Critical incident stress management (CISM)

A critical incident is a situation that is traumatic for the first responders involved. The incident causes the worker to experience an unusually strong emotional reaction either during or after the incident. 

Examples of a critical incident include:

• serious injury or death of a co-worker in the line of duty
• loss of a patient after prolonged rescue attempts
• incidents that attract considerable media attention
• personal identification with a victim or their circumstances
• suicide of a co-worker
• serious injury or death of a person
• death of, or violence towards, a child

When stress builds up it may contribute to burn-out, disruption in normal routine or the first responder leaving their chosen field.  After a critical incident, some people may experience post-traumatic stress.

Symptoms of post-traumatic stress can include:

• re-experiencing the traumatic event over and over
• recurring nightmares
• avoiding friends and family
• losing interest in activities that used to be enjoyable
• difficulty concentrating
• getting angry easily
• experiencing sudden attacks of dizziness, fast heartbeat or shortness of breath

This is not a comprehensive list, but if you identify with one or more of the above symptoms, talk to your doctor or the Critical Incident Stress Management team. 

The program is intended to reduce the buildup of stress among first responders and promote a culture of positive mental health in their workplaces. Teams are comprised of representatives from 14 regionally based teams and include psychologists, social workers and nurses. There are also peer support personnel from front line professions such as firefighters, police officers, emergency medical technicians and hospital emergency room staff. 

The team is responsible for providing education on stress management, creating a culture of wellness in the workplace and responding to individuals and groups following critical incidents. 

They provide:

• stress awareness sessions, offered in the workplace
• debriefing following a critical incident response, to enable first responders to share their thoughts and reactions while discussing the incident—confidentiality is emphasized
• follow-up contact and referral to mental health or private service providers for further assistance, if needed
• demobilization for first responders during an ongoing response to a critical incident
• on-going education and training for team members

Your regional Community Mental Health Services will provide you with the name and phone number of the regional team coordinator who will arrange any interventions needed.

PSPNET (Public Safety Personnel) provides resources for first responders and their family members. This includes self or therapist guided support for post-traumatic stress, information, strategies and a wellbeing course. These resources are free and do not require a referral. 

9-8-8: Suicide Crisis Helpline — If you are thinking about suicide or worried about someone else, call or text 9-8-8 toll free, any time. Lines are open 24/7.