Similar to special search-and-rescue teams that respond to the scene of a major disaster, such as the terrorist attack on the World Trade Center Sept. 11, a local band of counselors travel to emergency scenes to talk to victims.
But they're not there to counsel people who have lost loved ones or victims that have been traumatized by what they may have seen. The group is there to talk to the emergency responders - from on-scene officers, paramedics and firefighters to the emergency room doctors and nurses.
It is one of many programs the San Joaquin County Mental Health Services Department offers to citizens.
The county's Crisis Intervention and Stress Management team is made up of healthcare professionals, firefighters and police officers who respond after significant stress on the job.
"Fifty years ago you used to live near family that were a support system," said Marilyn Hughes of San Joaquin County mental health services. "We're so spread out now."
Frankie Engel, manager of county-run Lodi Outpatient Services, handles the dispatch. She usually receives the first call, likely at 2 a.m.
Hughes said the services are important to prevent post-traumatic stress and, if necessary, allow victims to get further help.
Although the group of volunteers is based in San Joaquin County, its members attend training all over the country to respond to local incidents to discuss how things didn't go right to get the feelings out, Hughes said.
"It helps get the facts out so others know how each person feels."
Well before a group responded to the World Trade Center in New York last September to counsel American Red Cross members affected by the tragedy, members were on scene at the Cleveland School shooting in Stockton in the 1980s, the Northridge earthquake the following decade and the San Joaquin County flooding in 1995.
"My job was just to watch and help people work out things," Hughes said of her 17-day visit to New York following Sept. 11. "People who want to help sometimes don't take care of themselves."
At times the counseling is more intimate.
Earlier this month, after returning from an accident that claimed the life of a three-year-old, Woodbridge firefighters discussed their feelings.
Commonly referred to as the "peer support program," the critical stress management team was founded in 1991. Clements, Lodi and Mokelumne also have similar operations.
The debriefing was especially helpful for Woodbridge firefighters Michael Nino and Mark Azevedo who said talking helped them deal with their emotions.
"I haven't seen a lot of things," said Nino, a firefighter for a mere month. "(Debriefing) really helped me a lot to get it off my chest."
County mental health workers talked to Escalon firefighters who had to remain on scene of a vehicle accident, Engel explained. Nearby were four bodies.
Talking about the incident can help, too, when the events hit close to home, Woodbridge Chief Mike Kirkle said.
For example, both Woodbridge firefighters have small children. "Anytime you see a child, you think of your own," Nino added.
Azevedo, a firefighter for 10 years, said talking about the incident within an hour has helped him train for the worst call. "It becomes engraved in your head. You change gears and get ready emotionally when you go out to a call."
Although it's not mandatory that public safety departments belong to the counseling unit, Kirkle has been part of the team for the last 10 years.
Capt. Mike Tecklenburg of the Lodi Fire Department said he trained as a peer support counselor in 1994 to help others.
"My father was a firefighter … it put a lot of stress on me as a child, and this was a way for me to let firefighters know stress affects them at home," he said.
The debriefing usually takes place quietly, sometimes even without the fire chief being made aware. The last one Tecklenburg was involved in was talking to firefighters following the fatal accident of Lodi police officer Rick Cromwell in 1998.
"In the profession, we are all sort of in the same realm," said Tecklenburg, one of four trained firefighters in the department. "You see a lot of things. This just helps us relieve a lot of the stress and not take it home with you."
Although local police departments are invited to participate in the program, officers have access to a paid psychologist for major incidents. They also have internal peer counselors and an on-staff chaplain, according to Lodi Police Capt. David Main.
"It's very beneficial. I didn't want to go through the counseling (when Rick Cromwell) was killed, but I did it. People offered explanations of things we were going to feel, going to experience," Main said.
The service is available not only to officers, but to dispatchers who handle the initial emergency call.
"You never get used to what you see, you just learn to expect the worst," Main said.
The California Highway Patrol in Stockton subscribes to a similar program through the state referred to as the employee assistance program.
"We have several officers throughout the state on the list. If officers are stressed and need to talk, they can go to the counselor or the counselor will come here," said Ted Montez, CHP spokesman.
A critical incident, through the program, is defined as anything that can cause undue stress such as potential loss of life and mass casualties.
When there is a large-scale incident, such as a shooting or the death of an officer, that involves other agencies, a stress debriefing is scheduled, Montez explained. "That's when there is a small group discussion and follow-up counseling one-on-one later."
Engel said debriefing of any kind is important. The critical stress management team handles about 20 per year.
"It's peer-driven, not mental health driven. It's not counseling. It's not a critique, and it is confidential," she added.
For Kirkle, it's all part of the healing process.
"You find out your fellow firefighters have the same feelings," he said.
"In the fire service, you're going to see things the general public never will. We're concerned about the accumulation of stress.
"It's like a bookshelf. You can put an incident up on it, but it's never forgotten. Occasionally, it needs to be cleaned out and not filled up too full."
Nino agreed. "It was good not to dwell on it for a few days. If you don't get it off your chest, you take it home with you."
The incident management team is seeking contributions to help train representatives from every police and fire department, ambulance company, dispatching service and hospital who can counsel their peers.
The Sunrise Rotary Club recently gave the group $500, according to Hughes.
County mental health also offers community mental health services and victim witness programs through the District Attorney's Office.
"It is our plan to normalize what they went through within 72 hours of the event," Engel explained. "We want to help people now, instead of later. It helps minimize the effects of post-traumatic stress syndrome."
In general peer counseling, trainers are taught to watch for the following signs:
. Withdrawing from work, friends, family and regular activities
. Change in eating and sleeping habits
. Persistent feelings of sadness, disbelief and unreality
. Downplaying the reaction, also known as denial
. Lack of concentration
. Unusual anger and irritability
. Emotional numbness
Engel said, in general, getting help earlier can also help victims refrain from drugs and alcohol, often used to dull the pain of something traumatic.
For more information about programs, call 468-8700.
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