On-Scene Support Services

Front line responders are trained and experienced in confronting scenes that are often very unpredictable and dangerous.  They have designed routines, procedures and are educated to be able to confront these events with little noticeable stress. Just because the event may seem disastrous to the lay person, not so to the trained professional.  There are, however, situations or circumstances which may create significant stress for an individual or group during these encounters.  The loss of a colleague, or the death of a child for instance, can have a tremendous impact to first-line responders.  Having trained, CISM personnel at the scene can help manage the stress reactions and keep the response on target.

Intervention of this type is generally brief and follow the principles of crisis intervention. If there are responders free to attend to other distressed workers, this will help limit the level of distress. This is done informally and services of this type are limited.  A more formal approach involves trained CISM personnel organized in advance of an incident.  They may be on stand by, or regularly attend incidents. Usually there is some form of predetermine criteria which initiates their response.

Those called onto provide on-scene support services are generally peer support personnel trained in CISM and crisis intervention.  Chaplains may be called upon if the incident has loss and tragedy, and mental health providers may be called upon if the incident is large scale or so overwhelming that the peer support of the CISM team are too busy to do the supportive services.

As a peer supporter, when called to the scene the support is provided immediately, that is, as the incident is taking place.  Services are provided as close to the scene as safely possible with the goals of stabilizing the situation, mobilizing resources and restoring to function as quickly as possible.  The support provided is short in duration.

When providing on scene services keep in mind that what is going on is intense and the defense mechanisms of the responders do not allow for complex interventions.  They must be short and simple.  Services must only be provided to people showing signs of distress. Let all others do their work.  Do not interrupt to "check" to see how they are doing.  Keep the intervention short. Sometimes only seconds are needed, while five minute interventions are considered long. Going beyond that, say up to fifteen minutes and the person does not show signs of marked improvement, they are unlikely able to return to work at the scene. Interventions need to stay focused on immediate concerns, or the here and now.  There should be no exploration into other issues.

Mental Health, Clergy and Others

The most important thing to remember as a non-peer support provider, is to not come unless summoned as part of a normal response team.  While the incident may be overflowing with loss, chaos, and mental health issues, it is not time for your skills until they are summoned. If you are contacted, report to the command center. Do not wander around and keep a low profile. It is not time to pass out business cards. Do not try to draw attention to yourself. It is important that you blend into the scene and minimize distraction.  When you notice someone distressed, your approach needs to be discreet and subtle. If you are not needed, stay on the perimeter of the scene or by the command center.

Mental health providers and clergy are best utilized when they are available to provide consultations to command staff and supervisors. As professional helpers, the desire to insert yourself into the scene needs to be managed.  Your focus is on support, listening and resourcing.

Non peer personnel should consider training/orienting with emergency services. Going on ride-alongs and touring facilities, learning about roles and responsibilities, this education is invaluable from a practical standpoint while also becoming a more familiar face to the emergency personnel.