There's a reason I just flew to Michigan for a 3 day conference (I hate Michigan!). I'm now certified in Individual and Group CISM, which I did to help out with my Search and Rescue team (now there's two of us, instead of just one, yay!) If used properly, CISM techniques can help individuals identify the need for further counseling... especially when said certified person is helping to evaluate that need.
PTSD happens. I don't think it makes you any more or less of a risk at your job, as each individual is different and handles different psychiatric diagnoses differently. There's great bipolar medics, medics with clinical depression, etc... there's TONS of medics with PTSD who don't even know they have it. Does stress affect how you do your job? Sure. Does it mean you'll freeze up, or that fear of freezing up is weird? Nah. All of us have that unspoken fear that we'll drop the proverbial soap at the worst possible moment. I don't think that's a PTSD thing.
I'm bad about seeking help after calls that mess with me, because my hubby is also on the team and I just go to him with what's bothering me. However, I am good at identifying "bad ju-ju" signs in myself and in others. Between myself and the other gal on the team, we make contact with people after a call we knew was hairy to see how they're doing. If even ONE person asks for it, we will hold a debriefing or defusing, depending on the time table. Or we'll do 1:1 with the person if that's what they're more comfortable with.
Sometimes, people just need the reassurance that they're not nutso for reacting the way they are. Sometimes, they need a little bit more. We have psychologists that we can refer people to if they're really struggling and need someone with the ability to help them work through deeper issues.
We're hoping to establish a CISM response team for our area (closest one is a couple counties away), so we can help out other departments and such. It's a catch-22; if you're too close to what happened, you have your own emotions to deal with... if you're not part of the department/team you're trying to debrief, folks are less likely to open up.
It's a complex issue, that's for sure. Especially so for those who are returning to civilian life from a military deploy. It's not just the stuff you saw while you were out there, it's learning to readjust to a "normal" life again. I think those who are the most honest about where they are struggling do the best, at least from what I've observed with folks I know. Those who try to put on the "tough face" end up suppressing, and suppressing, and suppressing, until they reach a catastrophic point of some sort.
We discussed this in my conference with a police LT, who has had trouble with re-integrating his undercover detectives back into the main part of the force after they come off a lengthy undercover assignment... same kind of deal- you have to switch over your mentality completely from what you were doing to something that is much more mundane, and has its own challenges.
Just my thoughts on the matter... also, disclaimer- I do not think CISM is for everyone, and nobody should EVER be mandated to go to a debriefing. Oh, and someone who's not trained shouldn't run one. And there should be backup with referrals to psychologists as needed. And nobody should be forced to talk during a debriefing if they don't want to.
Thanks for posting this, Maverick!
Wendy
CO EMT-B