Critical Incident Support Process

Legal aspects

Health and Safety at Work Act 1974
The Management of Health and Safety at Work Regulations 1999

Critical incident defusing

Once Occupational Health, Safety and Welfare has been notified:

The incident is documented in the Critical Incident file (CI).
The OiC is contacted via email/telephone to ascertain all who attended the incident are not displaying any concerns or effects.

If concerns are raised by an individual or groups, then the following procedure occurs:

The option of a referral to Marchwood Priory or specialist counsellor.
The option of an informal chat to the crew by Occupational Health, Safety and Welfare or a referral to the Welfare Adviser will be offered. Support from PPC.

Recognising the symptoms of Post Traumatic Stress (PTS)

'The development of characteristic symptoms following a psychological distressing event outside the range of normal experience.' (Jackson, G 2003)

What is PTS?

It is the normal reaction of normal people to abnormal events.
PTS can affect individuals in different ways.
For some it can influence and affect our whole life.
If PTS symptoms persist for more than a month, it is possible that it will develop into Post Traumatic Stress Depression (PTSD).

What is the difference between PTS and PTSD?

PTS occurs as a direct result of a traumatic event/trauma.
PTSD has been defined as a recognisable set of symptoms caused by a traumatic event that has lasted for four weeks or more.

Immediate reactions to trauma

Acute stress reaction: disorientation, restricted responses to surroundings, fatigue.
Guilt: questioning whether more could have been done to change the outcome.
Numbing: this may be the calm before the storm! Some talk of feeling disconnected, 'floating'.
Black humour: is used as a way of dealing with what has happened, however, some members of the public and watch/group may have difficulty understanding this!

Characteristics of PTS/PTSD

Re-experiencing (flash-backs)

The incident can be re-experienced for days, months, even years after the event.

Such feelings can be triggered by sights, sounds, smells, taste and touch.
Sometimes reactions can be happened when you least expect them, without a trigger or any warning.

Avoidance

This can be anything that potentially would remind the individual of the event. They may even try to avoid the thoughts and feelings associated to the event.
Some may experience the loss of the ability to feel certain emotions.
Some will avoid thinking about the future.

Arousal

This can make an individual sensitive to certain noises and cause them to be 'jumpy'.
It can also affect someone's sleep, concentration or even make some more vigilant.

Typical general symptoms

Feelings

increased anxiety
depression and sadness
intrusive thoughts
shame, anger, regret, guilt and bitterness
sense of isolation
fear of closed and open spaces
fear of crowds or groups of people

Behaviour

inability to concentrate or make simple decisions
impulsive action, or searching for quick fixes
irritability, anger, violence
disturbed sleep, dreams/nightmares
retreating into isolation

Physical

illness, headaches, stomach pains, tightness in the chest, generally feeling unwell
listlessness and feeling tired
increased sensitivity to noise, people, work, home
excitement and hyperactivity
increased dependency on smoking, drinking

Some further effects of PTS

marital problems
breakdown of other relationships
work difficulties
change in values and beliefs
inability to stop talking about the event
loss of self-esteem and worth
confidence effected when making decisions

Help!!!

Our bodies possess the amazing ability to heal from the most debilitating of 'wounds' inflicted upon it. Being able to talk through what has happened with a sympathetic listener is very valuable.

Trauma support - the model

Initial stage

This would be done by the OiC as soon as practicable, if possible, soon after the crews have returned from the incident

An informal procedure where the crew would be invited to talk through the incident

Information is given about the Occupational Health, Safety and Welfare contacts page which contains support numbers such as Workplace Options, Chaplain and other useful information

Middle Stage

This would be completed by a member of the Occupational Health, Safety and Welfare Unit

Can be provided either to the whole watch or on an individual basis

Final Stage

The initial role of helpers would be to provide practical help, psychological techniques should not be incorporated into the support offered

Occupational Health, Safety and Welfare would identify whether individuals need further psychological intervention from qualified therapists/psychiatrists

When to seek professional help

Please contact OHSW Department for more guidance.

if you feel that you cannot handle the intense feelings, emotions or bodily reactions
if you continue to have nightmares or disturbed sleep
if your relationships seem to be suffering
if you start to smoke, drink or take drugs
if you are suffering from depression or exhaustion
if the memories of the event are still as vivid as the time they occurred