incident stress has been a recognized mental health concern for generations. World war I brought us the shell shocked soldier. During World War II the study of mental health had evolved, and the concept of battle fatigue became a diagnosable concern. As time marched on so did mental health care. By the time Vietnam came around both of these old diagnoses were replaced with the concept of Post Traumatic Stress Disorder (PTSD). During that famous conflict nearly 16% of returning veterans suffered from PTSD. Although common in the emergency response industry the concerns associated with incident based stress did not become a concern until the Oklahoma City bombing which occurred in 1995. After that stressful event the concept of PTSD became a focus of research and study. In one recent report 15% of law enforcement officers have suffered from PTSD, and as much as 31% of suburban fire based Emergency Medical Services personnel have the same disorder.
Having discovered that there was a tremendous need several entities dedicated their careers towards the mental health of emergency responders. One of the leaders of this movement has been Doctor George S. Everly of the Johns Hopkins University, and the Loyols College in Maryland. Doctor Everly and his International Critical Incident Stress Foundation has paved the way for much of the modern theory and discussion associated with Critical Incident Stress Management (CISM).
I recently experienced a 2 day critical incident stress management class. This course was hosted by the city of West Des Moines Iowa. The class was small, but informative. We learned about mental health, stress, and what is part of a normal response to stressful situations. In spite of all we learned I don't feel that anyone in our class feels comfortable going out and conducting group debriefings. It is apparent that this course is not intended to build an experienced team. Luckily for us Iowa has a very active state wide CISM network. I strongly recommend that anyone who completes a CISM program spend a few sessions mentoring under the wing of those experienced professionals.
