Introduction
When a critical incident occurs, everyone looks to the Chief, Division Commander or Commissioner for leadership and guidance. Under crisis conditions, you are responsible for providing the psychological support and resources to help your personnel come to grips with the traumatic event. This Guide is intended to provide information about Public Safety EAP’s Critical Incident Benefits available to you and your employees. It also outlines best practices to consider should a critical incident occur.
Employee Reactions to Critical Incidents
Critical Incident Stress is the human response to a variety of unsettling events that affect one or more of your employees. This stress may occur in the wake of mass casualty events; incidents involving death or serious injury to children; acts of violence or aggression directed at public safety personnel; on-the-job injury; or the death of a co-worker. Responses will vary from employee to employee based on personality variables and the individual connection to the traumatic event. Several steps should be considered:
- Personnel who were directly involved in or observed the traumatic event first hand should be spoken to immediately on return from the scene of the incident to assess their response and their level of trauma. You may want to call Public Safety EAP for a consultation.
- Watch for any extraordinary reactions and be prepared to send an employee to the local emergency room if he or she exhibits unusual distress. Some examples of symptoms to watch for include reports of chest pain, breathing difficulty or inability to stop crying. Reported “anxiety attacks” should be watched closely – you may want the ER to rule out another serious underlying condition, such as a heart attack.
- If you decide to send employees home for the remainder of the shift, remind them of their EAP benefits before they leave. Our counselors will provide immediate counseling and arrange a face-to-face counseling appointment to speak about the incident further should any of them wish to do so. It is important to understand that the EAP cannot make direct contact with the employee unless the employee calls and requests assistance. The employee can be helped only when he or she has made the decision to seek assistance. Our 25 years of trauma experience clearly demonstrates that for our counseling to be effective, the employee needs to want help and take the first step towards receiving help.
For many employees, the initial response to a critical incident or traumatic event is shock. Employees will be heard recounting events and voicing their disbelief to each other. This conversation is part of a normal, informal, defusing process. It is a healthy response to the traumatic event and evidence that your employees are building the ongoing support network they need in order to process and recover in the days and weeks to come.
Supervisors should be aware that some critical incidents have the potential to provoke an anti-management response from employees. Often when tragedy occurs, the human response is to look for a cause or a place to lay blame. Such a response is more likely if there has been a history of unresolved or poorly handled employee relations issues. Any existing mistrust can be exacerbated by post-accident emotions. Anger, rumors and negativity can follow. Educating first-line supervisors about what to expect and how to handle this kind of reaction is important so that they feel supported and know how to respond appropriately. Factual, timely, updated information should be relayed to those involved to minimize rumors and speculation (within legal limits of disclosure). When certain information cannot be released, explain why. This will help to alleviate any frustration at the situation.
Immediate Resources
Everyone benefits when leadership takes timely steps to address a traumatic workplace event. Immediately in the wake of a trauma, you should remind employees of their EAP benefits. EAP Counselors are available toll free 24 hours a day, 7 days a week. Employees may want privacy when contacting the EAP, so be prepared to provide a private room. If you have a concern that the call will be made, initiate the call and introduce yourself and the employee, and then leave the room to give the employee privacy.
The EAP Website (www.PublicSafetyEAP.com) offers a selection of useful articles that you can quickly access to either e-blast or print and distribute to your employees soon after the event. You should also remind employees that they can access a variety of useful articles on their own at the EAP Website. A sampling of articles include: Coping With a Traumatic Event; Managing the Loss of a Co-Worker; How Do You Cope With a Major Loss?; Help For When You Are Grieving; Coping With Loss; and Post-Trauma Debriefing Coping Suggestions.
Onsite Critical Incident Response
Onsite Critical Incident Response (sometimes referred to as a Debriefing or Defusing) is designed to assist those immediately involved in the critical incident. This involves on-scene personnel and should include the dispatchers who received the initial call for service. There are many scenarios that qualify for an onsite debriefing. The most common events include prolonged extrications, the involvement of children, severe injury, loss of life, threat of serious harm or injury to personnel, or co-worker injury or death.
In a Critical Incident Stress Debriefing (CISD), we send trained personnel to the worksite to provide a group intervention. The purpose of the debriefing is to help employees understand and process the trauma, to normalize symptoms, and to increase coping skills. It is not a psychotherapy group. A number of studies have been conducted regarding debriefings, and some studies question the value of such a tool. We believe that when done correctly, they can be very beneficial in helping an organization to process the event.
To be effective, it is critical that a debriefing occur no sooner than 24 hours after the event has occurred. Research indicates this type of response is most beneficial when employees have had time to absorb what has occurred and have moved out of the initial “shock” phase. While there may be pressure to move immediately to a CISD, employees are better served when a CISD occurs 24 to 48 hours after the incident. This allows them to get over the initial shock and be more prepared to accept the information they will be provided in the CISD.
Requesting a Critical Incident Response
Generally, participation in CISD should be voluntary. Supervisors should talk with employees to determine the level of interest in participation. While some encouragement may be in order, including employees against their wishes can inhibit those who want to attend from opening up and often results in a general lack of participation. In some instances, supervisors may choose to mandate participation by employees who were involved in a highly traumatic event, such as a child death, a co-worker serious injury or co-worker death.
Scheduling a Critical Incident Stress Debriefing simply requires a brief call to the EAP by a supervisor or personnel designated by supervision to speak on behalf of the agency. Be prepared to suggest available dates and times. During your call, your EAP Counselor will need to obtain factual information related to the incident. This information will be kept confidential and will not be relayed to anyone outside the group of on-scene response personnel.
- Basic facts available about the incident
– When did the incident occur?
– Were there any deaths or serious injuries?
– Were any children involved?
– Number, location and health status (if hospitalized) of personnel involved in the incident (including the dispatcher who took the initial
call).
– Health status of the victims (non public safety personnel) involved in the incident.
Many public safety officials find this call to the EAP invaluable. In addition to making arrangements for CISD, it is an opportunity for us to provide leadership with emotional support and guidance in your organizational efforts.
How to Plan and What to Expect from a Critical Incident Response
To conduct an effective CISD, we will need a private room, preferably one that is large enough for employees to sit in a circle. Tissues should be readily available, as well as access to drinking water, if possible. The EAP representative will arrive approximately 15 minutes early in order to meet briefly with you or whomever you have designated as the organizational representative.
A CISD session typically lasts one hour and is a time for group process. Employees will be reminded of their EAP benefits. After the session, the EAP representative will remain onsite to be available for anyone who would like to meet individually. Within a few days of this session, your EAP Counselor will follow up to get your feedback about the debriefing and an update on how your employees are doing.
Non-Traditional Response
Sometimes there is a need for an onsite CISD, but, for various reasons related to the nature of the business, it is impossible to have a group of employees participate together. In such cases, we will talk with you about the possibility of having two smaller groups or a room set aside for one-on-one employee sessions with the EAP representative. Since there is more long-lasting therapeutic value in the group interaction, the latter method is recommended only when business necessity eliminates any possibility for a group session.
Questions?
Please feel free to contact us anytime with any questions about how we can support you in dealing with critical incidents or any other workplace problems that you face. Often, supervisors think of us for their employees but overlook the broad range of services we can provide to support the work that they do, as well. If you haven’t had a reason to contact our toll-free line before, please call. We would be happy to talk with you about the broad range of benefits we have available for both you and your employees.