Bexar County Sheriff's Office Policy Manual: Peer Support Critical Incident Response PDF

BEXAR COUNTY SHERIFF’S OFFICE POLICY MANUAL Original Date Effective Date Chapter Number New Policy May 2, 2022 Forty-Nine Subject Office Peer Support Criti...

BEXAR COUNTY SHERIFF’S OFFICE POLICY MANUAL Original Date Effective Date Chapter Number New Policy May 2, 2022 Forty-Nine Subject Office Peer Support Critical Incident Response Sheriff’s Administration References Enclosures HSC Title 9, Subtitle B, Chapter 784, PC 1.07 None Distribution Supersedes Reevaluation Date Pages All Sheriff’s Employees None 5 Approved by: Javier Salazar, Bexar County Sheriff 49.01 POLICY First responders of the Bexar County Sheriff’s Office (BCSO) will encounter a wide variety of events that are considered critical incidents. In order to address potential mental and/or physical health side effects of exposure to these incidents, the BCSO will employ multiple intervention strategies to address the needs of the first responder for a full and efficient recovery. These strategies will help the first responder return to work and maintain a healthy career through retirement. References to the term “deputies” in this Chapter includes BCSO sworn members of all ranks. 49.02 PURPOSE This Chapter provides guidelines for Critical Incident Response from Performance & Wellness Services and the BCSO Peer Support Team and Sheriff’s Administration. 49.03 DEFINITIONS A. CRITICAL INCIDENT - Any event that may involve such intense emotional energy that it may overwhelm a person’s or a group’s ability to respond and/or cope. This can include, but is not limited to the following: 1. Officer Involved Shooting (OIS); 2. Arrestee to deputy violence; 3. In-custody death; 4. Significant deputy injury due to arrestee violence; 5. Exposure to suicide/homicide and other deceased person(s); 6. Deputy injury/illness/death. B. FIRST RESPONDER - Sworn deputies, to include both jailers and peace officers regardless of tier, and telecommunicators/telecommunication specialists of the BCSO. C. MENTAL HEALTH LEAVE (MHL) - Paid administrative leave approved by the Bureau Chief, Chief of Staff or Chief Deputy when a first responder is exposed to or experiences a critical incident. 1 D. PEER SUPPORT RESPONDER (PSR) - Members of the BCSO who are trained in individual Crisis Intervention & Peer Support, as well as other related topics. PSRs are not professional counselors or therapists. E. PSYCHOLOGICAL DEBRIEF - A psychological first aid intervention that is conducted by the agency psychologist and selected Peer Support Responders whom have been trained in the appropriate intervention model. This intervention is conducted within a small group setting and follows the 7- Step Critical Incident Stress Management (CISM; Mitchell & Everly, 2001) Debriefing Model. F. PSYCHOLOGICAL DEFUSING - A psychological first aid intervention that is conducted by the agency psychologist and/or Peer Support Responders on a 1:1 basis with the impacted first responder. The intervention includes the allowance of the first responder to vent and for the provision of education on the signs and symptoms of critical incident stress with ways to cope and available resources. G. SERIOUS BODILY INJURY – Bodily injury that creates a substantial risk of death or that causes death, serious permanent disfigurement, or protracted loss or impairment of the function of any bodily member or organ (as defined by Texas Penal Code § 1.07). 49.04 CALL-OUT/REQUEST FOR SERVICES PROCEDURE A. In the event of a critical incident, the managing supervisor will notify the agency psychologist and the BCSO Peer Support Team by: 1. Emailing the current agency psychologist; and 2. Emailing the Peer Support Team at [email protected]; or 3. Utilizing the Staff Injury Notification system to provide information. B. The following information shall be included when utilizing email for notification: 1. Full name(s) and employee number(s) of the first responder or first responders involved; 2. Phone number for each involved first responder; 3. Short description of the incident, including any injuries; 4. Status of the first responder (at the hospital, at home, back on duty, etc.) C. The managing supervisor will refer to the Peer Support Team Roster for the respective Bureau to identify the PSR who may be on the current shift and can respond to the incident in-person to conduct a psychological defusing. In the event that there is no PSR available, the supervisor will notify the Public Safety Communications Center (PSCC) dispatcher, who will call out the appropriate PSR. The agency psychologist will provide an updated on-call roster to the PSCC manager every 90 days. PSR call outs may be subject to the following conditions: 1. If the first responder is injured and is on the way to be medically evaluated, contact will be made by Peer Support and/or the agency psychologist via phone to the first responder. No other action by the supervisor is needed once information has been passed to the PSR and/or psychologist; 2  2. If the first responder is displaying the following symptoms/reactions, the supervisor should contact the BCSO Mental Health Unit (MHU) or if the MHU is not on duty, the supervisor should request the PSCC dispatcher to notify the on-call MHU deputy: a. Disorientation of personal identifiers, time, or place, etc.; b. Active hallucinations or delusions; c. Changes in speech patterns; d. Anger outbursts; e. Suicidal or homicidal ideations; f. Inability to care for or perform daily activities (i.e. personal hygiene). 3. The supervisor can follow the recommendations made by agency psychologist on alternate procedures if the situation is otherwise unique. D. The first responders involved in the incident will receive an email from the agency psychologist that is entitled Critical Incident Stress. The purpose of this email is to provide information about the signs and symptoms of critical incident stress, ways to cope, and resources available. E. Based upon the stress symptoms of the first responder and the severity of the incident, the agency psychologist may recommend administrative leave or mental health leave (see section.06 below) in order to facilitate psychological recovery from the incident. For the purposes of this Chapter, administrative leave refers to leave for critical incident stress not covered under section.06 as mental health leave is effectively a form of administrative leave as well. F. The first responder’s chain of command will receive a brief notation via email indicating that first responder was provided education, assessment and intervention due to the critical incident. Specific details regarding the content of the defusing or debriefing shall not be provided to the first responder’s chain of command. G. In the event of a larger scale critical incident, the managing supervisor can request a group psychological debriefing for a small group of first responders. The supervisor will consult with the agency psychologist and the Peer Support Team to determine the best strategy and schedule for intervention. H. If a first responder is requesting Peer Support services, the managing supervisor can contact [email protected], or refer to the Peer Support Roster to determine the on-call PSR that is available. 49.05 CONFIDENTIALITY A. A formal agreement statement has been created that provides written assurance that, within the limits of confidentiality, the PSRs shall not be asked to give information about first responders to whom they provide support. 3 B. All Peer Support Team members will sign for and be familiar with this written agreement of confidentiality. C. The written agreement will provide the extent of protections and limitations of confidentiality. This agreement is consistent with state law, and may include the following requirement to disclose: 1. Threats to self; 2. Threats to specific persons; 3. Felonies requiring disclosure by state law; 4. Misdemeanors of a serious or troubling nature; and 5. Child abuse and elder abuse (to include physical and sexual abuse, neglect, and/or exploitation). D. The only information the County, State, or Sheriff’s Office Administration may request is the anonymous statistical information concerning the number of contacts and the number of activities the team is involved with. E. Peer Support Team members will keep numerical records of their contacts, but will not keep records that include names or specific information of the contact. PSRs will keep information about their contacts in a secure location. F. PSRs should inform first responders of the limits of confidentiality when exceptions occur, and consider potential role conflicts, such as supervisor PSRs providing support to subordinates. G. PSRs should not volunteer information to supervisors and, if asked, should advise supervisors of the written agreement guidelines and Texas Health and Safety Code (Title 9, Subtitle B, Chapter 784). 49.06 MENTAL HEALTH LEAVE A. First responders that are involved in critical incidents in which a death or serious bodily injury (as defined above) has occurred may request the use of mental health leave (MHL). The request shall be made orally or in writing through the chain of command. This request may also be made at the recommendation of the agency psychologist or on behalf of the first responder by the PSR. PSRs must articulate in their request how they determined MHL is appropriate and why the first responder was unable to make the request on their own behalf. B. MHL requests shall be treated as a priority matter and a decision on the granting of the leave shall be made no later than 24 hours following the submission of the request. The request shall be granted unless the Sheriff or designee articulates specific compelling reasons to deny granting the leave. C. Supervisors, PSRs, or co-workers who become aware of behavioral changes in a first responder directly involved in a qualifying critical incident event should suggest to the first responder that they seek MHL and the assistance of a mental health professional. 4 49.07 CONFIDENTIALITY OF REQUEST A. Any request for MHL shall be treated as strictly confidential by all parties involved and shall not be discussed or disclosed outside of the first responder’s immediate chain of command, and only as necessary to facilitate the use of leave. Any supervisor, PSR, or co-worker who becomes aware of behavioral changes and suggests the first responder seek MHL shall not discuss that matter with any third party. Any breach of this confidentiality shall be grounds for discipline. B. Confidentiality may be waived by the first responder seeking MHL. Confidentiality may be waived under circumstances which indicate the first responder is a danger to themselves or others and BCSO personnel must confer with mental health professionals, however, this waiver is limited to the time and circumstances of the episode in which the first responder is a danger to themselves and others and confidentiality is restored once this episode has passed. 49.08 DURATION OF MENTAL HEALTH LEAVE A. A first responder who requests mental health leave may request up to 40 working hours of leave. B. Additional hours may be granted as clinically indicated. C. MHL days shall be granted without a deduction in salary or other compensation. 49.09 MENTAL HEALTH SERVICES AVAILABLE TO FIRST RESPONDERS A. Deer Oaks Employee Assistance Program: 1. Helpline: 1-866-327-2400 2. Email: [email protected] 3. www.deeroaks.com, login/password: BCSO 4. iConnectYou App Code: 46125 B. Aetna Teledoc: 1. teledoc.com/aetna C. San Antonio Counseling and Behavioral Center: 1. Contact Line: 1-210-614-4990 2. Email: [email protected] 3. www.sacounselingcenter.com D. Aetna Able To Program: 1. Contact Line: 1-844-330-3648 2. ableto.com/aetna 5