By Leischen Stelter, editor of In Public Safety
The June 12 massacre inside an Orlando nightclub left 49 people dead and 53 wounded. After police killed the gunman, officers, firefighters and medical professionals entered the building to provide aid to the wounded. According to news reports, the scene inside was absolute carnage with bodies scattered across the dance floor and in the restrooms. The trauma of the event affected not only those who were in the nightclub that night, but also those who responded.
The Role of a Critical Incident Stress Team
American Military University’s criminal justice program director, Dr. Chuck Russo, lives in Central Florida and was a founding member of his agency’s Critical Incident Stress Team (CIST). He is also the team leader for Florida’s Regional Disaster Behavioral Health Assessment Team. In that role, he oversees psychologists, psychiatrists and social workers, as well as specially trained volunteers, who provide services to first responders following a traumatic incident. Russo was on call for several days following the Orlando incident, ready to provide support to the police officers, firefighters, medical personnel and other first responders who assisted with the gruesome scene.
While Russo’s team was not deployed to assist in Orlando, he has spoken with several colleagues who were involved. “Most people hadn’t seen anything like it before – the only ones who had seen anything similar had been in war,” he said. There’s no level of training as intense as actually responding to a mass casualty incident. “If you’re a police officer long enough, you’re going to come across bodies and the results of violence. Most officers can deal with a certain level of blood and gore, but this exceeded everyone’s normal,” he said.
CIST Members Help Officers Return to “Normal”
Immediately after responding to an incident, Critical Incident Stress Team members start discussions with first responders about what to expect, both physically and mentally. Reactions can vary widely. For example, many people will have physical reactions like nightmares, difficulty sleeping, flashbacks, mood swings, sexual dysfunction, extreme changes in appetite, and visual or auditory distortions.
[Related: How Police Can Reduce and Manage Stress]
There is often a psychological reaction as well. Some individuals may become emotionally numb while others exhibit extreme aggressiveness. Often officers have a hard time remembering certain aspects of the incident. Others fixate on the event, playing it through their mind repeatedly. “Many officers end up playing the ‘what if’ game and questioning their actions,” said Russo. Some feel guilty about not being able to help more people or convincing themselves they could’ve done more to try to change the outcome. All of these responses can add to the stress a responder is feeling, so it’s important for them to be prepared to experience an array of emotions. “CIST members help responders understand that they are having a normal reaction to an abnormal event,” said Russo.
As a general rule, Russo said about 80 percent of first responders will return to normal without external assistance. However, as many as 20 percent of responders may have a difficult time returning to normal because of what they did, saw, heard and smelled. For those, Critical Incident Stress Team members do a preliminary assessment and refer responders to appropriate professionals, whether they are psychologists, licensed mental health practitioners or licensed clinical social workers.
In addition to educating responders, it’s also important to offer support to families. Spouses need to know what to expect when their loved one experiences trauma. “Spouses are the ones who will pick up on changes in a person’s personality and change in sleeping, eating or mood,” said Russo. “They need to know what is a normal reaction and what is beyond normal or what is self-destructive so they know when to seek help for that person.”
Some people will have reactions immediately after an incident, while others may not respond until days, weeks, or even months later. Regardless of the timing, it’s important for the person — and their family members — to continually assess a person’s behavior to ensure that it’s not impeding their ability to function and seek help when needed.