By: The Medical Reserve Corps of Southern Arizona Interagency Peer Support Team
There is a question dating back into antiquity regarding if it is the rugged and unforgiving environment of Southeastern Arizona that makes people hard? The other side of the question possesses what if it is the reaction of these same hard people that have so often-made human life short and cheap? Since before the transcontinental railroad was completed in 1881 and shots rang out at the OK Corral in Tombstone that same year, the Old Pueblo, the nickname for Tucson, was not a place for the faint of heart to seek their fortune. First inhabited by the Hohokam Indians around 300 A.D., the Old Pueblo eventually found itself part of the Spanish Empire, then the Mexican State of Sonora, and then as part of the State of Arizona. Outlaws, the elements, accidents, war, and other tragedies have marked the landscape alongside a history of nations and empires that were bursting to increase their lands and wealth.
In the modern day, Tucson is generally considered one of the better places to retire in America, at least in the winter. With seventeen different Law Enforcement Agencies and numerous other Public Safety Organizations operating in the metropolitan area and many more in the surrounding rural areas, the networking, interoperability, and deconfliction of response on any given day can be exhaustive. Even though Tucson is home to five major hospitals and one – level one trauma center where your physical needs can be readily addressed, direct mental health professionals for its first responders are still in short supply. The number of professional mental health personnel that are strictly dedicated to servicing this unique population can still easily be counted on one hand. This factor alone makes having Critical Incident Stress Management tools in use a paramount need. Organizational Peer Support Teams and Crisis Response Personnel from all sides of public service regularly meet to exchange training information, important dynamics in trends, and often to work together in responding to the massive needs of a community located just 60 miles north of the International Border with Mexico.
Just like other communities in America, these teams have generally united under an interagency concept of mutual aid that at times has been informal and at other times formal, with written policy and bylaws. Like any other community, as one era of Crisis Responder exhaustively gives way to the next reformation of the effort to reach out to a community’s first responders will always be an overwhelming demand. This demand while different in scope and formation in Tucson is ultimately no different than any other area that attempts to deal with the needs of the hurting on all sides of equation of human suffering.
If you want to see what a community is really like when the sun goes down, look no further than the stressors carried by the nearest ten-year veteran Police Officer, Firefighter, or Paramedic/Emergency Medical Technician. Much the same idea can be applied to the ten-year veteran School Counselor to ascertain the status of your school system. What would happen when you put their collective Peer Support Team Members, Mental Health Professionals, and Chaplains all on the same team and responded to several large wildland fires, a constant string of small-scale crises of varying trauma levels, several line of duty deaths, suicides, murders, helicopter crashes, and capped it all off with not one, but two large scale mass shootings? This reflects the response level of the Medical Reserve Corps of Southern Arizona Interagency C.I.S.M. Team in Tucson between the years 2002 and 2011. By now you will have noticed that this author has rendered few names, no statistics, and has not quoted another writer in an attempt to provide credibility to these words. It is Tucson, once the territory of Wyatt Earp, Geronimo, and Poncho
Villa. It’s a land where your words mean something or they do not. There is no room between those two ends for persuasion. In the Old Pueblo something works or it does not. It is the perfect place to make a decision about the efficacy of Critical Incident Stress Management.
It all started in Jail…..
While the formation of this Interagency C.I.S.M. Team began before the turn of the 21st Century it took on a new direction one evening when a Mental Health Professional, a motivated Peer Support Team Leader, and a young Law Enforcement Chaplain all met in the briefing room of the county jail to determine what course to take next in dealing with the line of duty death of a Corrections Officer. Thus, began a collaboration built on C.I.S.M. Training, Crisis Response, coffee, trust, and bad jokes. The team began to thrive and before long, and with the support from the local Air National Guard and other entities, an entire Air Wing Dining Facility was filled with personnel attending a string of I.C.I.S.F. Trainings that underpinned what would become the backbone of Crisis Response in Southeastern Arizona for the next two decades. Agencies large and small turned out to receive training and guidance over the course of several summers in Critical Incident Stress Management from some of the big guns in CISM Training, like Dr. George S. Everly, Ph.D, Dr. Jeffrey Mitchell, Ph.D., and Douglas Mitchell. Trainings continue regularly in the area to this day. Members of our team are trained through the ICISF as trainers in Assisting Individuals in Crisis, Group Crisis Intervention, and Managing School Crises.
The personnel that responded to the bombing of the Alfred P. Murrah building in Oklahoma City in 1995 eventually sat down and wrote what would become known as the Oklahoma Standard in its aftermath. The Oklahoma Standard is a standard of care that exemplifies how a community should respond to itself in such tragic times.
The Old Pueblo Guidelines: What were the major lessons learned?
The gunslingers of C.I.S.M. in the way out west now attempt to do the same thing for this unique time period. These are, of the lessons learned, the most important ones to truly ingest and apply to any operational C.I.S.M. Team that will serve in a protracted time period. As we discuss these, please imagine us not in a classroom or clinic, but maybe having this discussion around a morning campfire over a cup of coffee.
The Old Pueblo Guidelines:
It is the hope of our team that our simple but battle hardened guidelines help your efforts down the road. In an age of pandemic response and telemedicine, the application of these foundational ideas will change. However, it is easy to see from our campfire discussion that the need to help alleviate human suffering will likely remain a constant in an uncertain world. We continue to meet, to train, and to act across agencies.
The Medical Reserve Corps of Southern Arizona Interagency Peer Support Team was formerly called the Northwest Fire District’s Interagency Peer Support Team. It was the vision and backing of the late and former Fire Chief, Jeff Piechura, who was killed on July 10th, 2021 in a wildland air attack plane that made our team possible. Godspeed Chief Pie!