CISM as the Standard of Care in Response to COVID
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(Video)
Overview
Learning Objectives:
- Estimate surge of mental health distress
- Define CISM
- Explain why CISM is the standard of care for COVID
Presenter
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George S. Everly, Jr., PhD, ABPP, CCISM
Co-Founder
The ICISF, Inc.
George S. Everly, Jr., PhD, CCISM is an award-winning author and researcher. In 2016, he was ranked #1 published author in the world by PubMed PubReMiner in the field of crisis intervention. He holds appointments as Professor in the Department of International Health (affiliated) at the Johns Hopkins Bloomberg School of Public Health, Associate Professor (part time) in Psychiatry at the Johns Hopkins School of Medicine, and Professor of Psychology at Loyola University in Maryland (core faculty). He is considered one of the founding fathers of the field of disaster mental health. He was a co-founder of the Dept of Psychiatry at Union Memorial Hospital and served on the management committee 12 years. In addition, he has served on the adjunct faculty of the Federal Emergency Management Agency, the FBI’s National Academy at Quantico, Virginia, and ATF’s Peer Support Team. He is an advisor to the Hospital Authority of Hong Kong. Dr. Everly is co-founder of, and serves as a non-governmental representative to the United Nations for, the International Critical Incident Stress Foundation, a non-profit United Nations-affiliated public health and safety organization. He was Senior Advisor on Research in the Office of His Highness the Amir of Kuwait. Prior to these appointments, Dr. Everly was a Harvard Scholar, visiting in psychology, Harvard University; a Visiting Lecturer in Medicine, Harvard Medical School; and Chief Psychologist and Director of Behavioral Medicine for the Johns Hopkins Homewood Hospital Center.
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Overview
The current spotlight on policing and law enforcement issues is focused mainly on urban departments rather than rural areas. Ironically, the majority of police agencies across the nation are not in large cities, but small or rural towns. In 2013, 71% of all police departments served jurisdictions of fewer than 10,000 residents, and 30% served communities of less than 2,500 residents. About half of law enforcement departments have fewer than ten officers (Weisner et al., 2020).
The U.S. Census Bureau (2016) defines rural areas as less dense and sparsely populated than urban areas. Ninety-seven percent of the United States’ landmass is rural. About one-fifth of the population, sixty million people, inhabit rural areas; many are employed in agriculture, forestry, mining, and manufacturing, sectors that are plagued by declining job opportunities. Rural areas tend to be impoverished and do not have the tax base to fund social programs, including police and public safety adequately. As a result, rural agencies are underfunded, understaffed, often undertrained, and lack the necessary equipment. (Ricciardelli, 2012). Rural agencies face challenges in training opportunities, access to resources, types of crimes, interaction with citizens, degree of scrutiny, inferior technology, and mutual aid access, and cooperating overlapping jurisdictions e.g. Native American, federal and local.
Rural areas are often characterized by conservative values, aversion to government interference and authority, a tendency to exert social control among their own, and higher gun ownership that urban areas. Crimes related to wildlife, agriculture, and hate groups are common. Of necessity, rural police departments tend to have a unique culture and way of doing things depending on local history, demographics, size, and budget. (Weisheit et al, 1994).In addition, because rural agencies are generally spread over large geographical areas and sparsely populated areas, response times are measured not in minutes, but hours. With few resources and more area to cover, they are spread thin. Consequently, big city solutions to policing issues are often not relevant to small town and rural police departments.
A sheriff’s deputy explains: “When our department goes to trainings in the big cities we just sit there. What they are teaching is not relevant to our daily operations. They have departments for every job. In rural policing we see and touch it all. Any of us could be first on scene at a traffic collision or a homicide. We’re search and rescue, the coroner, the victim advocate at the scene of domestic violence, the family therapist, the sex crimes investigator, and the ones who evacuate people from wildfires.”
Although the study of rural agencies has been largely neglected, it is essential as the profession faces upheaval. Rural policing is plagued by a lack of material resources, limited staffing, and vast response areas with limited back up. Rural officers also face mental health issues such as depression, anxiety, PTSD symptoms, and suicidal ideation similar to urban officers. These issues may be exacerbated by isolation, cultural barriers, and unique organizational expectations. Geographical location and long shifts often limit access to mental health services. Emerging advances and ongoing research in interventions such as telehealth and existing treatment modalities such as peer-support groups and critical incident stress management (CISM) may prove to be a bridge in closing the gap for this underserved population.
The purpose of this paper, while not comprehensive in addressing the myriad issues that are relevant to rural policing, will elucidate the stressors unique to rural law enforcement agencies and the peace officers who serve in them. Additionally, methods to increase resiliency and stress management will be proposed.References
– Ricciardelli, R. (2018). “Risk it out, risk it out”: Occupational and organizational stresses in rural policing. Police Quarterly, 21(4), 415-439. https://doi.org/10.1177/1098611118772268
– U.S. Census Bureau (2016). New census data shows differences between urban and rural populations. https://www.census.gov/newsroom/press-releases/2016/cb16-210.html
– Weisheit, R. A., Falcone, D. A., & Wells, L. E. (1994). Crime and Policing in rural and Small-Town America: an overview of the Issues. National Institute of Justice Rural Crime and Rural Policing, 2(2). https://www.ncjrs.gov/txtfiles/crimepol.txt
– Weisner, L., Otto, H. D., & Adams, S. (2020). Issues in Policing Rural Areas: A Review of the Literature. Criminal Justice Information Authority. https://doi.org/10.13140/RG.2.2.10290.76489Learning Objectives:
Upon completion, participants will be able to- To be able to identify five challenges faced by rural law enforcement .
- Describe five implications of the challenges.
- Identify three specific applications to help remedy the challenges.
Presenters
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Marilyn J. Wooley, Ph.D.
Psychologist
West Coast Posttrauma Retreat
Marilyn J. Wooley, Ph.D. is a clinical psychologist who has a private practice in semi-rural Redding, California. Her primary focus is treating first responders and their families, treatment of post traumatic stress injuries, pre-employment psychological evalutions, and crisis response. Marilyn teaches Mitchell Model CISM through the International Critical Incident Stress Foundation. She is actively involved with the First Responders Support Network and has regularly served as a volunteer lead clinician for the West Coast Posttrauma Retreat in California since 2001. Her published articles include the topics of crisis response, first responder resilience, critical incident stress, and surviving the 2018 Carr Fire. She is currently writing a manuscript about post-traumatic growth in first responders and a biography about her grandfather's experiences liberating Dachau Concentration Camp during WWII. Marilyn grows roses and enjoys adventures with her husband, daughter, and two brilliant grandchildren. She has survived skydiving, SCUBA diving with sharks, summitting Mt. Shasta, swimming a class IV rapid while attempting to whitewater kayak, and belly dancing at a biker bar.
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Shaneika Smith, MA
Psychological Assistant
West Coast Posttrauma Retreat
Shaneika Z. Smith currently resides in Redding, CA. She is a Clinical Psychology doctoral Student at Fielding Graduate University. Prior, she attended the University of Chico where she earned a B.S. and M.S. in psychology with an emphasis on Marriage Family Therapy. Shaneika became interested in working with first responders when she began a practicum with Dr. Marilyn Wooley in 2018. She quickly became affiliated with the West Coast Posttrauma Retreat where she provides treatment services for law enforcement, fire, communications dispatch, and medical personnel. She plans to continue her training in CISM and working with families of first responders while she pursues her doctorate in Psychology.
Handout
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Overview
The International Association of Campus Law Enforcement Administrators (IACLEA) featured the above named article in the 2021 Winter edition of their Campus Law Enforcement Journal. The action plan described in the article is consistent with recommendations from the National Consortium on Law Enforcement Suicide: Final Report, published October 1, 2020. ‘Unspoken Questions’ refers to the reluctance to and/or avoidance of asking direct and specific questions, due to concerns of stigma and negative occupational impact, that can occur when a law enforcement employee experiences a personal mental health issue. Despite being generally aware of available mental health services, skeptical perceptions exist regarding accessing mental health care. For the agency, this skepticism contributes to the suspicion of intent and general distrust among employees. Consequently, the specific and direct questions may never get asked and remain ‘Unspoken Questions’. The worst case outcome is death by suicide or ‘loss of a whole life’. Another tragic result is that an employee may continue to experience the pain and despair of unresolved mental health issues, ‘the loss of a partial life’. This bold action plan challenges agency leadership to demonstrate organizational commitment by endorsing two separate transparent trainings that call for the integration of command staff and designated human resources representatives in the actual training in order to provide a forum for employees and give a voice to those ‘Unspoken Questions’.
Learning Objectives:
Upon completion, participants will be able to- Be instrumental in leading an agency-wide culture committed to promoting physical and mental health and wellness.
- Play a critical role in the agency’s transparent integrated approach to ensure that suicide prevention is prioritized and that norms and practices that support mental health and wellness are integrated into every aspect of policing.
- Be more capable to support efforts to reduce law enforcement deaths by suicide and eliminate the stigma associated with law enforcement personnel who experience mental health issues.
Presenter
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Kevin W. Condon, LCSW, BCD
Owner
Law Enforcement Response to Mental Health, LLC
Kevin W. Condon, Licensed Clinical Social Worker (LCSW), Board Certified Diplomate (BCD). In June of 2002, Kevin retired from the Coral Gables (FL) Police Department (CGPD) as a lieutenant with over 25 years of service. He served as Commander of the Crisis Negotiation Team and SWAT Team. Kevin participated as a member of a CISM team for emergency responders serving Miami-Dade County. Kevin received the CGPD Life Saving Award for his interaction with a person with a mental illness.
Following his retirement, Kevin moved to Georgia and began a second career as a mental health professional. He held positions as a community Child and Adolescent therapist, Clinical Director of a State of GA residential program, and therapist at the University of Georgia. In March of 2018, after over six years with the Department of Veterans Affairs (VA), Kevin retired from the position of LCSW.
Kevin is certified by Georgia Peace Officer Standards and Training Council (P.O.S.T.) as a Lecturer on Law Enforcement and Mental Health. He is a certified instructor for Mental Health First Aid - Public Safety. Kevin has developed and presented training courses on issues of law enforcement and mental health.
Kevin has been recognized as a Subject Matter Expert (SME) on law enforcement and mental health by the Collaborative Reform Initiative-Technical Assistance Center. CRI-TAC is a partnership with the Department of Justice's (DOJ) Office of Community Oriented Policing which is implemented under the leadership of the International Association of Chiefs of Police (IACP).
In November of 2018, Kevin founded ‘Law Enforcement Response to Mental Health, LLC’. He provides training, consultation, and presentations related to law enforcement and mental health. During Kevin’s early years as a law enforcement officer, he experienced his own mental health issues. Kevin shares his personal journey in the interest of ‘paying it forward’.
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Overview
The purpose of this presentation is to shed light and start the conversation of addressing PTSD in the 911 telecommunications profession. In 2015 I was working as a police dispatcher for Boston police, and successfully managed an officer involved shooting. While I received many awards for how I managed the situation, the fallout of PTSD and lack of support had me making the difficult decision to leave 911 altogether in order to address my mental health. During my journey of healing, I came to the realization that the 911 field was my passion, and that dispatchers everywhere are lacking the support needed in order to continue in the field. I’ve now been back in the filed for 4 years. In addition to sharing my story, I’ve applied my experience to working on NENA’s Wellness Committee, specifically the Peer Support sub-committee, and the Acute Stress working group. Locally, I attended the Group and Individual Counseling Training, and applied to be a part of the local CISM team, which recognizes the important of including 911 personnel for defusing and debriefings. I am currently the point of contact for my agency. Recently, myself and other 911 professionals on the team have been meeting to discuss the 10 top calls for dispatchers, as well as discuss how we can spread the word that CISM teams in our area is a resource available to all dispatchers. In addition to walking viewers through my story – the initial call, the PTSD fallout, and the steps I took to change my mindset and heal – I want to be able to present the dispatcher’s point of view in handling critical incidents, and how agencies can help stop burnout and high turnover by providing resources to their dispatchers.
Learning Objectives:
Upon completion, participants will be able to:- Identify problems 911 professionals face on the job
- Understand how they can contribute to changing the conversation about PTSD in first responders
- Identify obstacles 911 personnel face utilizing a CISM team
Presenter
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Nicole Janey
Emergency Communications Supervisor
Chelsea Emergency Management
Nicole has been working in the 911 field for 15 years. Highlights of her career include working the Boston Marathon Bombing and the ensuing week, as well as successfully managing an officer down call. Following that event, she took a break from 911 in order to address the PTSD. She returned to 911 with a passion for all things related to 911 mental health and wellness, and is particularly focused on spreading the word about the effects of PTSD in the 911 community, and the need for better support and services for our personnel. She is also involved in the Greater Boston Law Enforcement CISM team, and the National Emergency Number Association. She is active in several subcommittees within NENA's wellness continuum. As a side project, she is currently curating “You Are Not Alone: Portraits of the Gold Line Family” , a photography project that seeks to put a face to all members of the 911 profession, and showcase how everyone is effected by the job, regardless of role.
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Overview
Crisis responders, peer supporters, and caregivers have entered into the world of COVID crisis and trauma. They experience the worst of situations many only read about or see through electronic media. They enter into COVID crisis day after day and hour after hour. Distress and the results of this high level of stress are a constant companion and the ramifications are life altering for most of these providers of care in crisis. Research, education, and training have taught them that stress mitigation is an essential part of their survival. Self-care is fundamental to being a crisis responder and building resiliency is not an option. Unfortunately, most crisis responders have only learned and practiced the physical and emotional aspects of building resiliency, and sometimes they have found it lacking. Rest and exercise, diet and hydration– these are the physical essentials for building resiliency. Building a strong system of social support, catharsis, and reinterpretation – these are some emotional essentials for building resiliency. What if there’s more? What if there are untapped resources for enhancing the resiliency we try to build? What if you could develop a few habits that could multiply your ability to be resilient even through the worst events and times of your life? What is you could do it without going to the gym, without spending a lot of money, or without having to go to a therapist? It can be done. Transformational resilience can happen!
Transformation is not a change brought about by simply doing good or improving our behavior. Imagine a person who is undernourished, sickly, and pale, but who puts on makeup to improve their appearance. They may look healthier, but the makeup is only cosmetic, something externally applied. What they really need is a genuine change that results from a life process within.
If that same undernourished, pale person were to eat healthy, nourishing food, a noticeable change would begin to occur. Their color would improve and their body would be strengthened. Eventually, their appearance would become healthy not because of something they did outwardly, but because of something that changed inwardly.Transformation occurs at the cellular level – the lump of coal, under a great deal of pressure, becomes a diamond. The coal does not become fluorescent nor does it change color – it becomes completely different matter with different characteristics, value, and purpose. Coal does not pretend to be a diamond; it completely becomes a diamond.
NEED THIS PRESENTATION ADDRESSES:
Today, responders face a myriad of COVID challenges on a regular basis. These challenges may be physical, emotional, operational, organizational, financial – in addition to relational, personal, spiritual, mental, behavioral, etc. Unfortunately, most crisis responders have only learned and practiced the physical and emotional aspects of building resiliency, and sometimes they have found it lacking.Each individual may experience COVID challenges differently. However, each responder has the ability to transform his or her present self into a healthier self by using the pressure of the COVID crisis to transform characteristics that will enhance resilience.
PURPOSE OF THIS PRESENTATION:
To teach crisis responders, peer supporters, and care providers to enhance resilience at the cellular level in a COVID world.PRESENTATION CONTENT:
1. Presentation includes a broad survey of factors that influence resiliency – internal, external, and personality characteristics.
2. Based on the principles of self regulation, actions to choose responses that will enhance resilience will be presented through data, anecdotes, and research.
3. A final action plan with responses, action required, and stress/resilience benefits will be presented.Learning Objectives:
Upon completion, participants will be able to- Understand pandemic’s unique stressors
- Describe traditional and transitional resilience
- Describe strategic application of transformational resilience tactics
Presenter
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Naomi Paget, BCC, DMin, FAAETS
Rev. Dr.
K-LOVE Crisis Response Care / FBI
Rev. Dr. Naomi Paget BCC is the Chair, National VOAD ESCC. Her work in disasters/crises has officially spanned 55 years with Red Cross, FBI, SBC Disaster Relief, ICISF, National VOAD and other crisis relief agencies. Instructor, curriculum writer, awarded Fellowship in American Assoc. of Experts in Traumatic Stress and Fellowship in the National Academy of Crisis Management, she is a published author and K-LOVE CRC and ICISF Approved Instructor for many crisis and trauma courses, consulting for several national and international organizations. She is an adjunct professor at Denver Seminary and Gateway Seminary. She has written several courses in peer support, crisis intervention, and chaplaincy which receive contact hours from Crown College. She received the Life Time Achievement Award from ICISF and from Southern Baptist Disaster Relief, and Distinguished Alumni Award from Golden Gate Baptist Theological Seminary.
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