CISM – Critical Incident Stress Management

Are you struggling with thoughts of suicide, feelings of hopeless, feeling lonely and isolated?  Are you worried about someone you care about who may be struggling with these thoughts or feelings?  You can receive help immediately through the resources below 24 hours a day, 7 days a week or you can seek immediate medical attention at your local hospital Emergency Department.     


ACTS Helpline (Dumfries, VA)  24 Hour Helpline - (703) 368-4141  Teenline - (703) 368-8069  Spanish 6pm - 10pm M-F - (703) 368-6544

CrisisLink (Arlington, VA) 24/7 Hotline  (703) 527-4077  TTY Accessible

Safe Call Now (206) 459-3020  A 24/7 helpline staffed by first responders for first responders and their family members. They can assist with treatment options for responders who are suffering from mental health, substance abuse, and other personal issues.

Fire/EMS Helpline – (888) 731-3473 Also known as Share The Load. A program run by the National Volunteer Fire Council. They have a helpline, text-based help service, and have also collected a list of many good resources for people looking for help and support.

National Suicide Prevention Lifeline – (800) 273-8255 The national (USA) suicide hotline. Not first responder specific, but they can and will talk to anyone who needs help. They have a large number of first responders and veterans who volunteer.

Crisis Text Line  A service that allows people in crisis to speak with a trained crisis counselor by texting “Start” or “Help” to 741-741.


 What is Critical Incident Stress Management (CISM)? 

CISM Teams can help emergency workers deal with stress.  These teams work with individuals or groups of emergency medical service, fire and police personnel who may suffer from stress after being involved in a critical incident. Team members provide pre-incident education and post-incident defusing, demobilization and debriefing.


Examples of critical incidents are:

  • Suicides
  • Mass casualty incidents
  • Injury or death of an emergency worker
  • Threats to emergency worker’s safety
  • Prolonged events
  • Natural disasters
  • Injury or death of children


The constant intake of stress or encountering a highly stressful event can cause the emergency service professional to suffer stress reaction symptoms. These symptoms may include:

  • Fatigue
  • Identification with the victims
  • Nausea
  • Nightmares
  • GI upsets
  • Flashbacks
  • Memory loss
  • Fear of repetition of the stressful event
  • Concentration problems
  • Mood swings and depression
  • Problem-solving difficulties
  • Changes in sleep patterns
  • Anxiety
  • Changes in eating and work habits
  • Fear
  • Unusual actions or behaviors
  • Depression

A debriefing should be requested if stress symptoms continue beyond the first 48-72 hours of the incident. Overwhelming stress symptoms usually occur in the first 24-48 hours following a critical incident. If you or your agency is in need of CISM Team assistance, please contact your area’s team.


pdf Click here for a contact list of CISM Teams in Northern Virginia (28 KB)


If you need immediate help, please use the resources at the top of the page 24 hours a day, 7 days a week or you can seek immediate medical attention at your local hospital Emergency Department.   

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