Local volunteers provide ‘emotional first aid’ for tragedy victims

Deaths, injuries and fires are all in a day’s work for emergency service workers. They may also be part of a shift for Trauma Intervention Programs of WNC volunteers, who provide emotional first aid to family, friends and bystanders after traumatic events.

This is the message that Hendersonville Fire Department Deputy Fire Chief Justin Ward imparted to a Zoom class of potential TIPWNC volunteers Jan. 11. During the six years TIPWNC has supported HFD, Ward says, the most common reason volunteers are called is for cardiac arrest. Drug overdoses, suicides and house fires round out the top four scenarios.

First responders have immediate and potentially lifesaving responsibilities when arriving at a traumatic event, says Mandy Atkission, the CEO of TIP nationwide and a trainer for the WNC affiliate. However, people who are close to the victims — the survivors — can be in a state of shock or confusion.

“Emergency responders try really hard to be very compassionate and very caring and provide information,” Atkission explains. “But at the same time, they have this job that they have to do, and they can’t stop what they’re doing in order to meet the needs of the family.”

In the Jan. 11 class, Ward noted that Hendersonville is home to many retirees who may not have family living nearby. Oftentimes after a tragic event, like the death of a spouse, it can take a while for family to arrive from afar.

Atkission sees TIP volunteers as unburdening first responders in the moment and giving them peace of mind when leaving a scene. “For an emergency responder to be able to get back in his patrol car or get back on the fire rig, knowing that 80-year-old Mrs. Jones is not sitting all alone until her daughter from Atlanta arrives, is a great mental relief for them, too,” Atkission explains. “It’s very difficult for them to just say, ‘Sorry, Mrs. Jones, but there’s another call, we’ve got to go’ and leave her with a dead husband in the room until the funeral home gets there.”

Helping hearts

In the aftermath of public tragedy, a quote from Fred Rogers, star of the children’s TV show “Mr. Roger’s Neighborhood,” often makes the rounds on social media. “When I was a boy and I would see scary things in the news, my mother would say to me, ‘Look for the helpers. You will always find people who are helping,’” he said.

Rogers could have been speaking about the volunteers for TIP. The organization’s 25 current WNC volunteers work 12-hour shifts, and coverage is 24/7. According to Atkission, TIPWNC responds to an average of 22 calls per month, primarily in Buncombe County.

The nationwide program, existing in over 250 cities, came to Buncombe County and Hendersonville in November 2015; Atkission plans to expand to Henderson and Transylvania counties this year. Municipalities served by TIPWNC pay 12 cents per capita, and the program is also funded by grants, including support from the nonprofit WNC Bridge Foundation and Buncombe County Health & Human Services.

Volunteers for TIP are not credentialed as mental health counselors. They are trained to provide emotional first aid, also called psychological first aid.

The American Psychological Association calls psychological first aid “an initial disaster response intervention with the goal to promote safety, stabilize survivors of tragedy and connect individuals to help and resources.” Atkission says the words to focus on are first aid. “Counselors deal with emotions, and support groups deal with emotions,” she explains. “How we’re different is we’re that first line.”

It’s work that volunteers find challenging but rewarding. “Being able to help someone, on what is often one of the worst days of their lives, is really just to me a very compelling way to help and to reach out to people in our community,” says Andrew Celwyn, an Asheville-based TIPWNC volunteer since 2018.

Logistical support

TIP is only dispatched through the 911 system. A first responder can request a volunteer through the 911 dispatcher, who then connects with the TIP dispatcher on duty. Volunteers average a 20-minute response time, Atkission says.

The organization trains police, fire departments and EMS to scan a scene upon arrival and assess whether it may be necessary to call the volunteer on duty. Survivors needing emotional first aid aren’t always showing obvious grief reactions such as crying; someone “standing in the background quietly,” explains Atkission, may be traumatized by the situation.

Buncombe County is fortunate to have numerous supportive resources, such as victims advocates and support groups, Atkission says. Much of this information is available online — for example, the Buncombe County Sheriff’s Office directs crime victims who are seeking reimbursement for medical expenses and lost wages to the N.C. Department of Public Safety Victims Compensation Services. But, she points out, “people don’t know about those things because they haven’t had to use them.”

TIPWNC volunteers can assist with navigating the red tape, as well as directing people to mortuary services. They can also set expectations.

“Usually, one of the first things that I tell families when I arrive on scene is ‘I’m sorry, but this is probably going to take a lot longer than you think it’s going to take,” Celwyn says. He explains that an unattended death requires a police investigation, and that can involve detectives taking photographs, contacting a coroner and having someone sign off on the death certificate.

Other people need basic questions answered, particularly those who have not experienced a trauma such as a death before. A trauma survivor may assume that police ask questions about an incident, such as the death of a child, because they think that person is guilty, Atkission says. A TIP volunteer can explain that asking questions is part of the information gathering that law enforcement is required to do.

Volunteers can also assist with logistical challenges, like if a victim has lost a phone or wallet in a car accident. Other aid includes helping survivors gather a loved one’s medications and important documents, get to a hospital or locate an animal that has been evacuated from a fire.

Learning to listen

TIPWNC’s biannual, 55-hour training occurs over a 10-day period. In an early class, volunteers learn to introduce themselves to first responders and survivors on a scene. As the training progresses, the students role-play responses for responding to a suicide, baby death, car accident, heart attack and elderly person’s death.

Victims often want to know why they aren’t receiving more information from first responders, Atkission says. A volunteer can explain that law enforcement may hold back information about a crime scene because it hasn’t been verified. In another class, first responders teach correct behavior — everything from not touching objects at a scene that may be evidence to not driving over fire hoses.

Some students drop out during training when they realize “this might be more than I bargained for,'” Atkission explains. During the Jan. 11 class, Ward, the deputy fire chief, warned that emergency services respond to “gruesome, out-of-the-ordinary things,” and shared a slide with disturbing images from the public domain: someone with a gunshot, a dead child, individuals who had overdosed and an injured animal.

TIP trainers will also eliminate potential volunteers who seemingly hold a grudge against law enforcement, as well as anyone who has had a recent trauma. The volunteer application asks whether a person has experienced previous traumas and asks to discuss them.

“We don’t need them retraumatizing themselves,” Atkission explains. “Maybe they came home and found their son hanging in the garage, and then they’re going to get a call where somebody’s son is hanging in the garage — that’s really traumatic.”

It’s also crucial for volunteers to be able to practice deep listening. A common reaction to hearing another person’s sad story is to offer support by connecting with a similar experience (“I lost my husband last year, too.”) But empathizing is not actually what survivors need immediately after a traumatic event, Atkission says. “We need people who are going to arrive on scene and be listeners, not talkers,” Atkission says.

Empathizing is important eventually. But during the first two or three hours after a tragedy, the victim feels “so raw, their world is just turned upside down,” she continues. “Nobody can even closely understand what’s happened to them, is how they feel.”

Adds Celwyn, “I say that 90% of the training is learning what not to say, which is really important, because there are a lot of cliches about death that can make a situation more difficult.”

Volunteers say they find it rewarding to help someone in a moment of tragedy, Atkission says. But unlike social workers or counselors, TIPWNC volunteers only walk beside an individual’s pain for a short period of time; the emotional involvement may be less pronounced.  Once volunteers join the organization, she notes, they average three years before moving on.

There is no ideal profile of an emotional first aid provider. But “a desire to help people one-on-one” is the most important quality, Atkission says. “We’d rather not be needed than not be called.”