International Critical Incident Stress Foundation, Inc.
International Critical Incident Stress Foundation, Inc.
By: Frank Sullivan, ICISF Board Member
Frank Sullivan is a Licensed Clinical Social Worker and former Executive Director of the Anne Arundel County Mental Health Agency, the “Behavioral Health Core Service Agency” in Maryland. He has been a member of the ICISF Board of Directors since 2002. Adrienne Mickler is the current Executive Director of the Anne Arundel County Mental Health Agency. Since 1999 the agency has partnered with the Anne Arundel County Police Department to have a comprehensive crisis response system (CRS) to deal with behavioral health crises in a coordinated and preferably therapeutic ways. A key element of the system is Mobile Crisis Teams (MCTs) consisting of a licensed mental health professional and a second master’s level mental health professional that response to police officers’ requests for assistance. Critical Incident Stress Management (CISM) is viewed as a key skill for the MCT personnel and others. Mr. Sullivan asked Ms. Mickler some questions about the relationship of Crisis Interventions and CISM.
Answer: MCT responds to police requests on demand (no screening questions as all officers are trained about the program using what they do/what they do not do approach). Typical calls are for persons who are acting strangely, non-responsive or disoriented, suicidal, family conflicts, accidents with serious injury, deaths, or with major mental health histories. When responding with police for trauma or death, the teams help police with assessing the situation and get information on how the person/community might be affected. All persons who may be affected are offered services, debriefings, or are referred for services. Teams will work with them and will contact any others identified as being in need. These contacts spiral out to others “it is amazing how far the net is flung”. CISM is most used in suicides and homicides. The Capital Newspaper Shooting was an example of widespread community trauma. The key ingredient is to offer follow up and be available on anniversaries. This system balances public safety with treatments and services that hopefully reduce officer time on scene and repeat 911 responses.
Answer: This question would be best answered by a police officer. Initially there was a lot of mutual learning. Now officers understand that these skills make their work easier. Each party brings different perspectives and skills to bear on each circumstance and provides a mechanism to bring in other services to a household or neighborhood.
The elderly and youth. Crises in schools is a major area that could improve. In situations that require CRS response, it is effective but the CRS arrival itself can be disruptive and traumatic. There is a need for CISM training to school personnel. Another typical need for debriefing would be barricades. A recent incident completely cut off a neighborhood. People were unable to return to or leave their homes for two days making them frightened and angry. The Teams responded and listened and helped people cope. Accidents, deaths in neighborhood, and children being killed are particularly difficult and require trained debriefers. CRS does outreach to help. An example is a young man who moved back to Anne Arundel to be safer and was shot and killed at his home. This was unbelievably upsetting to the family, neighbors, and the community at large.
The Capital Shooting was the largest incident. ICISF sent personnel and helped with the family information center. Numerous people and organizations responded, but many people try to help but were not prepared for the task. Teams were needed “to help the helpers” cope as they had not been trained in CISM and were overwhelmed. Teams canvassed for information to assure that all who were affected were contacted. Getting the incident site ready to reopen was difficult but with ICISF assistance the process was flawless. This expertise helped community leaders understand the extent of the psychological impact. A community good was having a Network of other trained debriefers to debrief our folks.
I think the design of the system. It has the ability to “shift and adjust”-dealing with the homeless, to shootings, opioids, and to work with other departments. CRS stabilizes and debriefs, but we are often able to find “root causes” for the crisis and trauma, an engage with other groups to follow up in a holistic way. An example is the Department of Social Services creating outreach teams to follow up with homeless persons who were in crisis. The Fire Department has “Safe Stations” for opioids. The Police developed support groups, trains CRS personnel in the police academy, and on and on. The result is we can often avoid crisis calls because others are expanding prevention and early interventions. NETWORKING!
“I can’t be more grateful to ICISF for their assistance. They were very helpful for helping CRS see and ask the right questions.” “You don’t know what you don’t know and can’t even ask the right questions. I am blown away with how well trained we are and the results we get. Unmet needs remain and we look forward to more training partnerships.”
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