An Update After The First Week

 

          I will start by expressing the heartfelt condolences of the board of directors, the faculty, and the staff of the International Critical Incident Stress Foundation, Inc. to all who have suffered the loss of family and friends in the immoral attacks upon the United States.  ICISF has a unique and special relationship with emergency services personnel worldwide.  We are, therefore, particularly saddened by the overwhelming losses encountered by the fire, rescue, law enforcement and emergency medical services agencies of the City of New York.  The pain of their loss lies deep within our hearts.  We are also concerned about the many people who have been injured in the horrific events of September 11.  Our sympathies, thoughts and prayers are with all of you.

          Next, I would like to thank those of you who heeded the warnings given on this web site last week not to over respond to the events in Washington, New York and Pennsylvania.  Your restraint is appreciated.

We continue the warnings that have been made in the past not to respond either as individuals or teams unless you have been specifically called to assist in the incident.  It would be helpful if those who have been requested to assist would coordinate their efforts with ICISF.  Some mental health professionals, peer support personnel and teams have self-dispatched to New York.  We have received numerous complaints already that there are some who are engaged in duplication of efforts or worse, some reports that a few people are working at cross-purposes to the main effort. 

The work at foundation headquarters proceeds at an intense pace.  An ICISF assessment and consultation team is on the ground and functioning in New York City.  We are receiving updates and direction from that team on a regular basis.  It is clear from their comments that CISM is only in its preliminary stages at this point and operations personnel are, for the most part, not ready for group interventions such as CISDs.  This operation is going to be a lengthy one.  We need to be prepared for that.  A small burst of uncoordinated effort very early on in the incident will not be that helpful in the long run.  What is needed is a carefully orchestrated program of CISM interventions and referrals in the months to come.

We have handled many hundreds of phone calls above our normal levels.  Every one of the five phone lines has been in operation practically every second of each prolonged workday since a few minutes after the attack.  This does not even address the calls made from the homes of the officers, faculty and staff of the foundation. The office has been operating from 6 a.m. to 8 or 9 p.m. each day since Tuesday.  The fax machine never stops.  There are hundreds of e-mails.  We have had a CISM mental health professional either in the office or immediately on call since Wednesday.  The ICISF headquarters was staffed over this past weekend even though the office is not ordinarily open on weekends.

We have handled calls from individuals in pain.  We have managed calls requesting referrals for friends.  Calls have come in from fire services, law enforcement agencies, emergency medical services, hospitals, school districts, airlines, businesses, employee assistance programs, government officials, the military and a host of others.  There have been urgent requests for information on managing children in the aftermath of the disaster as well as assisting adults with their needs.  Numerous articles have been written and put up on the web site so that the reader can pull them down and use them as they need.  More are being produced each day.  Please check the website (http://www.icisf.org/) to obtain specific information on what we have made available anyone who is interested.

We still do not have requests for CISD so please hold off any attempts to provide those.  The only exception so far has been the airlines which are trying to get back into action.  There are also some businesses that need group support at this time.  Some limited CISD work is planned for the next few days.  One-on-one services are being utilized most frequently at the scenes of these events.  Group work is not indicated at this time.  Remember, for group work to be effective it must be provided to homogenous groups, whose mission is completed and who have encountered roughly equal levels of trauma exposure.  It is also important that properly trained teams provide the services according to the standards of practice that have been established for CISM teams.

Given the magnitude of the search and recovery operations, I think it will be several more weeks before any serious group work is provided for the emergency personnel.  Civilians may require group intervention a bit earlier and some is planned on a case-by-case basis.

Please, let us keep the big picture in mind.  We need a comprehensive, systematic and multi-tactic approach to managing traumatic stress in these terrible times.  Clear planning, coordination with ICISF and thoughtful, carefully applied interventions can do much good.  No harm has ever been documented when well-trained people have intervened and utilized the well- established and widely accepted standards of CISM practice.  We need to be in this for the long haul, not just the short run.  Thank you!

 

Jeffrey T. Mitchell, Ph.D., CTS

President of ICISF