May 15, 2007
YKHC's new Critical Incident Stress Management (CISM) Program is based on a model that is proven to be an effective way to help people who have been affected by traumatic events.
YKHC's Health Aide Program has used CISM in the past for health aide debriefing following tragic or traumatic events in their villages.
Some of the recently trained CISM responders are Bethel-based, and some are village based. Although response capabilities can be limited, the CISM team has already had successes, and looks forward to assisting when needed.
What is a 'critical incident?' and how does stress management fit in with it?
A critical incident is "an unusually challenging event that has the potential to create significant human distress and can overwhelm one's usual coping mechanisms."
Have you ever lost a friend or family member to a murder or suicide? Those are examples of events that could be considered critical incidents. The CISM team will work with people to help them cope with the stress related to the critical incident in a healthy way.
Quick response to critical incidents is important. Research suggests that early psychological intervention may reduce the need for more intensive psychiatric services later, may reduce acute distress, and alcohol use. (Sources for these statements are available upon request.)
CISM is a system of services that can be used before, during, or after a disaster or traumatic event. The goals of CISM are to lower tension, help recovery, and to bring people back to a healthy level of functioning. Most of the time, individual interventions and Critical Incident Stress Debriefing (CISD) of small groups are used. CISDs are most effective when done from 13 days after the incident, while individual interventions can be done at any time, anywhere.
Who can I contact?
An important thing to remember is that most people who receive CISM are normal people having normal reactions to an abnormal event.
If you believe that you would benefit from counseling, individual CISM intervention, or a group debriefing, feel free to call. If a critical incident has just happened and you would like a response as soon as possible, please call the hospital operator and ask them to page the CISM coordinator (pager #3203). If the coordinator does not respond within 15 minutes, please ask the operator to page Behavioral Health on-call or Admin on-call.
YKHC Behavioral Health providers have responded to traumatic events and disasters for many years, sometimes using CISM, sometimes using other approaches. The Community Health Aide Program (CHAP) has used counselors for more than 10 years to support and debrief the Health Aides and CHPs.
Last fall, CHAP and Behavioral Health (BH) agreed that the Health Aides would be better served with the Health Aide support coming from Behavioral Health, and the transition was made.
In a recent CISM certification training, seven village-based Behavioral Health Aides (BHAs) were certified to use the CISM model. Edward Kelly from St. Mary's, Fred Joe from Nightmute, Patrick Pavila from Tuntutuliak, Alfred Ulroan from Chevak, Elizabeth Smith from Atmautluak, Marvin Deacon from Grayling, and Emma Matthias from Kotlik were all certified.
Pat Pavila, Fred Joe, and BHA Joe Mute also recently used CISM and traditional methods to assist BHA Mary Hill in Quinhagak after a fatality due to a house fire. The death affected family members, people who helped on the scene with the fire and the body, and other community members.
One of the most helpful things that happened during the response to the tragedy was the appearance of an elder who spoke to a group of people who were being debriefed. The elder related his own experiences with traumatic events, and explained to them how important it is to talk about it, to "get it out."
For more information on Critical Incident Stress Management, please visit the International Critical Incident Stress Foundation's website, at www.icisf.org.
The CISM team is also seeking input regarding traditional methods of coping with traumatic events, so if you know of any things that were traditionally done in your area to help people after critical incidents, or if you know of any elders who might know, please contact one of the above BHAs or Louis Mallette.
If you have any questions about critical incidents, contact Louis Mallette, BH CISM coordinator, at 543-6093, or by calling the hospital switchboard at 1-800-478-3321, and asking them for extension 6093.