By: Rachel Kucharski
The budget for the Critical Incident Stress Management team increases over the past two years due to the death of three firefighters.
Over this time the firefighters have suffered a line-of-duty death, a firefighter suicide, and active fire death due to COVID. Because of these incidents, it was crucial that the budget needed to grow to renew the focus and funding. Thomas Coe said, “Fortunately with the support of Frederick County Government leaders these programs have become a priority and we are actively working to build on our existing programs to support the need in Fire/Rescue as well as support our other public safety allied agencies.”
According to the National Interagency Fire Center, Critical Incident Stress Management is “the selection and implementation of the most appropriate crisis intervention tactics to best respond to the needs of the situation at hand.” The reason for the CISM team is to offer peer-based support to EMS, firefighters, law enforcement, dispatch centers, and other responders that may go through effects after a critical incident.
Communication with the CISM team is completely voluntary and remains confidential. The team comprises volunteer peer support and licensed mental health personnel. Both of which have to have completed training. The Maryland Institute for Emergency Medial Service Sytems says the people on the team “have been trained to assist responders in dealing with normal reactions to abnormal events.” Fire Chief, Thomas Coe, listed different pieces of training that the first responders may attend. These include, the International Association of Firefighters’ Peer Support Training, stress first aid, suicide awareness, and prevention training, and other training that can be related to critical incident stress. Each peer needs over 40 hours of training and yearly training refreshers.
There are many things the CISM team is able to give their support to, things as On-scene support, debriefings, defusing, peer or one-to-one counseling, referrals to mental health services, and employee assistance programs. While these are some things the team is able to do, they have their goals listed on the Department of Natural Resources of Maryland website. These include promoting psychological well-being and preventing delayed psychological reactions, reducing isolation and the feeling of being abnormal, reducing the impact of the stressful experience, and many other abilities.
These all contribute to the mental health of the responders of Frederick County. While it is possible for the responders to find a therapist by themselves, these services are available 24 hours a day by calling the Administrative Duty Officer. On May 31, 2017, Frederick County, Maryland signed a Standard Operating Procedure to go into effect for the Critical Incident Stress Management team.
Because responders deal with potentially stress-inducing situations most of the time, CISM makes a great outlet for them to grieve and debrief on what they are experiencing. In a study mentioned by the Substance Abuse and Mental Health Administration (SAMHSA), 69% of EMS professionals said they never have enough time to recover from traumatic events. It also mentions that as a result of the time crunch, depression, stress, post-traumatic stress, suicidal ideation, and other mental health issues have been reported.
An article called Suicides Among First Responders: A Call to Action, written by the Centers for Disease Control and Prevention, stated that “EMS providers are 1.39 times more likely to die by suicide than the public.” the article also goes on to say that 17%-24% struggle with post-traumatic stress disorder and 24% have symptoms of depression. The deaths of these first responders, for the most part, go unreported because there is not enough data on suicide and mental health for the workers.
When speaking with Frederick Maryland’s communication manager, Allen Etzler, mentioned that responders would be more likely to open up about their mental health issues to the CISM workers because they will have shared experiences and there is not a stigma for providers around meeting with a counselor. The providers see the stress put upon them as a part of the job and do not want to report any thoughts they may have because they do not want to be unfit for their job.
In order to help the providers, Frederick County has implemented mandatory CISM team activation in situations like terrorism/weapons of mass destruction, serious injury or death of an employee or member when responding to or on the scene of an incident, mass casualty incidents, death/suicide of an employee or member, death and/or violence of a child, loss of life following extraordinary and prolonged expenditure of physical and emotional energy during rescue efforts, and any indecent with a need identified by the incident commander.
