Civil Unrest
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Overview
Health and safety legislation exists to protect the mental health of workers, including those at high risk of psychological injury, by separating the responsibilities between the worker (for self and others) and the manager (for the work environment). However, the traditional clinical viewpoint seems to ignore this in favour or seeing all psychological injuries as phenomena in need of medical, psychiatric or psychological expertise once symptoms have emerged and persisted. For example, symptoms of posttraumatic stress disorder (PTSD) have to await the passage of 28 days before diagnosis and treatment, while health and safety law demands immediate action. As crisis intervention is designed for immediate action and clinical guidance requires a delay, crisis intervention appears to be in keeping with legislation created to secure mental health. The tension that exists between the clinician’s advice to ‘watch and wait’ and the peer’s compulsion to ‘act now’ might be resolved by a psychological risk assessment undertaken in the immediate 28 day post-incident period.
Risk assessment for any health condition has three steps: 1. Identify the hazard, 2. Intervene to minimise or eliminate the hazard, and, 3. Monitor to ensure the intervention has worked. An online portal that measures depression, anxiety and PTSD and reports results to the completer themselves has several advantages. First, the assessments can be the same as those likely to used by the clinician should symptoms persist and recovery does not occur. Second, the completer is now aware of their likely condition and the level of risk exhibited by the scores. Third, the organisation can be informed of the overall levels of mental health by demographic variables including team, department and location. With information shown to the worker and statistical patterns shown to the manager both carry their own legal responsibility to act to ‘minimise or eliminate’ the hazard represented by high scores on clinical assessments.
Taking the discrepancy that exists between the clinical viewpoint and the crisis intervention viewpoint a secure online portal has been designed to meet the health and safety demand for risk assessment by informing the worker themeslves (with contact details for support and guidance), informing the organisation’s managers of ‘hot-spots’ of mental health hazards in the workplace and putting both ‘on notice’ that they should now act. The ‘I didn’t know’ claim to justify inaction would become invalid for both parties. This presentation will show how the backdrop of health and safety legislation justifies the use of crisis intervention following critical incidents. It also offers a means by which workers can self-assess and decide how they will tackle the risk they have been informed of, In addition this will allow managers to shape the workplaces structure and policies in light of the patterns emerging from the de-identified data generated by the workers collectively. The potential to use the data generated to underpin mental health policy, identify training needs and show the effectiveness of crisis intervention will be discussed.
Learning Objectives:
Upon completion, participants will be able to:- Recognise key indicators that return to duty is safe following a critical incident
- Assess risks to mental health in compliance with workplace safety and health legal demands
- Complete assessment, intervention and return-to-duty within 28 days of a critical incident
Presenter
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John Durkin, MSc. PhD
STAGE-28 International
John Durkin Ph.D sits on the Boards of the International Critical Incident Stress Foundation (ICISF), Crisis Intervention Management, Australasia (CIMA) and is co-director of STAGE-28 International offering training, research and consultancy in crisis intervention and psychological risk assessment. His interest in posttraumatic growth took hold in his early career as a firefighter and was later strengthened by his role in the post-9/11 support effort at New York’s fire and police departments. Convinced that critical incident stress management (CISM) delivered by peers had the potential to prevent a number of mental disorders he sought enhancements that might challenge clinical therapies for effectiveness. Further qualifications and training persuaded Dr Durkin that peers delivering crisis intervention in a person-centered fashion would prove superior to standard treatments for PTSD and facilitate posttraumatic growth. A number of pilot projects have supported this and led to training a team of firefighters in CISM, informed by person-centered theory. When Dr Durkin was called to lead the crisis response for the Metropolitan Police Service following London’s 2017 terrorist attacks and Grenfell Tower fire, the same team of firefighters came in support. Over 80 police officers were seen and no report of PTSD or depression had been received three years later. Growth in police officers and firefighters has been widely reported and awaits empirical confirmation in future projects. The legal demands of occupational safety and health were met during this period leading to the design of a psychological risk assessment for use in the emergency, medical and military services.
Handouts
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Overview
Communities are demanding police change how they respond to incidents, which someone is in crisis or with mental health and/or social issue concerns. Traditionally, police have responded with a law & order approach, which at times is hurtful to those in need of help. This approach may further escalate someone in crisis, which is not helpful, but further hurts the person in their time of need. Even worse is when officers use physical force when de-escalation would have been far more appropriate.
Jen Corbin and Lieutenant Steven Thomas will discuss how the SAFER-R model and CISM can be utilized to assist the community in their time of need. Law enforcement routinely responds to traumatic incidents and they will discuss how CISM interventions can be used to help families and the community. Further they will discuss how the SAFER-R model can be adapted to assist citizens whether it be: for children living in traumatic living conditions, someone looking for recovery from substance abuse, someone facing re-entry into the community from incarceration or to assist someone making threats.
Learning Objectives:
Upon completion, participants will be able to- Describe how the SAFER-R model can be modified for various community policing interventions.
- List situations which the SAFER-R can be utilized in community policing.
- Describe a “trauma responsive mindset”
Presenters
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Steven J. Thomas
Lieutenant
Anne Arundel County Police
Lt. Steven Thomas, CCISM has a BA from UMBC and a MA from the University of Baltimore. He started as a patrolman with the Anne Arundel County Police in 1996 where he remained in patrol until he became the CIT and Peer Support Coordinator in 2016. In 2020 the Anne Arundel County CIT Unit was named International CIT Unit of the Year.
He is the Anne Arundel County CISM Team Coordinator. Further, he is an ICISF approved instructor and in the spring of 2019 received the ICISF Pioneering Spirt Award.
He is a Youth & Adult Mental Health First Aid Instructor and in 2018 he was named a top 100 instructor. -
Jennifer Corbin
Director
Anne Arundel County Crisis Response
Jennifer Corbin, LMSW is Director of the Anne Arundel County Crisis Response System. Much of her work is in collaborating with outside agencies to work with the crisis system such as A. A. County Police and Fire, Health Dept., Public Schools, local hospitals, and local providers. She is a trained instructor in Mental Health First Aid (MHFA). Ms. Corbin is also trained in Critical Incident Stress Management (CISM) and helped develop a peer support team for A.A. County Police. Ms. Corbin received her master’s degree in Social Work from The UMD School of Social Work.
Handouts
