2. CRITICAL INCIDENT STRESS MANAGEMENT (C.I.S.M.) CRITICAL INCIDENT STRESS MANAGEMENT (C.I.S.M.) Constructed & Presented by Chief Inspector Gary Raymond APM NSW POLICE Constructed & Presented by Chief Inspector Gary Raymond APM NSW POLICE EMOTIONAL FIRST AID FOR FIRST RESPONDERS EMOTIONAL FIRST AID FOR FIRST RESPONDERS 2005

3. CRITICAL INCIDENT STRESS MANAGEMENT Who do most people see themselves as?

4. CRITICAL INCIDENT STRESS MANAGEMENT *a special group of people *having specialised training *possessing unique capabilities *tolerant of the stress of demanding work *work in all kinds of weather & places

5. CRITICAL INCIDENT STRESS MANAGEMENT *action oriented *willing to take a degree of risk *dedicated and determined *prepared to make sacrifices

6. CRITICAL INCIDENT STRESS MANAGEMENT *reluctant to give up in the face of overwhelming odds *sensitive and understanding *able to suppress normal emotions & fears *able to experience forms of euphoria

7. CRITICAL INCIDENT STRESS MANAGEMENT *being tested beyond breaking point *winners against the odds *elite *having the opportunity to minister to the lost

8. CRITICAL INCIDENT STRESS MANAGEMENT *having satisfying work *having a sense of calling by God HOWEVER, ALL OF THESE IDEALS CAN COME TO AN UNEXPECTED AND ABRUPT HALT WITH THE IMPACT OF:-

9. CRITICAL INCIDENT STRESS OR POST TRAUMATIC STRESS CRITICAL INCIDENT STRESS OR POST TRAUMATIC STRESS CRITICAL INCIDENT STRESS MANAGEMENT

10. CRITICAL INCIDENT STRESS (CIS) “at the scene” CRITICAL INCIDENT STRESS (CIS) “at the scene” POST-TRAUMATIC STRESS (PTS) “afterwards” POST-TRAUMATIC STRESS (PTS) “afterwards”

11. CRITICAL INCIDENT STRESS MANAGEMENT I’M TOUGH “STRESS will never happen to me”

12. CRITICAL INCIDENT STRESS MANAGEMENT

13. ….be prepared, just in case!

14. CRITICAL INCIDENT STRESS MANAGEMENT You should become ‘stress aware’ by pursuing more stress education and training. Research shows that becoming ‘STRESS aware’ reduces it’s impact & helps recovery.

15. STRESS OFTEN BRINGS OUT THE BEST IN PEOPLE. CRITICAL INCIDENT STRESS MANAGEMENT

16. “Heroes rise from adversity.” CRITICAL INCIDENT STRESS MANAGEMENT

17. *the best of responses *the best leadership *the best of courage *the best of compassion *the best of sacrifice STRESS OFTEN BRINGS OUT THE BEST IN PEOPLE. *the best of determination CRITICAL INCIDENT STRESS MANAGEMENT

18. *the best of advice & help *the best of prayer & faith *the best of good life changes *the best of renewed love *the best of renewed vigor *the best of community CRITICAL INCIDENT STRESS MANAGEMENT STRESS OFTEN BRINGS OUT THE BEST IN PEOPLE.

19. CRITICAL INCIDENT STRESS MANAGEMENT Where does the word ‘STRESS’ come from? Where does the word ‘STRESS’ come from? from a Latin word meaning ‘force’, ‘pressure’ or ‘strain’. from a Latin word meaning ‘force’, ‘pressure’ or ‘strain’.

20. CRITICAL INCIDENT STRESS MANAGEMENT What is STRESS? *a response to a perceived threat, challenge or change *a response to a perceived threat, challenge or change *a physical and psychological response to a demand *a physical and psychological response to a demand *a state of physical and psychological arousal *a state of physical and psychological arousal

21. CRITICAL INCIDENT STRESS MANAGEMENT Yes. Despite the perceptions, the majority of people develop sustainable stress coping mechanisms and never suffer long-term stress affects from the scene of an emergency. Do people recover from a stressful event?

22. CRITICAL INCIDENT STRESS MANAGEMENT 80% - recovery within days 18% - recover within months 2% - recover within years

23. CRITICAL INCIDENT STRESS MANAGEMENT CONDUCT A SKILLS AUDIT ON EACH PERSON BEFORE THEY FACE SUCH EVENTS

24. CRITICAL INCIDENT STRESS MANAGEMENT CONDUCT A RISK ASSESSMENT ON EACH TYPE OF EVENT BEFORE IT HAPPENS CONDUCT A RISK ASSESSMENT ON EACH TYPE OF EVENT BEFORE IT HAPPENS

25. CRITICAL INCIDENT STRESS MANAGEMENT IMMEDIATE DELAYED (the reaction time varies) DELAYED (the reaction time varies) CUMULATIVE (the number of events varies) CUMULATIVE (the number of events varies) STRESS REACTIONS MAY BE:-

26. CRITICAL INCIDENT STRESS MANAGEMENT CUMMULATIVE STRESS A so called minor event could be, “the straw that broke the camel’s back.” CUMMULATIVE STRESS A so called minor event could be, “the straw that broke the camel’s back.” Remember, it’s personal

27. CRITICAL INCIDENT STRESS MANAGEMENT A critical incident is an emergency situation that causes a person to experience unusually strong thoughts, emotions and physical effects which have the potential to interfere with their ability to cope with pressure either at the scene or later. What is a Critical Incident?

28. The ability or inability to cope is an individual’s unique response and will never be repeated. CRITICAL INCIDENT STRESS MANAGEMENT Don’t overlay your own ability to cope.

29. CRITICAL INCIDENT STRESS MANAGEMENT THOUGHTS EMOTIONS PHYSICAL THREE AREAS THAT MAY GET AFFECTED THREE AREAS THAT MAY GET AFFECTED

30. CRITICAL INCIDENT STRESS MANAGEMENT SPIRITUAL BEHAVIORAL TWO OTHER AREAS THAT MAY GET AFFECTED TWO OTHER AREAS THAT MAY GET AFFECTED

31. CRITICAL INCIDENT STRESS MANAGEMENT When looking at the IMPACT of stress, we overlay the three tenses. PAST IMPACT PRESENT IMPACT FUTURE IMPACT

32. CRITICAL INCIDENT STRESS MANAGEMENT SATURATED MEMORY SATURATED MEMORY LIKE A FULL DISK, TRANSFER SOME MEMORY FILES BY RESTING AND TALKING LIKE A FULL DISK, TRANSFER SOME MEMORY FILES BY RESTING AND TALKING

33. CRITICAL INCIDENT STRESS MANAGEMENT ACCEPT THAT MEMORIES STAY

34. CRITICAL INCIDENT STRESS MANAGEMENT Dreams and nightmares are just “normal disorganised subconscious replays” DREAMS

35. CRITICAL INCIDENT STRESS MANAGEMENT MASKING *covering up the pain of their reaction *a permissible form of hypocrisy and denial *a normal reaction DON’T TEAR OFF THE MASK, LET THEM TAKE IT OFF.

36. CRITICAL INCIDENT STRESS MANAGEMENT FANTASY REPLAYS After a traumatic event, some people may re- think the event and change the facts in their mind and construct better outcomes. In the fantasy they may:- After a traumatic event, some people may re- think the event and change the facts in their mind and construct better outcomes. In the fantasy they may:-

37. FANTASY REPLAYS *become detached *become not involved *become the hero instead of the victim *don’t make mistakes *deny misjudgments *pretend it was pre-planned *they allowed it happen CRITICAL INCIDENT STRESS MANAGEMENT

38. FANTASY REPLAYS People may feel guilty, angry or ashamed after fantasising. They may be confused and go into denial for a time. Be patient with them and don’t judge or rebuke. They will return to reality and resolve the issues in their time. Remember… CRITICAL INCIDENT STRESS MANAGEMENT

39. NORMAL REACTION ABNORMAL EVENT NORMAL REACTION ABNORMAL EVENT CRITICAL INCIDENT STRESS MANAGEMENT FANTASY REPLAYS

40. CRITICAL INCIDENT STRESS MANAGEMENT Allow people to vent inner thoughts and feelings even though it may be confronting and irrational to you. EMOTIONAL VENTING REMEMBER CONFIDENTIALITY AND DON’T JUDGE

41. CRITICAL INCIDENT STRESS MANAGEMENT FIGHT OR FLIGHT What happens to your body in stress? THE ADRENAILINE RUSH THE ADRENAILINE RUSH

42. CRITICAL INCIDENT STRESS MANAGEMENT What action do I take if physical signs keep manifesting and persist? OBTAIN IMMEDIATE MEDICAL TRIAGE

43. CRITICAL INCIDENT STRESS MANAGEMENT STRESS AFFECTED What’s the difference between those present and those not present? THE SENSORY STIMULI

44. What is the sensory stimuli? What is the sensory stimuli? CRITICAL INCIDENT STRESS MANAGEMENT

45. SENSORY STIMULI sounds sights smells touchestastes silences temperature pressure

46. CRITICAL INCIDENT STRESS MANAGEMENT SENSORY STIMULI The senses interrelate impacting simultaneously or in sequences.

47. One sensory stimuli may be worse than the others in the same event e.g. a sight may be worse than a sound or a sound worse than a sight etc. CRITICAL INCIDENT STRESS MANAGEMENT SENSORY STIMULI

48. CRITICAL INCIDENT STRESS MANAGEMENT SENSORY STIMULI The senses are strongly related to FLASHABACKS

49. CRITICAL INCIDENT STRESS MANAGEMENT FLASHBACKS It looks like… It sounds like… It’s quiet like… It smells like… It feels like… It tastes like… It reminds me of…

50. CRITICAL INCIDENT STRESS MANAGEMENT SENSORY STIMULI As the song says, “Always something there to remind me.” As the song says, “Always something there to remind me.”

51. CRITICAL INCIDENT STRESS MANAGEMENT SENSORY STIMULI ACCEPTANCE We accept the sensory stimuli is part of our mission and learn to minimise the impact by protection at the scene or getting help if needed afterwards. We accept the sensory stimuli is part of our mission and learn to minimise the impact by protection at the scene or getting help if needed afterwards.

52. CRITICAL INCIDENT STRESS MANAGEMENT What are some of the causes of Critical Incident Stress?

53. CRITICAL INCIDENT STRESS MANAGEMENT Reasons for Critical Incident Stress *horrifying death or injury *personal threat of death or injury *death or injury of a peer *personal injury or sickness

54. CRITICAL INCIDENT STRESS MANAGEMENT *barricaded or taken hostage *threatened by a violent person *death of a victim during a rescue *victim of terrorism Reasons for Critical Incident Stress *threat of legal action (criminal or civil)

55. CRITICAL INCIDENT STRESS MANAGEMENT *strong sensory stimuli *victim known to you *large number of victims *identify with a victim group Reasons for Critical Incident Stress

56. CRITICAL INCIDENT STRESS MANAGEMENT *dealing with blood & body parts *child involved *exhaustive or prolonged event *failure of people or equipment Reasons for Critical Incident Stress

57. CRITICAL INCIDENT STRESS MANAGEMENT *displaced people *overwhelming act of nature *intrusive media attention *intrusive onlookers Reasons for Critical Incident Stress

58. CRITICAL INCIDENT STRESS MANAGEMENT Stress Accelerants What things inflame stress and have the potential to make a situation more difficult to deal with? What things inflame stress and have the potential to make a situation more difficult to deal with?

59. Stress Accelerants *people unprepared for stress events *people unprepared for their response *lack of timely help or equipment *too much help or interference *a deadline has been set *an uncomfortable environment CRITICAL INCIDENT STRESS MANAGEMENT

60. *making a misjudgment *bad sights, sounds, smells, touches *victim’s family or friends present *personal injury or sickness *media scrutiny *fear of legal ramifications CRITICAL INCIDENT STRESS MANAGEMENT Stress Accelerants

61. *unresolved personal issues *unwilling to rest *unwilling to eat or drink *conflict with management *inter-chaplaincy rivalry or jealousy *failure to trust inexperienced members CRITICAL INCIDENT STRESS MANAGEMENT Stress Accelerants

62. CRITICAL INCIDENT STRESS MANAGEMENT What groups can be stress affected?

63. CRITICAL INCIDENT STRESS MANAGEMENT STRESS AFFECTED 1) PRIMARY AFFECTED 2) SECONDARY AFFECTED 3) TERTIARY AFFECTED THE VICTIM THE WITNESS(S) NOT PRESENT, BUT AFFECTED

64. CRITICAL INCIDENT STRESS MANAGEMENT Who is the worst affected group. Victims, witnesses or those not present?

65. CRITICAL INCIDENT STRESS MANAGEMENT Anyone. Remember, it’s the person not the event. Don’t forget to include all of the affected people from each group.

66. CRITICAL INCIDENT STRESS MANAGEMENT STRESS AFFECTED TERTIARY AFFECTED DON’T FORGET STATION & SUPPORT STAFF

67. CRITICAL INCIDENT STRESS MANAGEMENT How do we define Critical Incident Stress? How do we define Critical Incident Stress?

68. CRITICAL INCIDENT STRESS MANAGEMENT “The mind and body’s *normal reaction to an *abnormal event” What if we swap these*words around in the sentence? What if we swap these*words around in the sentence?

69. CRITICAL INCIDENT STRESS MANAGEMENT “The mind and body’s abnormal reaction to a normal event” “The mind and body’s abnormal reaction to a normal event” That’s INCORRECT The reaction is normal, the event is abnormal. That’s INCORRECT The reaction is normal, the event is abnormal.

70. CRITICAL INCIDENT STRESS MANAGEMENT “The mind and body’s normal reaction to an abnormal event” “The mind and body’s normal reaction to an abnormal event” Correct

71. CRITICAL INCIDENT STRESS MANAGEMENT REASSURE people they are reacting normally to an abnormal situation. REASSURE people they are reacting normally to an abnormal situation.

72. CRITICAL INCIDENT STRESS MANAGEMENT Stress reactions are normal unless they develop to become POST-TRAUMATIC STRESS DISORDER which requires specialised treatment. Stress reactions are normal unless they develop to become POST-TRAUMATIC STRESS DISORDER which requires specialised treatment.

73. CRITICAL INCIDENT STRESS MANAGEMENT How do we define Post-Traumatic Stress? How do we define Post-Traumatic Stress?

74. CRITICAL INCIDENT STRESS MANAGEMENT *it’s not mandatory you don’t have to be affected *it’s not mandatory you don’t have to be affected Post-Traumatic Stress The reaction which may come from the memory of a significant, disturbing or traumatic event. Post-Traumatic Stress The reaction which may come from the memory of a significant, disturbing or traumatic event.

75. CRITICAL INCIDENT STRESS MANAGEMENT When preparing for a stress reaction, there are three components to consider in any occurrence. What are they? the People the People the Event the Event the Place the Place

76. CRITICAL INCIDENT STRESS MANAGEMENT THE EVENT FINISHES… THE PEOPLE GO ON… *the people are more important than the event *the people are more important than the place

77. CRITICAL INCIDENT STRESS MANAGEMENT The tenses may stand alone or be in a cluster. One or more of the tenses may become a life affecting stress.

78. CRITICAL INCIDENT STRESS MANAGEMENT The stressed person or the carer may orientate into one or more of the tenses during discussions on stress. The stressed person or the carer may orientate into one or more of the tenses during discussions on stress. PAST PRESENT FUTURE

79. CRITICAL INCIDENT STRESS MANAGEMENT 1) Demobilisation What types of CIS interventions are there? 3) Defusing 2) Debriefing

80. CRITICAL INCIDENT STRESS MANAGEMENT DEMOBILISATION LARGE INFORMAL GROUP *Give event information *Give stress information *Referral information *Have refreshments *Help each other

81. CRITICAL INCIDENT STRESS MANAGEMENT DEBRIEFING SMALL FORMAL GROUP Professional clinical intervention Established cyclic protocol Detailed and in-depth Usually for serious critical incidents. ‘Mitchell Model’

82. CRITICAL INCIDENT STRESS MANAGEMENT Defusing “To render something harmless before it can do damage.” “To render something harmless before it can do damage.”

83. CRITICAL INCIDENT STRESS MANAGEMENT PRACTICAL HELP BEFORE DEFUSING PRACTICAL HELP BEFORE DEFUSING What’s the priority when considering defusing?

84. CRITICAL INCIDENT STRESS MANAGEMENT PRACTICAL BEFORE DEFUSING Safety & Security Cooling or Warmth Comfort or Toilet Shelter or Dry Clothing Food or drink (medical permission) Outside Contact (Police OIC permission )

85. CRITICAL INCIDENT STRESS MANAGEMENT IMPORTANT Before defusing, allow people to re-equip and prepare for the next emergency call. IMPORTANT Before defusing, allow people to re-equip and prepare for the next emergency call.

86. CRITICAL INCIDENT STRESS MANAGEMENT Defusing Goals A rapid intervention. A rapid reduction of the intense reactions of the event. Shorter, less formal, less structured version of a CIS debriefing.

87. CRITICAL INCIDENT STRESS MANAGEMENT A “normalising” of the social network. A re-establishment of “team”. An opportunity to assess each other. An opportunity to receive stress information. Defusing Goals cont..

88. CRITICAL INCIDENT STRESS MANAGEMENT Defusing Objectives Equalisation of information. Restoration of thinking processes. Give encouragement and congratulations. Discuss recovery expectations.

89. CRITICAL INCIDENT STRESS MANAGEMENT Defusing Protocol 6-8 people to a group. Up to 4 hours after event. Duration about 30-45 minutes. If possible, conducted by professionals, chaplains or peer support officers.

90. CRITICAL INCIDENT STRESS MANAGEMENT Distraction free and comfortable location, if possible. Distraction free and comfortable location, if possible. Agree on confidentiality. Sit or stand in a circle. No media or press releases about discussions in the defusing session. No media or press releases about discussions in the defusing session. Defusing Protocol cont…

91. CRITICAL INCIDENT STRESS MANAGEMENT Don’t discuss legally incriminating facts. Discuss only your own feelings. Partake of refreshments. Provide stress material and contact numbers. Defusing Protocol cont…

92. CRITICAL INCIDENT STRESS MANAGEMENT Don’t use after 12 hours. Not a substitute for professional help or counseling. Not a substitute for a debriefing. Defusing Contradictions Defusing Contradictions Not a place to solve past stress.

93. CRITICAL INCIDENT STRESS MANAGEMENT Not everyone has to talk to benefit, silence is okay. Don’t use ‘morbid’ humour. Not an operational debriefing. Not a quick fix or therapy. Defusing Contradictions cont… Defuser should not have worked at the incident scene.

94. CRITICAL INCIDENT STRESS MANAGEMENT Defusing can occur at:- *the scene *near the scene *a church or building *a home *a workplace

95. CRITICAL INCIDENT STRESS MANAGEMENT If possible, the defuser must have not attended the scene. That may not be practical however, in any case the more serious the event (co-worker killed for example) the more need for an uninvolved defuser.

96. CRITICAL INCIDENT STRESS MANAGEMENT Defuse just in case someone is falling into a reaction. Defusing is a ‘stress parachute’

97. CRITICAL INCIDENT STRESS MANAGEMENT PEOPLE BEFORE OPERATIONAL DEBRIEFING

98. CRITICAL INCIDENT STRESS MANAGEMENT Stressed people may give carers the cold shoulder at first, that’s okay.. OFFER FUTURE HELP & FOLLOW THEM UP

99. CRITICAL INCIDENT STRESS MANAGEMENT What type of event may cause a heightened emotional response and why? VIOLENT EVENTS due to human maliciousness or recklessness

100. CRITICAL INCIDENT STRESS MANAGEMENT SUCH EVENTS HEIGHTEN:- DisbeliefDenial DistressAnger Resentment Revenge

101. CRITICAL INCIDENT STRESS MANAGEMENT According to research, what type of event has the heaviest impact on a person? THREAT OF DEATH OR SERIOUS INJURY TO YOU PERSONALLY

102. CRITICAL INCIDENT STRESS MANAGEMENT Why does a personal threat have one of the heaviest impacts? It is subjective, that is happening to YOU not someone else.

103. CRITICAL INCIDENT STRESS MANAGEMENT DON’T FORGET VICTIMS OF VIOLENCE AS WELL AS VICTIMS OF ACCIDENTS

104. CRITICAL INCIDENT STRESS MANAGEMENT POST TRAUMATIC STRESS DISORDER POST TRAUMATIC STRESS DISORDER

105. CRITICAL INCIDENT STRESS MANAGEMENT POST TRAUMATIC STRESS DISORDER PEOPLE MAY BECOME DISFUNCTIONAL SEEK IMMEDIATE PROFESSIONAL HELP PEOPLE MAY BECOME DISFUNCTIONAL SEEK IMMEDIATE PROFESSIONAL HELP

106. CRITICAL INCIDENT STRESS MANAGEMENT How do emergency workers share their experiences with family and friends without offending or turning them off? The FF PRINCIPLE FACTS or FEELINGS? The FF PRINCIPLE FACTS or FEELINGS?

107. CRITICAL INCIDENT STRESS MANAGEMENT FACTS MAY REPEL SUPPORTERS I saw, I smelt, I touched, a heard, I tasted etc.

108. CRITICAL INCIDENT STRESS MANAGEMENT FEELINGS ATTRACT SUPPORTERS I felt sad, distressed, angry, helpless, stunned, confused, worried, I cried, I grieved etc.

109. CRITICAL INCIDENT STRESS MANAGEMENT FEELINGS are safer to talk about than facts. *avoids “misreporting” or “misinterpreting” the facts *avoids unacceptable boasting *avoids inadvertent contact with friends/relatives *avoids breaching confidentialities *avoids unacceptable “black” humour *avoids legal or departmental inquiries

110. CRITICAL INCIDENT STRESS MANAGEMENT How do we reduce the impact of CIS at the scene during an emergency? How do we reduce the impact of CIS at the scene during an emergency?

111. REDUCING THE IMPACT OF CIS AT THE SCENE *self diagnose a CIS reaction *tell a supervisor you’re stressed *de-stage in small segments *keep busy – do something *disengage non-essential people *conduct defusing during the incident CRITICAL INCIDENT STRESS MANAGEMENT

112. *rotate workers *take regular breaks at a ‘rest area’ *withdraw if injured or sick *control ‘morbid’ humour *triage workers (sort out tasks) *partake of healthy refreshments CRITICAL INCIDENT STRESS MANAGEMENT REDUCING THE IMPACT OF CIS AT THE SCENE

113. How do I reduce the impact of Post-Traumatic Stress after the emergency? How do I reduce the impact of Post-Traumatic Stress after the emergency? CRITICAL INCIDENT STRESS MANAGEMENT

114. *attend a defusing and debriefing session *physical exercise within 24 hrs after event *eat and drink healthy products *talk and express emotions openly REDUCING THE IMPACT OF PTS (AFTERWARDS) REDUCING THE IMPACT OF PTS (AFTERWARDS) CRITICAL INCIDENT STRESS MANAGEMENT

115. REDUCING THE IMPACT OF PTS *enjoy outings with family and friends *maintain a schedule *keep a journal or diary *accept memories stay *accept flashbacks & dreams are normal CRITICAL INCIDENT STRESS MANAGEMENT

116. REDUCING THE IMPACT OF PTS *seek professional help, if necessary *see a doctor if physical signs persist *avoid alcohol, caffeine, tobacco or non-prescription drugs *read stress information *be easy on yourself and others CRITICAL INCIDENT STRESS MANAGEMENT

117. REDUCING THE IMPACT OF PTS *avoid confrontation with others *care when driving or operating machinery *talk to a Chaplain *contact peers nationally or overseas *establish a relationship with God CRITICAL INCIDENT STRESS MANAGEMENT

118. REDUCING THE IMPACT OF PTS SOME PEOPLE MAY WANT or NEED TO:- *visit or re-visit a scene *visit a person in hospital *visit a person in custody *visit a survivor or rescuer *visit a church or the clergy *attend a court hearing *attend a funeral *attend a mortuary CRITICAL INCIDENT STRESS MANAGEMENT

119. REDUCING THE IMPACT OF PTS Should a dead body be viewed? The person should make an informed decision themselves on information gained from the Coroner, Police, Chaplain or a Mortuary Social Worker first. CRITICAL INCIDENT STRESS MANAGEMENT

120. REDUCING THE IMPACT OF PTS Be a support person only DON’T TAKE OVER & CONTROL THE STRESSED PERSON (unless they’re in danger) CRITICAL INCIDENT STRESS MANAGEMENT

121. Burn off the unused stress chemicals with physical exercise compatible with your fitness level. Burn off the unused stress chemicals with physical exercise compatible with your fitness level.

122. Get some rest in a quiet place, just for a little while at least. CRITICAL INCIDENT STRESS MANAGEMENT

123. Learn to Relax Read a book Get some more sleep Listen to your favorite music Hire a video or DVD Practice deep breathing

124. CRITICAL INCIDENT STRESS MANAGEMENT What should I eat during or after a crisis? What should I eat during or after a crisis?

125. CRITICAL INCIDENT STRESS MANAGEMENT Eat good food during and after a crisis; fruit, vegetables, grains, pasta & lean meat.

126. CRITICAL INCIDENT STRESS MANAGEMENT No fats or sugars at first...then you may “treat” yourself to a surprise after the crisis is over! Go on, spoil yourself.

127. CRITICAL INCIDENT STRESS MANAGEMENT EXPECTATIONS OF RECOVERY EXPECTATIONS OF RECOVERY

128. CRITICAL INCIDENT STRESS MANAGEMENT “GET BACK ON THE HORSE” WHEN?

129. CRITICAL INCIDENT STRESS MANAGEMENT EXPECTATIONS OF RECOVERY When does somebody get back on the horse? It should be discussed between the affected person, a professional helper and their employer.

130. *remember it’s their expectations, not ours *don’t force them by active or passive pressure to get “back on the horse” CRITICAL INCIDENT STRESS MANAGEMENT EXPECTATIONS OF RECOVERY

131. *refer to professional help from a team of specialists for advice and therapy CRITICAL INCIDENT STRESS MANAGEMENT EXPECTATIONS OF RECOVERY

132. CRITICAL INCIDENT STRESS MANAGEMENT What issues may affect survivors of a near miss or other traumatic event?

133. CRITICAL INCIDENT STRESS MANAGEMENT SURVIVORS MAY SUFFER FROM:- SURVIVOR EUPHORIA “Great, I survived” SURVIVOR EUPHORIA “Great, I survived” SURVIVOR ANGER “Why did this event happen?” SURVIVOR ANGER “Why did this event happen?” SURVIVOR DEPRESSION “Why did I survive and not them?” SURVIVOR DEPRESSION “Why did I survive and not them?”

134. CRITICAL INCIDENT STRESS MANAGEMENT Normal reaction to an Abnormal event

135. CRITICAL INCIDENT STRESS MANAGEMENT REMEMBER There is a heavy stress load on a person during a personal threat of death or serious injury (near misses).

136. CRITICAL INCIDENT STRESS MANAGEMENT What is Supportive Lurking? What is Supportive Lurking?

137. Being at the scene but not helping stressed people until the right time and in any case, when you’re invited. CRITICAL INCIDENT STRESS MANAGEMENT

138. SUMMARY

139. CRITICAL INCIDENT STRESS MANAGEMENT *prepare yourself & others *consider the tenses *consider the senses *consider thoughts, emotions and physical affects.

140. *manage the scene carefully *watch out for all affected groups *rotate workers *have rest breaks *encourage & award *relax, allow time to recover CRITICAL INCIDENT STRESS MANAGEMENT

141. *demobilise *defuse * debrief *exercise then rest *obtain professional help *see a Chaplain CRITICAL INCIDENT STRESS MANAGEMENT

142. Who cares for the carer? Do you have support in place for you and your family?

143. Jesus said, “Come to me all of you who are weary and heavy laden and I will give you rest” The Bible Matthew 11:28 Jesus said, “Come to me all of you who are weary and heavy laden and I will give you rest” The Bible Matthew 11:28

144. CRITICAL INCIDENT STRESS MANAGEMENT I’m Oskar Raymond. I provide free counselling for my Dad when he’s stressed. I trust he has helped you deal with managing CIS and PTS. You keep up the good work now.

145. Contact Chief Inspector Gary Raymond APM on:- 0421-206-671 (m) or raym1gar@police.nsw.gov.au SUICIDE NEGOTIATION