CRISIS INTERVENTION TEAM
In times of crisis, there must be a means of responding to the crisis, to mobilize the community, and to intervene.
Reservation communities are usually dependent upon the Indian Health Service (IHS) and the Bureau of Indian Affairs (BIA) to provide support in terms of crisis. This is not their mission, and they are unequipped in terms of personnel, or money, to provide these services. While IHS does have mental health services, these are usually limited to treatment and counseling--once the person enters the health care system. IHS does not normally provide prevention or outreach services. Until recently, IHS maintained a Special Initiatives Team that would be on call to go to Tribes in crisis. This team has been effectively dismantled. At this moment, IHS does not offer any services that are focused on suicide prevention or intervention. The BIA does not offer these services either. It is able to hold high risk youth in protective custody through law enforcement authorities, however, BIA does not hold itself out to provide "health" services.
Too often, a community is not prepared and must organize a Crisis Intervention Team (CRIT) under duress. In many cases, the cost may be lives lost. Suicides create particularly high risk situations, because they are so volatile. There is a "clustering" or "copy cat" phenomenon that describes multiple suicides which may be triggered by an attempt or successful suicide. Therein lies the dilemna and danger of not being prepared.
The purpose of a Tribal Crisis Intervention Team is to set in motion a community response to a crisis. The makeup of a CRIT may vary, however, it should include representatives from the following:
- Tribal Council
- Tribal Health Department
- Community Health Representative
- Indian Health Service
- Mental Health Department (psychologist and social worker
- Emergency Room (a physician and nurse)
- Ambulance team
- Police Department
- Fire Department
- High School and Mid-School (Administrator, teacher and counselor)
- Spiritual leaders (tribal elders, priests or ministers from
various denominations)
- Alcholism and Drug Abuse Prevention programs
- Youth Centers or other Youth programs
- Peer Counselors (these may be a trained team, and/or simply young people
with proven leadership qualities, and/or good listeners)
- Parents (several parents that have demonstrated leadership and committment
and are trusted by the young people)
Communication and the ability to respond quickly are critical. From the above group, select an alert command group of 5-7 people who are reliable and available. This group and these individuals will be responsible for notifying others on the team. The Passamaquoddy tribe in Maine issued members of the alert command group beepers. Each community must assess its own "accessibility and availability" to ensure that there are minimal breakdowns in mobilizing the CRIT.
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