Psychological First Aid

[heliodoc]

Anybody got a lone who is in charge of the CAP Critical Incident Stress Management (CISM) at NHQ

They might want to pay attention to the requests on social media the availability of training

CAP seems not to be emailing members back

CISM...something that CAP ought to take more seriously OR seriously leave it to the true professionals

People are paying attention and CAP NHQ ought to be doin likwwise

[etodd]

OR seriously leave it to the true professionals

^^^ I vote for this.  We have enough on our plate without diving into medical fields.

[Capt Thompson]

Anybody got a lone who is in charge of the CAP Critical Incident Stress Management (CISM) at NHQ

They might want to pay attention to the requests on social media the availability of training

CAP seems not to be emailing members back

CISM...something that CAP ought to take more seriously OR seriously leave it to the true professionals

People are paying attention and CAP NHQ ought to be doin likwwise

You do realize most of the groups on FB that have CAP in the name aren't official right? I know the post you are referencing, but I doubt anyone at NHQ has seen it as I don't believe that's an official page moderated by CAP.

[Eclipse]

OR seriously leave it to the true professionals

^^^ I vote for this.  We have enough on our plate without diving into medical fields.

+1

[heliodoc]

I get your point, CPT Thompson

Many do or don't monitor social media but CISM is something CAP might want to take alot more seriously than its entry into the ICS world

Doesn't exempt NHQ from returning phone calls or emails

We are not a multimillion dollar corporation

We can can talk Respect, Core Values, etc all day long here and there have been many a reminder...

Simple ...if the organization is going to portray itself as a "Premier SAR" organization and enters the CISM field ..we ought be demonstrating we can answer emails and phones.

[TheSkyHornet]

Not to derail too much, but here's my most recent experience with anything ES/SAR/IC-related:

An email goes out to the wing from the Wing ES Training Officer saying to sign up to man the virtual incident command center. Now, I have no ES qualifications; first to admit that. I emailed back saying that I did not have any ES qualifications; however, I play a role in emergency response/incident command for my paying job, and it's an interesting area to branch into. I asked if there was a way for me to observe/shadow since we were virtual, or if I could start any IC training as mission staff. What's the next step? How does this work?

The response I received back was after three weeks and said that my unit commander needs to approve me to be placed into Mission Staff Trainee status. That was the sole response.

I am the unit commander...

Okay. Thanks, ES. I got the point.

[James Shaw]

I attempted to reach out to the International Critical Incident Stress Foundation in 2018 (The one CAP has listed in the Task Sheet) about their programs and additional training. Psychological First Aid is a "micro" class in one of the classes I teach in Emergency Management. CAP was responsive about my inquiry but the ICISF never responded back and all I got was emails about Training Classes and the cost for the training. I had to complete the PFA and several other classes before teaching the class.

I had a good exchange with the CAP folks but the ones that provided some of the required training only sent me info on tuition costs. Never returned an email or call.

It may be the ICISF that is not providing the data needed.

Just a thought.

[N6RVT]

We are not a multimillion dollar corporation

Actually I think we are.  Maybe not by much, but thats less than $40,000 per state.  CAWG has two full time employees that cost more than that even if they were both minimum wage.

CISM is like having medical ratings where the amount of funding and training required to functionally have either one is way beyond the available resources which would almost certainly be used for something else if they existed.

You really want to deal with the legal fallout of these services being provided the way this organization almost certainly would?

My understanding was that CISM and Paramedic, medical badges were like the ones for Legal & Chaplain - which recognize qualifications you have from outside sources.  CAP does not train anyone to be any of these.

[NovemberWhiskey]

Also: the most traumatic event the 99.9th percentile CAP member experiences in any given year is likely to be an empty cookie plate at the FBO.

[Capt Thompson]

In early 2020 NHQ sent out a memo about a Red Cross course that was being offered free, and met the Psych First Aid requirement for the ES specialty track. I took the course and got the cert, I'll try to dig it up after work and see what it was and if it's still offered free. I know that doesn't address the issue of not receiving responses, but if you're looking for that course to meet the training requirements it might help you.

[Capt Thompson]

This is it: https://www.redcross.org/take-a-class/classes/psychological-first-aid%3A-supporting-yourself-and-others-during-covid-19/a6R3o0000014ZIg.html

No longer free, it's $20 now, very basic course but meets that requirement.

If you want further CISM training, I would reach out to your Wing Chaplain, they may be of help and would probably be more likely to respond to your emails.

[Spam]

Also: the most traumatic event the 99.9th percentile CAP member experiences in any given year is likely to be an empty cookie plate at the FBO.

Part of me laughs at your truly funny joke, and part of me hurts because having a cadet die (literally with his boots and BDUs on) under my command did traumatize me for years. 

It was hard for me to just tough it up, and extremely hard to continue to lead the squadron (it really brought home the lessons of how lonely the job of command can be). Would I have used amateur CAP crisis people vs. work through it alone as I did? Probably not, given how generally grabasstic and fumblenutty and nonprofessional most of our standards of practice are. 

I would say there are probably a few serious events out there that may qualify, and from that I would suggest that the appropriate CAP response would be not to divert into building yet another dumbass corps with their own buttons and ribbons and qual wings, but rather to have a short briefing for members to recognize and refer. "Psych first aid" should be to recognize the problem and our only "first aid" should be to support by referral to a qualified pro, just as we would do with a broken body.

R/s
Spam

(PS, yep, three highly perjorative phrases in one email. Respect on display - sorry. I'm feeling more real than respectful towards CAP this week, given how much wasted BS I've dealt with from dumasses this week).
(PPS, update, four phrases).

[heliodoc]

Spam

No disrespect taken

CAP allows some of the dumbassery to exist we have some benevolent dumbasserry here in my AOR from folks who can't follow a39-1 if it hit em in the face.

CAP just needs to pick a lane on 6 lane highway outside of medical practice.

CISM isn't anything I take lightly as a former Army Aviation soldier and wild land firefighter..as if I have to mention that more.

Time for CAP to take a break from breaking into everything from soup to nuts

[Capt Thompson]

It's not like CISM is something new for CAP, it's been around for several years. For a long time it's been commonplace if you are on a mission that has a fatality, you meet with CISM for a debrief before checking out of the mission. Those I've dealt with in the past were usually highly trained, many of which are part of the chaplain corps which requires the same level of training that AF chaplains go through.

Maybe your local CISM folks are untrained, but that hasn't been my experience here. As always, YMMV.

[TheSkyHornet]

It's not like CISM is something new for CAP, it's been around for several years. For a long time it's been commonplace if you are on a mission that has a fatality, you meet with CISM for a debrief before checking out of the mission. Those I've dealt with in the past were usually highly trained, many of which are part of the chaplain corps which requires the same level of training that AF chaplains go through.

Maybe your local CISM folks are untrained, but that hasn't been my experience here. As always, YMMV.

But, let's be respectful to the fact that CISM is often deployed as a "good idea;" although, it's widely debated as to its actual efficacy.

There are a number of research articles that conclude that CISM is not effective and, in some cases, more damaging due to a lack of training and professional education in mental health. But there are plenty of articles, just the same, that will tell you that it is an effective program, that the counter articles didn't "get the picture," and that it's better to attempt than to do nothing.

From a liability standpoint, it can be a case-closer in a lot of instances where you need that CYA to say, "We offered help; they chose not to take it."

Anyway, one thing that we should be cautious about is that, no, not everyone on a CISM team is a trained mental health professional despite taking the 2-day class and the online self-study. There are a multitude of complexities in how the human brain handles trauma and post-incident stress, especially factoring in that there are a number of underlying mental health issues that could be at play beyond just the stress and anguish from the incident itself.

I will add that I do feel that an after-action debrief is always a good option to gauge where your members are at and a mechanism to refer them to professional support. The debatable subject really is how "deep" does that person get with the member before that referral occurs.

[Capt Thompson]

Most of the CISM folks I've encountered here were trained chaplains, so they had a good deal more than a short course, an atta boy and a patch for their uniform. I would hope if nothing else, they are trained a little more than the average IC and can make those referrals after the debrief if necessary.

If it's only a 2 day course, I'd be interested to take it just for the extra bit of knowledge. It couldn't hurt for a GTL to have more knowledge on the subject, but you're right a 2 day course definitely isn't going to make someone a mental health professional.

[etodd]

The debatable subject really is how "deep" does that person get with the member before that referral occurs.

3pm accidental death at an event.  Fifty members waiting to go home, and "one" debriefer there thats wants to talk to everyone, one on one,  before they leave ....

[Eclipse]

CAPR 60-5 hasn't been updated since 2006, and the DRAFT task guide died on the
vine in 2016, which should show exactly how "important" CISM actually is to CAP.

https://www.gocivilairpatrol.com/media/cms/u_082503073826.pdf

https://www.gocivilairpatrol.com/programs/emergency-services/critical-incident-stress-management-cism--resiliency

FWIW, the two primary levels of CISM personnel Clinical Director and MHP, require the member to
be at least a degreed mental health professional, with additional training on top of that. Peer Members
need specific training with more encouraged.

I have had similar issues with CISM as etodd in that they want to have individual and
small-group discussions, and often won't allow members to sign out until they have been consulted,
even after SAREx's where nothing happened but a BBQ and a hike happened.

Further, anyone who has had to deal with a counselor or mental health issues knows too well
that the level of trust needed to provide or receive assistance will not manifest itself
in a 15 minute after-action session, but that same session could well make things worse if not
handled properly or the wrong thing is said by the wrong person.

As a CAP member...

If I need legal advice I am going to consult a private lawyer (even if it pertains to a CAP issue).

If I need anything but emergent care with no other choice, I am going to consult my
personal physician.

If I have an emotional issue related to mission activity, (or anything else) I am going to seek out
a private counselor.

These lanes are best left to professionals, separate from any affiliation with CAP.

Yes, there are excellent Doctors, Lawyers, and Counselors who are members, that doesn't change
the math that the organization as a whole is not prepared nor staffed to provide these sort of
services, internally or externally, on a consistent enough basis to be meaningful, but its often
ham-handed, 1/2-attentioned efforts to check someone's box trying to follow an inapplicable
USAF model fall somewhere between benign and making things worse.

[TheSkyHornet]

If it's only a 2 day course, I'd be interested to take it just for the extra bit of knowledge. It couldn't hurt for a GTL to have more knowledge on the subject, but you're right a 2 day course definitely isn't going to make someone a mental health professional.

Well, and let's make sure that we're abundantly clear: CISM isn't intended to replace a mental health professional. It's supposed to be a "middle man" to try to curb early onset of any form of traumatic stress disorder and to help individuals "return to normal" quickly after the incident.

But this is where it's been highly debated as to whether or not it's effective at bridging that gap and whether or not the CISM team identifies that this is a person who is at a much higher risk of self-harm or more comprehensive mental trauma; thus, the person is not referred to counseling and not addressed at a more appropriate level to get them the help that they may actually need. The training is supposed to aid in the development of that team member to recognize those areas of concern, but a lot of individuals just may not have that skill set to be able to enact in practicality versus a theoretical class.

For instance: In the airlines, we have Family Assistance Teams to aid families of passengers and crews, often involving a significant/severe amount of emotional stress and trauma as secondary victims to an aircraft accident. But one of the common "jokes" within the community: Who the heck thought it would be a good idea to put (that guy) on the FAT? A day's worth of special focus training doesn't change character traits, and it certainly doesn't make up for professional mental health experts in dealing with a traumatic experience which is often going to need a substantial amount of subsequent therapy/treatment.

It's one thing to show compassion and to help point people in a direction to receive professional support, and maybe even to hold their hand through the process and to get them there. It's another to take that role on and try to bridge that gap between "okay mental health" and post traumatic stress disorder as an unpaid consultant/volunteer who took a weekend class.

[TheSkyHornet]

I have had similar issues with CISM as etodd in that they want to have individual and
small-group discussions, and often won't allow members to sign out until they have been consulted,
even after SAREx's where nothing happened but a BBQ and a hike happened.

Further, anyone who has had to deal with a counselor or mental health issues knows too well
that the level of trust needed to provide or receive assistance will not manifest itself
in a 15 minute after-action session, but that same session could well make things worse if not
handled properly or the wrong thing is said by the wrong person.

A lot of police departments actually take this similar approach where an officer may be involved in a physical altercation or, particularly, a shooting. They will ask the officer(s) involved to go through a post-stress incident debrief before they may return to work. It often makes them feel alienated and patronized with no actual sense of resolution or assistance, but instead a sense of bureaucracy and red tape under the guise of compassion and welfare.

[Spam]

One other factor to add to the mix: job impacts and willingness to seek help.

Some of us who have security clearances have not, and will not, ever seek professional mental health care because it is a proven factor in adjudication of clearances, program access, and job assignments. I have spoken with several active duty coworkers who have been personally or have had friends and family who have been so impacted within the last ten years based on seeking help for combat, family, or other stressors.

They added a disclaimer to the SF86 and the other forms a few years ago, but I stand firmly that it is still being used in selection/assignment. It is wrong, but it is understandable, that this takes place despite official DoD policy that it will not. And it does happen. I'm not putting my job and my family in jeopardy to de stress about some bodies on an incident site, some when - and I won't perjure myself by answering "no" to the question, so I won't ever use those services.

We manage it, put it away, and we move on.

R/s
Spam

[THRAWN]

One other factor to add to the mix: job impacts and willingness to seek help.

Some of us who have security clearances have not, and will not, ever seek professional mental health care because it is a proven factor in adjudication of clearances, program access, and job assignments. I have spoken with several active duty coworkers who have been personally or have had friends and family who have been so impacted within the last ten years based on seeking help for combat, family, or other stressors.

They added a disclaimer to the SF86 and the other forms a few years ago, but I stand firmly that it is still being used in selection/assignment. It is wrong, but it is understandable, that this takes place despite official DoD policy that it will not. And it does happen. I'm not putting my job and my family in jeopardy to de stress about some bodies on an incident site, some when - and I won't perjure myself by answering "no" to the question, so I won't ever use those services.

We manage it, put it away, and we move on.

R/s
Spam

This is literally the absolute worst advice I've seen since my relationship with CAP started in 1994. 

[etodd]

One other factor to add to the mix: job impacts and willingness to seek help.

Some of us who have security clearances have not, and will not, ever seek professional mental health care because it is a proven factor in adjudication of clearances, program access, and job assignments. I have spoken with several active duty coworkers who have been personally or have had friends and family who have been so impacted within the last ten years based on seeking help for combat, family, or other stressors.

They added a disclaimer to the SF86 and the other forms a few years ago, but I stand firmly that it is still being used in selection/assignment. It is wrong, but it is understandable, that this takes place despite official DoD policy that it will not. And it does happen. I'm not putting my job and my family in jeopardy to de stress about some bodies on an incident site, some when - and I won't perjure myself by answering "no" to the question, so I won't ever use those services.

We manage it, put it away, and we move on.

R/s
Spam

This is literally the absolute worst advice I've seen since my relationship with CAP started in 1994. 

I know quite a few first responders (police and others) who say the same. They've seen it in their departments. Seek help outside and never let the department know. Nationwide, the suicide rate among police officers is very high. And a big factor is not seeking out help for fear of losing their jobs. They see it happening to others.

[Fubar]

Most of the CISM folks I've encountered here were trained chaplains

What training to Chaplains get that others don't that make them CISM experts. I'm not trying to be a smart-aleck here, I really don't know.

[Brit_in_CAP]

Wasn't going to enter this fray but decided to after reading everyone's posts to date.

My very last CAP training class was the 2020 Chaplain Staff College.  An interesting - at times - virtual event over several evenings.

CISM was not a topic but the subject did arise, and in the proper context.  The VAWG Chaplain, who is a member of the leadership team, made it clear that CAP was moving towards using the Psych First Aid with CISM being left to trained professionals.

My initial interaction with a CAP CISM team member left me underwhelmed.  An enthusiastic, trained, volunteer who's day job had nothing to do with counselling, nursing or anything vaguely related to CISM.  That individual "crashed" the Chaplain's meeting at the Wing Conference and generally berated the chaplains for not playing CISM; one chaplain, an AD Army Chaplain, pointed out that CISM was not as "in vogue" as it had been.  The CISM-person talked over him.  It got a little rough, to be honest.

I've done the Psych First Aid and refreshed it; I found it to be useful, very much for the non-professional in the counselling area, and I'd recommend it.

On two occasions the CISM team offered themselves to support cadets on my former unit; one followed the expected death of our retired chaplain, who had been declining for a while, and the other was a well-intentioned offer to provide a CISM-trained teenage cadet for a cadet having some difficulties.   

The first did not require CISM, and the second was easily declined.  The cadet's parents made it clear that it was not an intervention they desired in any form.

Having done some counselling training in my paying job, and within my ordained ministry, my 10c is to spend what time and resource we have in qualifying more people with basic training, such as Psych First Aid or Trauma Risk Management, and leave the heavy-duty "stuff" to trained professionals.  If a CAP member's day job provides that, so much the better for us.  It isn't an area for volunteers with no relevant experience, not least because the obtaining and renewing the training is expensive.  I suggest that it isn't something we should be asking our members to pay for.  There are other options for professional help for anyone who needs it.

[Brit_in_CAP]

Most of the CISM folks I've encountered here were trained chaplains

What training to Chaplains get that others don't that make them CISM experts. I'm not trying to be a smart-aleck here, I really don't know.

Good question.  It was never intended that CISM would be so Chaplain-centric.  That really did happen by accident and not design.

The Chaplains often have access more easily to formal CISM training as part of their day jobs outside of CAP.  For those working as hospital chaplains, first responder chaplains, VA chaplains etc, this training is often a required part of their annual / biannual training, and paid for by the employer.

There was a time when CAP Chaplains were seen as CISM experts, and some touted themselves as such.  They often were trainers for CAP, which served only to heighten the sense that this was a Chaplain-centric activity.  There are also ministries that use CISM as an evangelizing tool, which further damages the reputation of the method.

I hope this answers your question!

[TheSkyHornet]

One other factor to add to the mix: job impacts and willingness to seek help.

Some of us who have security clearances have not, and will not, ever seek professional mental health care because it is a proven factor in adjudication of clearances, program access, and job assignments. I have spoken with several active duty coworkers who have been personally or have had friends and family who have been so impacted within the last ten years based on seeking help for combat, family, or other stressors.

They added a disclaimer to the SF86 and the other forms a few years ago, but I stand firmly that it is still being used in selection/assignment. It is wrong, but it is understandable, that this takes place despite official DoD policy that it will not. And it does happen. I'm not putting my job and my family in jeopardy to de stress about some bodies on an incident site, some when - and I won't perjure myself by answering "no" to the question, so I won't ever use those services.

We manage it, put it away, and we move on.

R/s
Spam

This is literally the absolute worst advice I've seen since my relationship with CAP started in 1994. 

I know quite a few first responders (police and others) who say the same. They've seen it in their departments. Seek help outside and never let the department know. Nationwide, the suicide rate among police officers is very high. And a big factor is not seeking out help for fear of losing their jobs. They see it happening to others.

100%, this.

It goes beyond first responders all throughout high-stress and medically-linked careers: military, aviation, etc.

A good friend of was a Coastie E-5 and sought some personal assistance due to work-related issues (distractions) piling up. He spoke with the base psychiatrist, and, of course was promised that it wouldn't impact his career. But he was prescribed medication to help combat the stress and angst. In 30 days he was being removed from service and, following a medical review board, discharged. It totally crushed him; and it absolutely sucked watching someone go through that.

Is there a place for psychiatric help in a career? Absolutely. Do we want people with mental vulnerabilities in high-stress environments where lives may be at stake? No. But what we don't want are people faced with a career-ending diagnosis, often later determined by another psychiatrist as a misdiagnosis despite the fact that their career has already been lost over it. It often expands the suicide prevalence.

You watch someone fall to pieces because they clearly need help and won't get it out of fear for retribution; it's horrible. You watch someone fall to pieces because they did the right thing and sought help, and their career was destroyed in front of an audience; it's almost even worse.

I ask everyone to please note that I am not opposing psychological support and mental health services. But there is the side of the "victim" and the literal fear they have of any comment they make being used against them. It's a real caution that must be considered under every circumstance.

[AirDX]

We manage it, put it away, and we move on.

Truly horrible advice. The precise formula for depression and much worse.

The only data I'll present is my own. I worked in cleared positions my entire career. From 1997, when my wife was diagnosed with cancer, til she passed away in 2014, I saw a mental health professional. My clearance was just fine. I went through routine reinvestigations three times during that period. I also carried a flight physical the entire time. I moved into supervisory positions, retired from the FAA, and unretired to be hired by the Air Force, working another 5 1/2 years. At NO POINT during those 17 years did my mental health status impact my career, my security clearance, or my medical clearance.

Ignore your mental health at your own risk.

[UWONGO2]

Many moons ago, driven by the CAP-USAF ops evals, we wrote into our IAP that all CISM tasks would be handled by the Big City™ fire department, who agreed in writing to provide CISM services as needed. Our rationale was this type of task was to be handled by the professionals who have far more actual experience with CISM than we do.

The evaluators loved it and it's been in every evaluated exercise since.