Clinical Syndromes and Intervention Strategies
INTRODUCTION
Law enforcement and emergency response is stressful. From the first person to pick up the call to the forensic investigator who prepares the evidence for the prosecuting attorney, personnel are exposed to details, sometimes horrific of violence and suffering. Individuals experience stress factors differently. There individual natures, the type of exposure and their job are all factors. However, everyone working in emergency response has by one or more stress factors not common in the public sector. To help identify and address these factors this article explores the various employment positions, stress factors and two successful treatment programs.
STRESS AND COPING IN LAW ENFORCEMENT
Often the first person involved in responding to an emergency is the 911 operator or the dispatcher. They frequently have to juggle multiple emergencies and get vital information from hysterical people then prioritize the response teams knowing that a mistake could prove fatal to someone on the other end of the phone line, and they do this every day. Other support personnel are not immune; everyone involved in law enforcement shares some of the same stress. However, because they are not out on the streets risking their lives the everyday stress is not as widely acknowledged or appreciated.
The patrol cop and detectives are the first responders we most often associate with law enforcement stress. They are the “tough guys” out on the street. They get shot at by, and sometimes shoot, the most vicious predatory members of society. Officers cannot avoid stress and trauma and everyone has their breaking point. For the officers out in the field it is not an “if” it is a “when;” it is more of a matter of what form it will take and what will be the trigger. Officers suffer higher rates of hospitalizations, premature death, and suicide this is complicated by the potential repercussions of seeking treatment. Officers seeking help risk having their guns taken away or other career setbacks. Viewing treatment as stress management helps with this problem.
One effective technique to dealing with the inevitable stress associated with a particularly disturbing incident is the Critical Incident Stress Debriefing (CISD). The CISD helps all law enforcement personnel involved in a particularly traumatic incident. There are several effective CISDs. The basic premise is that all personnel must attend, but no one is put on a “hot seat” or forced to speak. The trigger and time frame for initiating the CISD varies but they all have common elements. The CISD uses a team approach, with peer support, and a combination of mental health professional and peer debriefers. Although frequently initiated 24 to 72 hours after a critical incident factors like an ongoing investigation can delay it.
A number of mental health professionals have developed CISDs. Most CISDs include the following; introduction, fact phase, thought phase, reaction, symptoms, education, re-entry and sometimes “unfinished business.” They usually use the following strategies; attentive listening, being there with empathy, reassurance, supportive and interpretative counseling, and departmental support. Other strategies created to deal with long term or cumulative stress use these same strategies.
CONCLUSION
There is no question that people subjected to extraordinary stress and trauma day in and day out need to have specialized care. The plan selected and how it is applied must be tailored to suit the people and the situation. This article introduced some of the options along with their features and discussed some of the pros and cons. Someone interested in the topic should look further into the treatment methods created by Mitchell, Sewel, Solomon, and Bohl. An extensive list of References provides many choices for further inquiry.
