Helping out our heroes

Paramedics, firefighters, and emergency response workers are the first on the scene when there’s trouble.
But behind the scene, there’s been a dedicated group of volunteers making sure the people who take care of us can keep on going.
For more than 15 years, Rainy River District’s Critical Incident Stress Management team (C.I.S.M.) has been working with groups like EMS to deal with critical incident stress—when an event, usually traumatic or tragic, causes a person’s coping mechanism to be affected and possibly overwhelmed.
“It’s not psychotherapy,” stressed Jon Thompson, a counsellor at Riverside Community Counselling Services who also volunteers as the clinical co-ordinator for C.I.S.M. “It’s meant to give people information at a crucial time to help them get back to their normal routines and lifestyle as quick as they can.”
The team is made up of volunteers: mental health personnel and peers from a spectrum of different occupations who have, over the years, helped hundreds of people, spent hundreds of hours on training and development, and is approaching 2,100 hours of community service.
That’s only from dealing with incidents C.I.S.M. was called to help with, noted Thompson, not all the ones they could have responded to.
The team has provided support after house fires, suicides, construction accidents, shootings, motor vehicle accidents, and death of children—incidents emergency workers can be exposed to.
“Nobody trains you to get used to seeing death and dismemberment and all that stuff. There’s no really easy way to,“ said Thompson.
Which is why the C.I.S.M. program stems from the experience of first responders, after years of dealing with critical incidents, as if they weren’t supposed to show emotion or be affected by what they saw on the job.
“A lot of them realized that that’s how they’ve lost a lot of colleagues, that way. A lot of these tough guys were committing suicide . . . and it was a real wake-up call,” Thompson said.
“We’re starting to connect the dots and realize that we’ve lost so many good people, sometimes to death, but sometimes people quit, saying, ‘I’m not going to do this anymore,’” noted Thompson. “That’s a huge loss to both the organization, the public, and to society, too.
“So we want people to be able perform their duties, we want to sustain them. Just like you’d want to invest in training in any job and work.”
Dealing with critical incident stress can depend on the individual, said Dan McCormick, Health Services manager for the Rainy River District Social Services Administration Board.
“Some people eventually just move beyond it and put it on the back burner, but that’s the problem,” he noted. “There’s the chance that there’s another incident that might trigger that and cause an emotional breakdown, or emotional upset.”
There’s no secret formula to dealing with these situations, said Thompson, but what C.I.S.M. does is try to provide support, education, and information. Services they provide include on-scene support, demobilizations, crisis management briefings, initial defusings, formal debriefings, individual referrals, and awareness training.
Despite the need for these type of programs, there’s no province-wide funding for dealing with critical incident stress among occupations such as paramedics, said John Beaton, a paramedic who also volunteers as the C.I.S.M. program co-ordinator.
Programs that do exist often are ad hoc and up to each area.
“We find in the rural communities there’s just not enough bodies to each service to have their own, so we work together to cross-train them, such as emergency services, youth workers, industry, and the school board,” noted Beaton.
It’s also why the C.I.S.M. is open to all community members who may have been involved with a critical incident.
“Even a bad car accident, we may not be called in for emergency service workers, but someone providing first aid there that has no experience besides first aid training, it could be more traumatic for them, so we try to make sure that they’re covered and they’re okay, and that they don’t have problems down the road,” Beaton explained.
One way the C.I.S.M. program is used by local EMS services is through requested debriefings after situations that could be considered a critical incident. Held usually 48-74 hours after the original event, the debriefing is led by a mental health professional alongside trained peers of those involved with an incident.
They aren’t operational briefings to go over whether procedures were done correctly, noted Thompson, and they are completely voluntary. A good debriefing can take three- four hours, or even longer if more people are involved, and are completely confidential.
“Generally it’s just talking about your part of the experience, what you saw and did, what your reactions were, what the worst things were about it, and then near the end of it, the re-entry part of it, we talk about how to deal with these incidents,” he explained.
“It’s not therapy, it’s an educational group session “It’s really about your emotional thought processes, physical reaction, so on and so forth.”
It’s these type of reactions that first response workers have to sit on and hold back to get their job done, said Thompson. But once the incident is over, it’s about externalizing these things so they can be dealt with.
“A lot of that, in a way, it kind of seems like common sense,” he remarked. “If you’ve ever been upset, why does that work for you? Well, because somebody gave you a hug or somebody understood, or you cried a bit or laughed a bit, and you felt better.”
Involving peers, Thompson said, make the C.I.S.M. more of a team support system, where those who come for help feel more comfortable.
“The peers are the only people who really understand what the job is like,” he noted. “That’s why having us together and in the same room is important.”
“One thing we find is that medics tend to talk to other medics, too,” echoed McCormick. “Because in our service there’s a wealth of information. There’s pretty well a lot of longtime medics who have done a lot, seen a lot, and seen the evolution of the service, and for them they’re a real resource to the younger medics.”
And while a debriefing isn’t a substitute if a person needs more help coping with an incident, it does help identify and engage them so they feel more comfortable getting more professional help if they need it, said Thompson.
Currently, there’s 15 peers who are active, alongside two mental health professionals. Peers come from a variety of backgrounds, everything from the EMS and the local fire department to AbitibiBowater and the United Native Friendship Centre.
The program also has connections with organizations like Associated Community Living and the OPP, which has its own internal process for dealing with critical incidents.
“You can see how much potential there is,” said Thompson. “There’s a lot of other groups that could be having peers trained.”
But since all of it is done through volunteers, it can be a challenge, admitted Thompson, since there are things like turnover and retirement.
“We badly need more [peers]. The more, the better,” he stressed. “That team can go down to almost nobody quickly if, say, we had a big incident.”
In situations like that, help from outside the district, such as from Kenora, which has a similar system, would have to be called in.
And there’s no set number for how many or what type of incidents they will be needed at, so ensuring volunteers remain trained and ready can be an issue, Thompson said.
“Like any other skill, you’re going to get rusty,” he noted. “The work we do . . . it’s kind of like a necessary evil. You never want to have to do this, but you want to do it, too, and do it well if there’s ever the need.
“There’s the resourcing of it,” added Thompson. “To sustain the team, to be able to send them for training, to bring [trainers in], it costs money.”
“We have to bring somebody in because we’re recognized under an international foundation and it’s actually recognized by workman’s compensation as a legitimate training program to meet their criteria,” noted Beaton.
Currently, an instructor costs around $2,000 per day, plus other costs to bring them in, he said.
“Most of our employers are pretty good to try to give us the time off, or our co-workers are pretty good to cover shifts, if we have to go do these things at a moment’s notice,” added Beaton, but the volunteers also have to cover things like travel costs to cover an area reaching from Atikokan to Rainy River.
Additional information on the Rainy River District C.I.S.M. is available by contacting it at P.O. Box 672, Fort Frances, Ont. or calling 274-4807 on weekdays.