First Responder Mental Health Support

• North Dakota Critical Incident Stress Management (CISM) — One of the strongest first-responder-specific resources. CISM provides confidential, free crisis intervention and peer/mental health support following critical incidents. It serves EMS, fire and rescue, law enforcement, dispatchers, medical providers and other emergency personnel.
• Regional Behavioral Health Clinics — Provide behavioral health assessments, counseling, peer support, crisis services and other treatment options throughout North Dakota.
• North Dakota Behavioral Health Program Directory — Search for mental health providers by location, telehealth availability, insurance and other needs.
• Peer Support — North Dakota's certified peer support system connects people with individuals who have lived experience with behavioral health and recovery.

• Substance Use Disorder Treatment Provider Directory — Find licensed substance use treatment programs throughout North Dakota, including outpatient and other levels of care.
• North Dakota Behavioral Health Program Directory — Search for both mental health and substance use services in one place.
• Addiction & Recovery Resources — Information about addiction, treatment, recovery and ways to find help.
• Regional Behavioral Health Clinics — Some clinics provide medication and withdrawal services, recovery support and peer support.
• 2-1-1 Helpline — Free, confidential, 24/7 assistance connecting people with local behavioral health and substance use resources.

• 988 Suicide & Crisis Lifeline — Call or text 988 for free, confidential, 24/7 crisis support. Support is available for suicidal thoughts, depression, substance use, trauma, stress and other concerns.
• North Dakota Suicide Prevention Resources — Warning signs, prevention resources, trainings, lethal means safety and postvention resources.
• Suicide Prevention Trainings — Training and resources to help first responders and others recognize warning signs and respond to someone who may be struggling.
• Suicide Postvention Resources — Resources for individuals, agencies and communities following a suicide loss.

• North Dakota CISM Team — 24/7 activation for emergency services personnel following critical incidents. Services are free, confidential and can be provided at the responder's location. 701-328-0707.
• 988 Suicide & Crisis Lifeline — Call or text 988 anytime for immediate behavioral health crisis support.
• Regional Behavioral Health Clinics — Some locations offer walk-in assessment, same-day care, 24/7 crisis and residential services and community outreach.
• 2-1-1 — Free, confidential, 24/7 information, referrals and crisis intervention.
• Behavioral Health Program Directory — Find local crisis, mental health and substance use services.

• Peer Support — Peer support can help reduce isolation and increase connection, engagement and overall well-being.
• Community Connect — Community-based behavioral health services that include care coordination and peer support.
• Regional Behavioral Health Clinics — Provide community outreach, peer support, skill building and recovery support.
• 2-1-1 — Connects North Dakotans with local behavioral health, social service and community resources.
• Behavioral Health Program Directory — A statewide starting point for finding local services and providers.

CISM teams are made up of first responder peers and a licensed mental health professional.

CISM is designed to provide a safe, supportive environment where first responders can talk about their experiences. Confidentiality is a priority for the North Dakota CISM program, and participants are encouraged to speak openly without fear of judgment or scrutiny.

CISM is not therapy or a replacement for ongoing mental health care. If additional support is needed, the CISM team can help connect responders with appropriate resources.

CISM can be requested during or after a critical incident or series of incidents that may cause significant stress or emotional reactions.

Consider requesting CISM when an incident:

• Involves death, serious injury or violence
• Involves children or particularly traumatic circumstances
• Is unusually difficult or emotionally overwhelming
• Causes strong or ongoing stress reactions among responders
• Affects a team, unit or agency's ability to function

You don't have to wait until someone is struggling. Any member of a team or anyone who sees a need can request CISM. A request does not need to come from a supervisor or agency leader.

• Anyone who sees a need for Critical Incident Stress Management services can request a debriefing by contacting the 24/7 Health and Human Services operation center (701-328-0707) or State Radio (701-328-9921) and requesting the HHS Case Manager. North Dakota Critical Incident Stress Management (CISM) Program | Health and Human Services North Dakota
• If you are requesting a CISM debriefing for a law enforcement agency, please identify the agency when you make the request.
• Avel eCare is contracted by North Dakota Dept. Of Health & Human Services to assist with rural crisis services. Avel eCare will also provide virtual CISM debriefings for any ND law enforcement agency. Contact 1-844-250-7302 to request a debriefing.

A CISM debriefing provides a structured, supportive opportunity for responders to talk about a critical incident with trained peers and a licensed mental health professional.

During a debriefing:

1. Introduction
The team explains the process, establishes expectations and reviews confidentiality.

2. Share the facts
Participants have an opportunity to describe what happened from their perspective.

3. Talk about reactions
Responders can discuss thoughts, feelings and reactions they have experienced.

4. Learn coping strategies
The team provides information about common stress reactions and healthy ways to cope.

5. Connect with resources
Participants learn when to seek additional support and where to find behavioral health resources.

Participation is voluntary. CISM is intended to support recovery — not to evaluate job performance or critique how an incident was handled. North Dakota's CISM materials also note that a debriefing typically takes about 2–3 hours and is not a critique of technical operations or performance.