CISM teams help communities with ‘mental first aid’
If you watched news coverage of the recent shooting in Parkland, Florida, you probably heard somewhere in the story that counselors were going to be available to students at the school where the incident took place. Likewise, if you’ve ever read about a workplace accident that took the life of an employee, you may have read that managers planned a company-wide meeting the next day and that grief counselors would be onsite.
These types of events, which can also include natural disasters, are tragic, but also traumatic — deeply distressing or disturbing to those who may have witnessed them or were involved or knew the person(s) that died. In some cases, those traumatized can be a large group — not just fellow students, but teachers, managers, co-workers, friends, family members, neighbors and even first responders.
But if hearing about counselors being available at schools, workplaces, emergency shelters and other locations following a traumatic event seems more common, it’s not necessarily because such events are increasing. Rather, a growing body of research has found that people who have experienced trauma benefit from intervention in the immediate aftermath.
Counseling, assemblies and meetings, talk sessions and even pre-event planning are all part of an important mental health intervention called critical incident stress management (CISM) — a type of crisis response to support people who have experienced traumatic events. CISM builds on the natural resiliency within all of us, and is based on the belief that when we understand how critical incidents can impact us, we can overcome much more quickly and effectively.
In much the same way paramedics and other first responders provide first aid at the scene of an accident — so that an injured person can be stabilized and taken to the hospital for needed treatment — CISM teams render ‘mental health first aid’ to individuals impacted by traumatic events. CISM teams help individuals ‘debrief’ after a traumatic event and can then refer them to other needed mental health resources (e.g., individual counseling, support groups) if needed.
Critical incident stress management interventions involve many components, and which components are used depends on the nature of the incident and who has been impacted. The goal of CISM is the same — to help individuals impacted by trauma process what has happened and link them with other needed resources to reduce the risk of longer-term psychological injury. Some of the most common components of CISM interventions include:
Pre- crisis preparation, including stress management education and crisis mitigation training for organizations and individuals.
Disaster or large- scale incident support programs, including demobilizations, informational briefings, “town meetings” and consultation.
Defusing is structured small group discussion provided within hours of a crisis for the purpose of assessment, triage and acute symptom mitigation.
Debriefing is a multi-phase, structured group discussion, usually provided 1 to 10 days post crisis, designed to further mitigate acute symptoms, assess the need for follow-up, and if possible, provide a sense of postcrisis psychological closure.
One-on-one crisis intervention/counseling or psychological support across the full range of the crisis spectrum, including family crisis intervention and organizational consultation.
The effects of trauma are well understood and can include, among other things, insomnia, anger, relationship problems and social withdrawal, as well as increased risk of anxiety, depression, substance abuse and suicide. Soldiers affected by post-traumatic stress disorder (PTSD) have been known to exhibit many of these symptoms after or even during combat, and CISM developed in part as a result. But the fact is, anyone exposed to trauma is at risk for PTSD and CISM can be effective in a variety of environments for almost any individual.
Staff at Highland Rivers Health are receiving training in CISM and will provide CISM teams and services in the communities we serve. Critical incident stress management is an important and timely part of the continuum of mental health services we provide in northwest Georgia as part of the mental health safety net, and will further strengthen the links among partners and individuals that help keep our communities healthy and safe.
Melanie Dallas is a licensed professional counselor and CEO of Highland Rivers Health, which provides treatment and recovery services for individuals with mental illness, substance use disorders, and intellectual and developmental disabilities in a 12-county region of northwest Georgia that includes Bartow, Cherokee, Floyd, Fannin, Gilmer, Gordon, Haralson, Murray, Paulding, Pickens, Polk and Whitfield counties.