The World Health Organisation (WHO), describes a critical incident as an event out of the range of normal experience – one which is sudden and unexpected, involves the perception of a threat to life and can include elements of physical and emotional loss. Often such events are sufficiently disturbing to overwhelm, or threaten to overwhelm, a person’s coping capacity. Most people would be severely shaken by a critical incident but are likely to recover from its impact with appropriate support.

Examples of these incidents include line of duty deaths or serious injury to operations personnel. By their nature, frontline staff such as those who work in the healthcare sector, emergency, military, security, rescue, enforcement and others who operate in similar industries within the private sector, are engaged in higher risk activities and are actively exposed to these stressors in their line of work.

Addressing critical incidents

It is widely accepted that there is a critical period in the aftermath of a critical incident or traumatic exposure during which there is a risk of developing clinical levels of traumatic stress. Research also indicates that a range of factors can modulate its effects and recovery – for example, primary measures such as prior stress management training, and secondary measures, such as the availability of peer support have been shown to have a positive effect. On the other hand, other factors may escalate the level of distress experienced, for example, continued exposure to the distress of the victims and on-going or pending investigations. Tertiary measures refer to confidential advice, support or counselling and access to specialised clinical services for those who need them.

Because of the nature of the job, attempting to minimise repeated exposures in these settings presents a major challenge for management. Therefore, employers and managers of occupational groups that are at high risk of exposure to critical incidents are required to have a robust set of primary, secondary and tertiary interventions to help minimise, as far as reasonably possible, the risk of psychological injury in the aftermath of a critical incident.

Work PositiveCI delivers structured guidance enabling organisations to develop an action plan to mitigate against workplace critical incidents.

What is Critical Incident Stress Management (CISM)? 

Critical Incident Stress Management, or CISM, is an intervention protocol developed specifically for dealing with traumatic events. It is a formal, highly structured and professionally recognised process for helping those involved in a critical incident to share their experiences, vent emotions, learn about stress reactions and symptoms and given referral for further help if required. It is not psychotherapy. It is a confidential, voluntary and educative process, sometimes called ‘psychological first aid’.

First developed for use with military combat veterans and then civilian first responders (police, fire, ambulance, emergency workers and disaster rescuers), it has now been adapted and used virtually everywhere there is a need to address traumatic impact in peoples lives.

One of the most important advantages of an integrated staff support programme is that it serves as a feeder system for the Employee Assistance Programmes and other mental health assessment and treatment services. This enables follow-up and referral to the Occupational Health services which can if required, facilitate rehabilitation and return to work, in partnership with the employee and manager.