Building a CISM Team: What Washington County Got Right (And What Your Agency Should Know)

In Washington County, Pennsylvania, a group of first responders is doing something most departments still talk about but never get off the ground. They're building a CISM team. According to a recent Herald-Standard report, a $179,574 grant from the Staunton Farms Foundation is funding it, and the plan is to train and certify up to 40 volunteers (peers from law enforcement, fire, EMS, and dispatch, alongside licensed mental health clinicians) to respond when their own people are hit by traumatic calls.

If you're a chief, a peer support coordinator, or a wellness lead reading the news coverage and thinking your agency should be doing this too, you're in good company. CISM teams have been around since the mid-1980s, and after forty years of evidence and experience, more agencies are treating responder mental health the way they treat broken equipment: as something you fix on purpose, before it costs you someone.

This post walks through what a CISM team actually does, why Washington County's approach is a strong model, and what it takes to build one in your agency.

What a CISM Team Is, in Plain Language

Critical Incident Stress Management is a structured framework for helping people who've been exposed to a traumatic event recover and stay on the job. A CISM team is the group of trained peers and mental health professionals who deliver that support.

The team gets called in after the kinds of events that mark a career: a child death, a line-of-duty injury, a mass casualty, the suicide of a coworker, or a call that ended badly through no fault of the people running it. The team's job is to help responders process what happened, normalize what they're feeling, and prevent small problems from turning into bigger ones.

A working CISM team usually offers some mix of one-on-one peer support, small group conversations after a difficult call, family support, referral to clinicians when needed, and follow-up. The work is peer support, with clinical backup when the situation calls for it. It's a recognized model with an evidence-based track record, and it's the standard most agencies in the U.S. are building toward.

Why Washington County's Approach Is Worth Studying

A few things stand out about how they're going about this, and they're the same things that separate teams that last from teams that fizzle in two years.

They invested before they needed it.

Dan Harvey, the deputy director of public safety, told the Herald-Standard: "As first responders, we invest significantly in equipment and training, and if a piece of equipment breaks, we make it a priority to get it fixed. We need to invest in our first responders the same way." That mindset shift is the whole game. If you treat mental health like equipment maintenance, you build the team before the crisis, while you have time and resources to build it well.

They're building it multi-agency.

The team will include peers from law enforcement, fire, EMS, dispatch, and corrections, plus licensed mental health clinicians. That matters. A single-agency team is a good start, but the work in your county doesn't stop at jurisdictional lines. The deputy who responded to a fatal crash and the EMS crew who worked it and the dispatcher who took the call are all affected by the same incident. A regional team can serve all of them.

They tied training to a recognized standard.

The CISM training is affiliated with the International Critical Incident Stress Foundation. That's the right move. Anyone can call themselves a peer supporter. The agencies that get this right train their people to a recognized curriculum so the team operates the same way every time, and so peers know what's inside their scope and what isn't.

They're addressing stigma directly.

The grant includes 200 licenses to the Corsica Wellness app, giving responders 24/7 anonymous access to mental health resources and self-assessments. Stigma is still the biggest barrier in most departments. Some responders will reach out to a peer right away. Others need to start with something they can do alone, on their phone, at 2 a.m., before they're ready to make a call. Giving them more than one way in is good design.

They built in scholarship money for treatment.

This is a piece most departments overlook. Sometimes a responder needs more than peer support. They need a clinician. And the cost of treatment is one of the most common reasons people don't get it. Washington County is using grant money to cover that gap.

What It Takes to Build a CISM Team in Your Agency

If you're the person in your department being asked to figure this out, here's what the process looks like.

Get leadership buy-in first.

Without the chief, the sheriff, or the EMS director behind it, the team won't survive its first hard conversation about confidentiality, call-out policy, or budget. Leadership doesn't have to run it. They have to back it.

Select the right peers.

This is the single most important decision you'll make. The best peer supporters often aren't the loudest people in the room or the ones with the most stripes, bugles, or stars. They're the responders that other responders already go to when something's wrong. Ask around. The names will come up. Look for credibility, the ability to stay calm under pressure, a reputation for keeping things confidential, and emotional maturity. Diversity helps too: shift, role, rank, gender. The closer the team mirrors your agency, the more responders will reach out.

Train to a recognized curriculum.

ICISF is the standard most teams in the U.S. use. The core courses are Assisting Individuals in Crisis (a form of psychological first aid for one-on-one peer contact) and Group Crisis Intervention (the small-group work after a difficult call). Both run two to three days. Most teams add suicide intervention training (QPR is an effective model) so peers can recognize and respond when a coworker is in crisis.

Write the policies before you take your first call.

Confidentiality is the foundation. If responders don't trust that what they say to a peer stays with that peer, they won't say anything. Your policy needs to spell out what's confidential, what isn't (the legal exceptions: imminent harm, child abuse, certain crimes), and what the team's relationship is to discipline and fitness-for-duty (none, if you want the team to work).

Get clinicians on the team.

Peers do peer-level work. Clinicians do clinical work. Both are needed, and they're not interchangeable. Find licensed mental health professionals trained in first-responder culture and put them on the team alongside peers from the start.

Build the referral network now.

When a peer encounters someone who needs more than peer support, they need to know exactly who to call. That list of culturally competent clinicians, EAP contacts, chaplains, and crisis lines should be in place before your team takes its first deployment.

Plan for sustainability.

Two-year grants are how many teams get started. They're also how many teams disappear when funding runs out. From day one, plan for how the team will be funded in year three: a line item in the department budget, membership dues from participating agencies, nonprofit fundraising, or some combination. Washington County is already thinking this way, forming a nonprofit to secure ongoing funding beyond the grant period.

What Trips Most Teams Up

A few common mistakes I've watched derail otherwise good teams over the years.
Confidentiality breaches, even small ones, kill trust faster than anything else. One peer telling one supervisor one thing, even with good intentions, can shut a team down for years.

Peer supporters who don't take care of themselves burn out and leave. The team needs its own support structures: regular peer-to-peer check-ins, supervision from the team's clinicians, and permission to step back when their own lives show signs of stress.

Teams that drift into discipline or fitness-for-duty work lose the trust of the people they're supposed to serve. Keep the wall between them clean. Peer support is for the responder, and the work has to stay that way.

Teams that try to do everything for everyone end up doing nothing well. Start with a clear scope: what kinds of calls trigger a team response, what services you offer, and what you refer out. Expand as you have the capacity to do it well.

A Quick Note Before You Move

Building a CISM team is one of the highest-leverage investments your agency can make in your people. It's also one of the easier things to do badly. The framework looks simple on paper, and a department can get six months in before realizing the policies are weak, the wrong people are on the team, or the training they paid for didn't prepare anyone for the conversations they're now in.

If you're at the point Washington County was eighteen months ago (knowing your agency needs this, not yet sure how to get it built), it might help to talk it through with someone who has helped other departments do it. I provide a peer support strategy call for coordinators and chiefs in your spot. We use this time to figure out where your agency actually is, what the next step looks like, and what to prioritize so the team you build lasts.

You can book the call at stresscaredoc.com/consultation. No cost, no pitch. Just a conversation about your department and what would help.

Your people are worth building this for. Washington County is proving it can be done.

A note before you go: this post is here to help you think through how a CISM team gets built. It isn't clinical advice for any responder you're worried about right now. If someone on your roster is struggling, please get them in front of a licensed clinician trained in first responder culture. If it's a crisis, 988 (the Suicide and Crisis Lifeline) is available 24/7, Copline for law enforcement is 1-800-267-5463, and Safe Call Now for first responders is 1-206-459-3020.

Source: Mansfield, Karen. "Mental health matters: First responders prepare to launch CISM Team." Herald-Standard, May 13, 2026. https://www.heraldstandard.com/news/local_news/2026/may/13/mental-health-matters-first-responders-prepare-to-launch-cism-team/