Critical Incident Debriefing: The cumulative effects of stress

WESTBOROUGH, MA – May 25, 2015 Police in Massachusetts and throughout America are faced with the worst of all human experience.  Arguably, everything from unattended death, domestic violence, child abuse, and a fatal motor vehicle crash may show up on the call board of any dispatcher on any day or night.  Critical incident stress debriefing or CISD is an important component to building police officer resilience and healthy career longevity.  It is not psychotherapy it is something more than therapy – with a purported focus of supporting first responders through events that most people never see in a lifetime.  It is well-known that first responders pay a price for the stress of the calls they receive as they move through their careers on physical and emotional levels.  These stressors often impact health and well-being and are associated with high rates of divorce, substance abuse, and suicide particularly among police officers.

WHAT IS CISD?

As recently as May, 2014, a police officer verbalized that a motor vehicle crash had been so horrific that he would never forget the images, the smell, the demeanor of those involved – even the weather at the time of the failed rescue of a teenaged boy who was trapped in his car and died.  These types of event occur more frequently than one might expect and there is little or no time to reflect on the events before the next call is received. When an event that is so highly charged, tragic, and experienced by a large number of professionals, public safety personnel must undergo critical incident stress debriefing.  Critical incident debriefing is a somewhat standardized follow-up to a chaotic, non-standardized event involving police, fire, communication dispatchers, and EMS.  It is more like peer support that permits police officers and others to examine the circumstances of a highly emotionally charged event – like the drowning death of a child or an officer involved shooting or injury for example.  CISD is provided when events occur that are out of the realm of usual like the tragedies just mentioned.  CISD is provided by trained peers like police officers, firefighters, and paramedics who volunteer for training and want to help their fellow officers.  They are available 24 hours a day – 365 days a year when the need arises.  CISD offers both support and education to first responders about what they might experience on an emotional and physical level for having been exposed to dangerous, traumatic events.

FOLLOW-UP CISD

Follow-up meetings should be scheduled after the first CISD because unless a 2nd meeting date is given no one will find their way back to the follow-up. In the case of a tragic motor vehicle crash, one central Massachusetts community experienced the death of a young member of the high school.  A CISD meeting was held and by all signs was productive and successful.  Sadly, the same community has since had 2 additional fatal car crashes involving young members of the community.  This takes an enormous emotional toll on police, fire, and EMS in terms of the cumulative impact of exposure to highly stressful events.   Some members have reported feeling anxiety during the same time of day as the crash and being unable to fall asleep for apprehension and fear that the tones may go off summoning them to another tragedy.  Follow-up meetings are designed to assess for signs of post-traumatic stress – a physiologic and emotional reaction to a highly stressful event.

Initial CISD meetings take place within 72 hours of the event.  They are usually conducted at the city fire house or police station in the city or town in which the events took place.  They are 1.5 to 2.5 hours long and should be followed by a second meeting within 30-45 days.  The problem is that officers rotate in and out of shifts so frequently that the core group of responders is rarely together for 2nd or subsequent CISD meetings.  Follow-up meetings are needed especially when events such as these occur in close proximity to one another as in the case described.  Officer safety is stressed repeatedly in all training.  In the case of traumatic events – officer safety demands CISD and in the long run physical health and well-being are the underpinnings of a resilient professional who will be there over and again –  when called upon for those once in a lifetime calls that most of us will never have to answer.

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