We will continue to support any activity if the need exists and I will continue to keep you updated.

• In anticipation of supporting CISM services requests for the next several months, ICISF has made the following contacts with state networks and shall cooperatively communicate directly with them for any/all CISM resources:  Canadian CISM Network, Colorado CISM Network, Florida CISM Network, Georgia CISM Network, Illinois CISM Network, Indiana CISM Network, Iowa CISM Network, Kentucky CISM Network, Michigan  CISM Network, Missouri CISM Network, Nebraska CISM Network, New Jersey CISM Network, New Mexico CISM Network, North Carolina CISM Network, Ohio CISM Network, Pennsylvania CISM Network, Tennessee CISM Network, Texas CISM Network, Tennessee CISM Network, Virginia CISM Network, Washington State CISM Network and Washington, D.C.
   
• Any State Network that is not listed is encouraged to contact ICISF to advise of 24 Hour contact information.
   
• All other CISM Teams will be contacted on an individual basis. 
   
  NOTE:  Please note that this section was meant to provide 'clarification'. As Teams were being requested to deploy, either due to their proximity to the assignment area or a specialty they might possess, ICISF would make the Team request through the respective State Network, as identified above. If the Team was not part of a State Network, then ICISF would make contact directly with them. Being part of a State Network does not mean they are the first to be requested, just that the request would go through the State Network and not directly to the Team. This message was also intended NOT to overlook any State Network, as stated in line two. If ICISF inadvertently overlooked a State Network, please assist me by brining this oversight to my attention.
   

  ---

   
   
  In communicating with many of the agencies identified in this update, as well as many other Local, State and Federal Authorities and respected individuals involved with the many aspects of Disaster Management and Mental Health, this recovery process will start slow, intensify and maintain that level for a significant period of time. How that translates to anticipated CISM efforts is that they will be minimal at first, intensify (possibly starting as late as 4 - 6 weeks post incident) and maintain that level for an unknown period of time (weeks to months).
   
  Given the magnitude of these incidents, the impact of CISM Team involvement will be just as crucial at 3 weeks, 6 weeks, post incident as it will be 3 months post incident.
   
  I need not remind CISM Teams that may read this posting, to be part of this incident you do not have to respond to actual disaster sites, the casualties are coming back to every state in the union and many countries abroad in the form of USAR Teams, DMORT Teams, Fire/EMS/Law/Communications personnel who did provide assistance and now return to your own communities. Providing appropriate CISM services is not visiting 'ground zero', but assessing the realistic need and providing that need where it may be needed, even if it is hundreds or thousands of miles away. 
   

  ---

   
  • ICISF is continuing to prepare to provide an appropriate level assistance when requested by responsible authorities. However, the request must be accompanied by a formal written request by a responsible agency, defining a clear mission, clarity of command structure, discipline and appropriate logistical support.

  ---

   
   Please refer the ICISF Web Page http://www.icisf.org  ,  "Attack on the USA"  http://www.icisf.org/911.htm   for useful information that you may utilize and reproduce.
   
  Should you have need for emergent contact with ICISF and/or myself, please access my digital pager  410-313-0061
   
  Restraint, patience, preparation and professionalism are the actions that we ask of all CISM Teams.
   
  Warmest regards,

  Don

   
  Donald Howell
  Executive Director
  International Critical Incident Stress Foundation, Inc.
  10176 Baltimore National Pike, Unit 201
  Ellicott City, Maryland  21042
  http://www.icisf.org/
  410-750-9600
  410-750-9601  (Fax)

September 26 update:

No update has been provided since our last report.

PENNSYLVANIA

On Monday, 9/24/01, the Pennsylvania CISM effort changed directions with the FBI Crime Scene Operation shutting down in Somerset County last evening, 9/23/01. The Somerset County Coroner's Office has assumed command of the scene with approximately 50 individuals remaining on location.

The Somerset County CISM site is functioning very well with the original team being replaced on Saturday, 9/22/01 and remaining until Wednesday, 9/26/01. A meeting later on today will determine if any other PA teams will need to be rotated through since the operation is shutting down.

On Friday, 9/21/01, Pennsylvania received a request from NYC to provide (1) team to supplement the NYC effort, but as of this date no team has been dispatched to the NYC incident.

Jim Abromitis

VIRGINIA

The Virginia Office of EMS deployed EMS Task Force Coordinating Teams (C-Teams) to the Pentagon site by the afternoon of the September 11, 2001 attack. As part of the Virginia CISM Team network massage therapists were deployed to the Pentagon site late on September 11.

Therapeutic massages were offered to EMS, fire, police, and government rescue/investigative personnel beginning on the morning of September 12, 2001. The massage therapists were rotated on shifts to provide the availability of massages 24 hours a day for the rescue workers.

The success of massage therapy in relieving stress was acknowledged when like therapy was requested for the search and rescue dogs. The massages allowed the dogs (as well their human counterparts) to resume their rescue/recovery tasks.

The last group of massage therapists left the scene on Monday September 24, 2001. CISM support was provided to the massage therapists on site and each group attended a Demobilization before returning home.

The northern Virginia CISM Teams (Arlington, Fairfax, Alexandria, Loudoun and Prince William) provided support to their own fire, police and EMS personnel on site at the Pentagon. That support continues at this time.

Carol Morrow Va OEMS CISM Program Manager

NEW JERSEY

Several agencies are providing CISM Support Services within New Jersey to targeted groups. The following agencies are in constant touch with each other as they continue to serve.

The CISM Network of New Jersey was activated on September 11, 2001, moments after the World Trade Center was struck by terrorist. The State Executive Director was in contact with the State Clinical Director and all CISM Network Teams were alerted. Shortly afterwards contact was established with ICISF and continues on at least a daily basis since the attack.

The CISM Network along with allied NJ Teams (NJ State Police, Cop2Cop, Hospital Teams, and NJ PBA) have provided Crisis Management Briefings, Individual Consults, Defusings, and Referrals to thousands of individuals effected by this tragedy.

Our primary population has been Emergency Services Personnel (Police, Fire, & EMS) and we have also provided interventions to lay groups when formally requested by agencies and companies.

The CISM Community has been active at the local, state, federal and business community level with providing appropriate assistance to those that have been affected by the New York City tragedy.

Standby or Walk Around CISM Services were provided at several locations such as NJ / NY Port Authority, Chelsea Pier EMS Staging Area, Liberty State Park Staging Area, Javets Center Staging Area, and Ground Zero.

I am proud of all CISM trained individuals that have devoted their talents and time in this crisis. I also would like to thank ICISF for their support and guidance.

Sincerely, 

Jim Schatzle 

Executive Director 
CISM Network of New Jersey

The New Jersey CISM Team 
has been at the Port Authority since day 2 of the attack. We have been staffing the numerous stations of the Port Authority. Today is day 15 of the operation. At this time, we have been doing numerous one on ones. We have the Concerns of Police survivors working closely with us helping the families of the fallen officers.

We are establishing a semi-permanent command post on the second floor of Journal Square/PATH building. We anticipate that a letter will be forwarded to ICISF to request additional teams to come in and help this afternoon.

Roland Kandle 
CISM Team Coordinator 
for the Port Authority NY/NJ

Response by Department of Law & Public Safety, Office of the Attorney General and the NJ State Police CISM Teams began on Tues 9/11 with a makeshift office at the Jersey City Liberty State Park directly across from WTC (Hudson River). 

The initial purpose/mission was support for the Emergency Responders, i.e., Dr.s and Nurses (190), over 200 EMT's and State Police and local PD's involved in the evacuation of lower Manhattan and the injured from WTC. Mental Health Screeners were separated out to address the patients/evacuee's and 4 CISM Teams were set aside to diffuse the EM people. As it came to be very few cases were transported across the River. 

Beginning on Weds., 9/12, NJSP-CISM began to process the New Jersey Task Force 1 - Urban Search and Rescue members and the New Jersey State Police T.E.A.M.S. special unit with pre and post defusings as the worked the rubble pile. An office was set up at the Javits Center and 4 CISM Teams, (14 personnel), provided support at this location and at ground zero for their 10 day assignment. 

Our staff has been providing the Dept. of Law and Public Safety with various informational sessions to the 8,000 employee's focusing on the CIS issues. The NJSP Operational Dispatch Unit in Northern New Jersey received an overflow of 911 calls at the time of the disaster and least to say the conversations on tape are horrendous. For the past two weeks and to continue indefinitely we have been debriefing that group. 

Direct briefings with the Governor's Chief of Staff continues as well as conversation/ coordination with Office of Victim Advocacy. Continued stand-by support for NYPD with NJSP-CISM (16) Teams of Peer and MH personnel.

Thanks for all your efforts and more information will be forthcoming.

Jim Nestor, Director 
State of New Jersey 
Department of Law & Public Safety 
Office of the Attorney General 
Office of Employee & Organization Development

September 22 update:

NEW YORK
 
Several Non-Governmental agencies are providing focused/regional CISM Intervention Services within New York City and the surrounding communities. ICISF is actively supporting one of those agencies and is fulfilling their requests for CISM Teams. It is anticipated that the number of Teams to support their efforts will increase dramatically over the next several weeks. ICISF will continue to support these focused requests.

See the message below from Ken Bohn, Assistant Director of Operations. 

PENNSYLVANIA

The Somerset, Pennsylvania CISM Command Center has informed ICISF that that the on-site Federal investigation component is winding down. CISM presence will remain at the crash site through next weekend, 9/30/01. At that time the Pennsylvania CISM component will shift to Emergency Services Assessments and interventions as appropriate.

VIRGINIA

The Virginia CISM Network, who have been efficiently coordinating efforts at the Pentagon crash site have indicated that they will winding down their on site presence by Sunday 9/23/01. At that time the Virginia CISM Network will shift to Emergency Services Assessments and interventions as appropriate.

NEW JERSEY

Information from New Jersey remains the same as 9/18/01:

The New Jersey State CISM Network has been functioning with an operating command post since the first day of the incident. ICISF has been in daily contact with their command staff. They have been efficiently providing CISM services since day one. It is anticipated that additional resources may be needed to provide assistance to the New Jersey Network in the near future.

MESSAGE from Ken Bohn, Assistant Director of Operations:

Ladies and Gentlemen,

As many of you are aware ICISF was requested by the NYC Dept. of Mental Health to meet with their staff and see what ICISF could do to assist them.

Dr. Everly, myself and Pete Volkmann met with Director of Mental Health for NYC 's staff and discussed many issues from status of incident, organizational structure , future scenarios, politics, logistics, services needed, possible funding, ICISF resources and capabilities and many other topics as you can imagine. This included an article put within a NYC newspaper that called for "doing nothing for 30 days , then doing cognitive therapy" . The result of our meeting was a request from the Director for ICISF to make a written proposal to his office. The proposal proffered to the Directors office was from three fronts, Consultation, Training and Collaboration in actual Crisis Intervention. At this time we have not heard from Directors office. Although there was a request from one of the Directors Deputies for School based consultation and this is being worked out.

The ICISF Advanced Incident Assessment Team met with many other organizations that are providing assistance to their constituencies and have offered ICISF assistance in any form they choose:

Red Cross - Has many sites open including the "Family Center" were surviving families not only get Red Cross assistance but local,state and federal in dealing with all facets of this tragedy.

The International Association of Fire Fighters has established a CISM presence and is working hard with the FDNY's EAP to provide onscene services and CISM services and support in other area's as request by the FDNY.

Local 2507 EMT's and Paramedics have requested assistance in some form and are working to establish mechanism within their organization surrounding EMS organizations and representative EMS groups for this to occur

Disaster Psychiatry Outreach PC is working within the family centers and met with the Advanced Incident Assessment Team to Learn what ICISF is about and how our organizations can possibly compliment each other and work together.

On behalf of the ICISF Advanced Incident Assessment Team to NYC, thanks to all of you that assisted us when we were there and for the professional advice you all have offered to assist us in this mission.

The magnitude of this tragedy, the amount of human loss, I can not put into words. The courage and dedication that the governmental leaders, spiritual leaders, command staff, uniformed, non-uniformed, military, civilians and outside responding resources to NYC displayed and continue to display until their missions are completed make all of us proud. As NYC continues to move towards recovery, the complexities of the NYC organizational structure and politics will dictate the role we may all fill to assist them in the future.

On Other Fronts:

CISM Teams of all types, emergency service based, business based, Red Cross, spiritual based and community based are starting to get active North, West and South of NYC. This is due to many factors, as those who worked and proudly served  in NYC lived in many of these outlying areas.

Pockets around the country and in Canada are starting to get request for services due to deaths of business co-workers and family members . Also, USAR Teams, Clergy military  and emergency service workers of all types are now starting to return from all three crash sites.

Airlines continue to make request as their people slowly but surely return to the air.

Purely due to the size of the incidents working at the Pentagon and Somerset Co., PA incidents seem to be moving on an even keel and presently most request unless from a special population are being handled by the Virginia Network, Chip Theodore, Rich Boland and PEMA respectively.   

Sorry for not emailing sooner our computers were down at ICISF for about 18 hrs. 

Warmest regards, 
Kenny 
C. Kenneth Bohn, Jr. 
Assistant Director of Operations 
ICISF, Inc. 
10176 Baltimore National Pike 
Unit 201 Ellicott City, Md. 21042 
(410) 750-9600 
pager 1-877-715-1726 
kbohn@icisf.org

GENERAL ANNOUNCEMENTS

• In anticipation of supporting CISM services requests for the next several months, ICISF has made the following contacts with state networks and shall cooperatively communicate directly with them for any/all CISM resources:
  • Canadian CISM Network, Florida CISM Network, Georgia CISM Network, Illinois CISM Network, Indiana CISM Network, Iowa CISM Network, Kentucky CISM Network, Michigan CISM Network, Nebraska CISM Network, New Jersey CISM Network, New Mexico CISM Network, North Carolina CISM Network, Ohio CISM Network, Pennsylvania CISM Network, Texas CISM Network, Tennessee CISM Network, Virginia CISM Network and Washington, D.C. 
  • Any State Network that is not listed is encouraged to contact ICISF to advise of 24 Hour contact information. 
  • All other CISM Teams will be contacted on an individual basis.
       

As I am sure that all CISM Team Coordinators and Clinical Directors have already considered that there may be CISM Team casualties (emotional), therefore the selection of CISM Team members to provide services should not be taken lightly. 

Responsible CISM Teams, before deploying their personnel, must have in place a Debrief the Debriefer program for their personnel upon return. (See article on the ICISF Web Page) As a part of CISM Team selection, individuals must agree to attend a Debrief the Debriefer component upon return. Second thoughts should be given to detailing CISM Team members who do not agree in advance to this important post intervention component.

ICISF is continuing to prepare to provide an appropriate level assistance when requested by responsible authorities. However, the request must be accompanied by a formal written request by a responsible agency, defining a clear mission, clarity of command structure, discipline and appropriate logistical support.

I wish to thank the Baltimore City Fire Department, the Anne Arundel County Fire Department and the Howard County Fire/Rescue Service (all in Maryland) for their personnel who have been assigned or donated their time to staff our operations center here at ICISF.

To provide, update or review your CISM Team information, please contact ICISF and you will transferred to the ICISF CISM Team office.

Please refer the ICISF Web Page http://www.icisf.org  ,  "Attack on the USA"  http://www.icisf.org/911.htm for useful information that you may utilize and reproduce

Should you have need for "emergency contact only" with ICISF and/or myself, please access my digital pager 410-313-0061

The next scheduled e-mail update will be Monday 9/24/01. Please be patient with the office staff as we process and respond to the many inquiries.

The position of ICISF is still, "before an ICISF response, the request must be accompanied by a formal written request by a responsible agency, defining a clear mission, clarity of command structure, discipline and appropriate logistical support."

Restraint, patience, preparation and professionalism are the actions that we ask of all CISM Teams.

Warmest regards,

Don

September 18 update:

September 15 update:

September 13 update:

September 12 update:

Early Thoughts After the Attack on the USA

By

Jeffrey T. Mitchell, Ph.D., CTS

President of ICISF

Ellicott City, Maryland September 12, 2001, 5:00 a.m.

          The United States has sustained the most brutal terrorist attack in history.  Perhaps thousands of its citizens have been murdered.  Thousands more have been injured.  And all of us are shocked and overwhelmed by the massive losses in lives and property that have yet to be calculated.  Everyone feels driven to do something to respond to the death and destruction in New York City and Pennsylvania as well as in our nation’s capital. 

No one doubts that there will be many physical and psychological needs to be met.  But, we must be very careful to avoid the common mistake of an uncoordinated psychological over-response that has occurred in so many past disasters.  We have seen the negative effects of too many counselors and even CISM teams in the Oklahoma City bombing, numerous school shootings, airplane crashes and natural disasters.

It is important to remember that when people are in a state of shock and denial they feel overwhelmed and confused.  They are not ready to psychologically “process” their experiences.  What they need right now is verifiable information and some simple, clear suggestions to guide them through the turmoil.  They also need reassurance that everything that can be done on behalf of the victims is being done.  The Crisis Management Briefing (CMB) is the most useful CISM tactic for groups of citizens who have been exposed to the tragedy.  One-on-one individual support is recommended as a follow-up procedure.  Many other interventions and even referrals for therapy can be made in the weeks and months to follow, but not right now.

  Emergency response and military personnel, in particular, suppress their emotions in order to be able to do their jobs.   They will have to continue to do this for several weeks as they clear the debris to find the victims.  Too much psychological “help” at this time will cause a rejection of such help now and anger and resentment toward any type of psychological support in the future.  Emergency personnel will benefit from demobilizations in the first 24 hours.  Then the tactics need to change to a combination of one-on-ones, guidance for supervisors and other interventions that have been developed by ICISF in past disasters.  Debriefings are out of place and inappropriate in most cases until considerably later in the operations.  They are most useful after the recovery of the victims is completed.  In the current situation recovery will likely take several weeks.  Rushing in with the wrong tactics now is not helpful and in fact is counter-productive.

ICISF is actively working with authorities in New York, Pennsylvania and in Washington, D.C. to coordinate an effective and efficient CISM response to those tragedies.  Please do not “self dispatch” as individuals or as teams to any of these tragedies.  Instead, please contact ICISF and let us put your team on a resource list. Please use ICISF as a single point of contact in this disaster situation.  Calls to various individuals and organizations within the disaster areas will only confuse things.  As the needs of the personnel involved in the tragedies become clear ICISF will coordinate the dispatch of skillful and well-trained CISM personnel to the disaster areas.  Please, let us work carefully in concert with one another and with the authorities in the impacted areas.  The right approach at the right time can be enormously helpful.

Thank you!

Important message regarding the events which occurred Tuesday, September 11, 2001 :