that's a really important point to make. And so I'm really glad that you mentioned that claims handlers and agents and customer service representatives will be handling thousands of these claims in the days to come. And hearing people's stories of loss and despair I think will have a profound impact on them as well. What can they do to protect their mental health during this time? And I think this kind of goes to what you're talking about earlier, the secondary response, but what are some warning signs or indications that maybe they're becoming overwhelmed or affected by what they're hearing from policy holders and what should they do?
Mark Debus (23:10):
Well, keep in mind that, and we did talk about this before, but the short and long-term effects of trauma that I mentioned before are also things that claims adjusters and handlers are going to be experiencing themselves. And so look for those signs. Look for difficulties in your own sleeping. Do you feel more agitated? Do you ruminate? Are you having some digestion problems? Are you having worry? Excessive worry? Are you having negative thoughts? Those are things that are going to be, again, normal reactions to trauma, even secondary trauma.
These are very normal reactions. A couple things you can do to help alleviate some of these symptoms. Again, talk to your loved ones about it. Maybe seek counseling. There's a lot of different resources available through your employer. An employee assistance program can be a valuable tool for that. Talk to your supervisor about the stress that you're experiencing with this. Your supervisor should be able to talk about this with you if they're kind of ill-equipped to talk about emotional stuff. And let's be honest, not all managers are cut out for that. Talk to your coworkers about this. They're all experiencing this too, and providing support to each other can be really valuable in getting through this.
Patti Harman (24:30):
Yep. I can see yeah, where that would definitely be important. I mentioned my opening, how affected I was personally by just watching the coverage of the wildfires, and I would imagine that other people are having similar reactions. In my case because I cover news as soon as I got up every morning, I was like, oh, I have to see what's going on. I wanted to know what was going on, if they were contained, just trying to kind of get a handle of what was going on, but besides changing the channel or participating in different activities, what are some practical steps that people can take if they find that watching this coverage is just becoming a little bit too much for them to handle?
Mark Debus (25:15):
It's a really good question. I'm glad you brought this up, because our natural inclination as humans during trauma is to gather as much information as possible to make sense of what we're witnessing. That's human nature. And I mentioned before some hypervigilance. That's your body's response to that as well. You're trying to seek out threats. But as a bystander or people that are just viewing this from afar, doom scrolling is really common and it's human nature to do this. And so that's our natural inclination. We're trying to make sense of what's going on in horrific situations. We're trying to gather as much information so it makes sense. It's ironically not the healthiest approach, and it actually causes us to experience a lot of similar symptoms of trauma that people who were going through that or experiencing if we overindulge in media consumption during this time. So I would suggest, and this may not be the most popular suggestion, but you really need to limit your media consumption, limit your news consumption as much as possible during this.
(26:29):
Yes, keep yourself informed, but put some limits on it. A key limit to really focus on is don't do it late at night before going to bed. Don't watch the news. Do not watch the evening news, I saying that, but don't watch the evening news and talking about, give yourself a buffer and you can watch the evening news, but give yourself a buffer before bedtime of at least two hours because your body needs to then calm itself down before engaging in sleep activities. Otherwise, you're going to be too stimulated to sleep in and it's hard to shut your mind off after that. So really focus on shutting off medial altogether, all screens completely for two hours or more before bedtime. Develop a bedtime routine, maybe have a light snack or talk with your loved ones. Maybe have a conversation about, I don't know, pop culture or something that has nothing to do with the devastation in the news.
(27:30):
This is something that takes your mind off of that for at least two hours before bedtime. Other things you can do on a practical basis is set yourself a timer and limit your news consumption to particular times during the day. So you mentioned getting up and turning the TV on or going to your smartphone and scrolling through the news, fine. If that's your morning routine and that kind of gets you jazzed up for the day, fantastic, but shut it off after 30 minutes. Set a timer on that for yourself. Limit yourself. I'm only going to read the news for 30 minutes in this chunk of time and then set a time for maybe two o'clock in the afternoon. I'm going to check out the news, do it for 30 minutes or whatever works for you, but make sure there's a time limit to that and an intentionality to it because that's going to help you keep on track with this because it's easy to let your time get sucked up in this, and then you're not taking care of other things you need to take care of, which includes eating well and better sleep and time with loved ones and other things that are going to help you manage your stress overall.
Patti Harman (28:36):
I love that you set a timer, and I've noticed that when I have to cover major events like this, and I'm thinking when 9/11 happened, I was on the ground in New York City, and you're right. You almost have to step back and say, okay, this is it. I can't take any more of this and I need to focus elsewhere. And I said to myself mentally, as I've been covering this over the last week or so, this is enough. I need to go do something else. I can't stay focused on this. So I'm glad that you've mentioned that.
We've talked about a lot of different people who will be affected by the wildfires, but one group we haven't discussed are the children who lost homes, schools, basically everything they've ever known. What are some steps that parents and other adults can take to help them begin to understand what's happening and give them reassurance and kind of help them process what they're thinking or feeling? Because it's a lot for adults and it's got to be a lot for kids, and I'm wondering what sign should adults even be looking for That could be indicators that their child is maybe having some difficulty managing this situation?
Mark Debus (30:00):
And I think it kind of goes back to just recognizing that people who are traumatized in these disasters are going to have some reactions, and that especially is true with children. Now. Kids are really good at covering that up sometimes and sensing that their parents are also stressed, so they may not share as much of what they're going through. You have to be really focused on your kids during this time because they are going through something and they don't have, depending on their age, they don't have the critical thinking skills to navigate and understand that they're safe right now. If you made it to safety or in a shelter someone's house or something like that, kids don't understand or have the concepts to address some of these things, and so parents need to be really attuned to that. It's going to be hard because parents have also gone through this traumatic event and they are probably more inwardly thinking to begin with, and so it's hard to kind of be in touch with people outside of your own mentality, but if you got kids that you have that extra responsibility to do that.
(31:13):
I would say one thing that can be really helpful is loved ones, other people that aren't part of the circumstances, aren't directly impacted by this. If you have kids in your extended family, reach out to them, reach out to the parents if you can. It takes a village, and there's a lot of people that can provide some support to children, even if the parents are overwhelmed by some of the practicalities of the loss of property and the navigating, where are we going to stay tonight? That type of thing. If you know a family that's going through that, reach out to them if you can and provide some special assistance to the children. Kids are going to show stress in slightly different ways. You're going to see a lot of acting out behaviors. You're going to see some temper tantrums. You're going to see them shutting down. It's not always going to look like they're upset or crying. It's going to show up in other ways, and a lot of times angry outbursts don't have a lot of, cause. You can't really put your finger on what caused that outburst. Those are all things you're going to see in kids, and it's not going to seem real predictable. The only predictable part is that we know what's going to happen, and that is something just to be aware of and provide as much support as you can.
Patti Harman (32:30):
Okay. Yeah, those are a lot of just really great ideas and recommendations. We have covered a lot over the last few minutes. I feel like we've barely scratched the surface on the topic, but what's maybe one or two things that you want our listeners to keep in mind when facing a major loss like this? Whether it's how they're feeling or that it's okay to express your emotions or ask for help or whatever it is. What's a takeaway that you want our audience to have?
Mark Debus (33:03):
Well, I'm going to sound like a broken record, but I think if there's one takeaway, keep in mind that these devastations are trauma and there's going to a reaction to that, whether you've experienced it firsthand, whether you are a first responder who is in the thick of things and helping people directly that are in harm's way, or you're a claims adjuster who's hearing these stories afterwards and you're investigating sometimes on the scene after the event. It's a traumatic event and you are going to have a trauma response to that. It's normal. It's absolutely normal. You need to talk about it. You absolutely need to talk about it, and you don't have to hold onto that by yourself. You can talk with loved ones, you can talk with your supervisor, you can talk with your coworkers, whoever it is, talk about these feelings because that will help normalize it for you and reduce the intensity of them for you over time. Now, if you do need some professional help, it is available to you. Oftentimes, employers offer an employee assistance program, which is free and confidential. There's community mental health resources, there's the American Red Cross. There's all sorts of response services. And then one thing I just want to throw out there is a nationwide mental health crisis hotline. You can dial it from anywhere from your cell phone, landline, although who has a landline, but from your cell phone, nine, eight, eight. It's very simple to dial 988. It will connect you to a live counselor 24/7, 7 days a week.
Patti Harman (34:39):
Wow. That is a great resource to share. Thank you so much, Mark, for just sharing your insights with our audience. Thank you for listening to the DigIn podcast. I produce this episode with audio production by Adnan Khan.
Special thanks this week to Mark Debus of Sedgwick for joining us. Please rate us, review us, and subscribe to our content at www.dig-in.com/subscribe. From Digital Insurance, I'm Patti Harman, and thank you for listening.