Here is something that I am passionate about and something that I do have knowledge of from an aussie perspective. Some years ago, in my dark deep past, I looked under the lounge, found god (he was hiding there the whole time) and became an ordained minister and a chaplain. I have also completed Critical Incident Stress Management (CISM) training.
A CIS debrief, or diffusion, is intended to allow people to vent their thoughts and feelings before they have an opportunity to eat the person up and they lash out in a reaction. I do not see it as fair on an individual if they are dismissed from employment from not talking during a debrief or not attending one - it compounds the original problem as the individual then has thoughts of failure and leads the spiral into depression and further problems.
Recent research has indicated that a debrief or not does not make any difference in the development of PTSD - but attending a debrief may allow the early signs to be recognised.
If an individual is dismissed from employment for these reasons, here in Australia it can be considered unfair dismissal, as the employer caused the problem and has an obligation to rectify it.
In my experience, people react to the same situation differently.
A fatality may in one individual cause a reaction of feelings of failure (if i had just done a little bit more...), in another individual they may throw themselves into training (if I can learn from this, I can stop it from happening again), another individual may develop PTSD, another individual may turn to substances to cope. A person may say that they are fine at the debrief, and some time later it affects them. A person may not be affected.
A person may say that they are not affected and seek counselling later as they are uncomfortable sharing thoughts and feelings in a group situation, there are many reactions.
During CISM training, I was taught that not every person is going to open up and not to force them to if they dont want to. It is not conducive to the recovery process from CIS and may actually force an individual to relive an experience that they are not fully prepared to process at that instant and cause further psychological problems in reaction to the added stress.
Another thing to remember is that what is said should remain confidential. The purpose of the CIS debrief is not to pass blame, but for the individuals to understand what had happened, and if upper management are using the CIS debrief as a means of passing blame, the agencies CIS process should be looked at carefully and possibly passed to an outside agency for management.
If you are feeling the effects of CIS, then do seek counselling. I can honestly say that I have done it after attending a couple of fatalities where the patient has died during the rescue, and it has helped. Even if you sit down with your work mates and discuss what happened - many of us tend to do that with our partner on our way back to the station, so we are actually getting an informal difusion happening without even thinking about it - or seek out any peer support team members (if your agency has them) or even chaplains are good to turn to, and you dont have to be religious as the role of the chaplain is simply to listen and provide spiritual comfort - not tell you how God would have wanted you to do it.
