Crisis Intervention

Abstract

The current paper is a case study of crisis intervention applied after the MH17 incident, which has been developed on the basis of available theoretical material and empirical information relating to the issue under consideration. Today crisis intervention is a rather topical field of psychology that is being actively developed by specialists due to its importance when coping with all kinds of crises. The modern world is a place where crisis may be deemed an integral part of life, and timely intervention is the only possibility to mitigate consequences and insure that persons affected by a crisis can restore their normal functioning levels. Although many people suppose that crisis intervention should not be perceived as a separate field of study, practice proves that it is not true as only specially trained people can assist in dealing with effects of various crises like natural disasters, incidents of personal nature, plane crashes, hurricanes, and terrorist attacks, among others. Thus, the current paper strives to evaluate crisis intervention after the MH17 incident from the perspective of available crisis intervention strategies and tactics that are considered to be the most efficient with a view to determining whether the adopted approach has been successful as well as offering some suggestions and recommendations how it could have been improved.

The MH17 incident is a tragedy that has impacted lives of hundreds of people from all over the world. The tragic situation of all these relatives of the deceased is complicated by uncertainties associated with the attack on the plane and difficulties relating to return of bodies. Moreover, international media have highlighted the incident showing pictures of the deceased and broadcasting audios and videos from the incident location, including the ones displaying terrorists boasting of killing innocent civilians. Media attention, impossibility to return and identify remnants of the MH17 passengers and crew, as well as inability to obtain justice have contributed to stress and tension normally occurring after a crisis.

Introduction and Background Information on the Incident Studied

The contemporary world is full of various events and incidents that some people cannot cope with and, thus, require professional assistance when facing such cases in their life. Under circumstances when people face a crisis that they cannot deal with on their own, crisis intervention becomes of utmost importance and specially trained counselors are the only ones who can help victims and all other related stakeholders successfully overcome difficulties with minimum losses and outcomes. Although the majority of incidents trigger crisis and many people involved need professional intervention, crisis intervention is not always implemented as it should be due to a variety of reasons. Consequently, many people suffer from long-term effects that render it impossible for them to return to normal lives without severe repercussions. One of incidents requiring professional crisis intervention is a recent MH17 tragedy when hundreds of families from all over the world lost their loved ones in a plane crash caused by a missile attack from the territory of Ukraine occupied by anti-Ukrainian terrorists who call themselves anti-government rebels. As a result of this incident, hundreds of people, predominantly from the Netherlands and Malaysia, required immediate crisis intervention in order to cope with the tragedy and be able to continue their lives.

All incidents and traumatic events cause tension and stress for all parties involved as well as for some easily impressed spectators and observers, yet not all of them trigger a crisis as it is defined from the psychological perspective. In fact, there are many definitions of a crisis that slightly differ in terms of emphasized features. This paper adopts the so-called trilogy definition of a crisis stating that a situation shall be characterized by three key elements to be deemed a crisis, including “(1) a precipitating event, (2) a perception of the event that leads to subjective distress, and (3) diminished functioning when the distress is not alleviated by customary coping resources” (Puleo & McGlothlin, 2010, p. 1). Crises encompass a wide range of events depending on individual peculiarities of people involved and their ability to cope with stress. Thus, for instance, crisis intervention may be required in such situations as homicide, natural disasters, plane crashes, financial crises, rape, divorce, and even job termination provided a person is psychologically weak and is extremely distressed because of the event, which makes further functioning complicated or impossible. Hereby, all natural disasters and significant incidents like plane crashes, especially if they are international, require efficient and timely crisis intervention in order to mitigate consequences at all levels.

The MH17 tragedy seems to be a valid incident for developing a case study of crisis intervention as this event complies with the definition of a crisis and bears international character, which escalates the significance of professional assistance rendered to all stakeholders of the event. The incident occurred on July 11, 2014 when Malaysia Airlines flight MH17 flying from Amsterdam to Kuala Lumpur was shot down by a Buk surface-to-air missile over the territory of Donetsk region in Ukraine because of an ongoing conflict between the state army and anti-government rebels called terrorists by many Western countries and the Ukrainian government (BBC, 2014). The total amount of victims murdered was 298 passengers and 15 crew members, including 193 from the Netherlands, 48 from Malaysia, 27 from Australia, 12 from Indonesia, and 10 from the United Kingdom (The Rakyat Post, 2014). In this case, crisis intervention was provided to family members of victims with psychological support being required for the most affected nations in general due to the severity of a trauma.

Historical Overview of Crisis Intervention

Crisis intervention is a relatively recent and understudied subject that over the years has undergone a “dramatic transformation…from a psychological backwater field to a pervasive specialty” (James & Gilliland, 2013, p. 6). Over the years, crisis intervention researchers and practitioners have developed different theories. Among them are the Basic Crisis Intervention Theory promoted by Lindermann and Caplan in the 1940s, the ABC-X Model of Crisis offered by Hill in the 1950s, subsequent Double ABC-X Model of Crisis advanced by several Hill’s followers, different ecological and contextual crisis intervention theories, and many others adopted at different stages of the field’s history (Puleo & McGlothlin, 2010).

Although crises have existed throughout the entire history of the humanity’s existence, the acknowledgement of a crisis as a peculiar incident that requires intervention by specially trained people originated in the 1940s (Puleo & McGlothlin, 2010). At the times of World War II, thousands of families faced crises when their family members went to participate in military actions and never returned. Moreover, soldiers who managed to survive had to deal with after-effects and somehow return to normal lives. However, a typically recognized benchmark that is deemed an official start of crisis intervention study is the Boston nightclub fire that caused death of about 400 persons (James & Gilliland, 2013). Survivors were treated by Dr. Erich Lindermann who noticed that most of them had similar responses and displayed similar behavior patterns, which enabled him to conclude that crisis stakeholders manifest similar emotional problems and, thus, need professional psychological assistance in coping with the crisis. Since then, crisis intervention has gradually transformed from a subtopic in psychology to a specialty taught in universities and employed in many spheres of life.

The first attempts to structure knowledge relating to crisis intervention were in the 1960s and are connected with a change in the provision of services to mentally ill persons in newly created community centers (James & Gilliland, 2013). Crisis intervention has always been a rather controversial issue causing heated debates among the general public and specialists as to its significance and even a need for its existence and development. Today crisis intervention may be considered as a specific psychological subfield with its own scientific methods, strategies, and techniques that are most applicable in various kinds of crises and under different circumstances. However, this field would not have existed without several social grass roots movements like Vietnam veterans, women’s movement in the 1970s, and Alcoholics Anonymous that have managed to transform themselves and crisis intervention into specialties despite all the obstacles (James & Gilliland, 2013).

Thus, a social movement aimed at acknowledging existence and institutionalizing psychological assistance for Vietnam veterans has been essential in the development of crisis intervention as it has drawn public attention to the issue of special intervention being necessary after crises. Moreover, suicide hot lines and assistance agencies have been of utmost importance for establishing crisis intervention as a separate field of psychology. First crisis intervention agencies were opened in the 1970s on the basis of local YMCAs with the help of private donations (James & Gilliland, 2013). The aforementioned grass roots movements have been successful as they have managed to capture the media’s attention and impact on the public so that the latter could influence legislators and the government with a view to engaging the state into the provision of crisis intervention. Apparently, this success would not have been possible without the media as they exert essential influence on the public, which has transformed crisis intervention into a sort of a political agenda promoted by separate political groups with a view to gaining support of voters.

Although much is spoken today about crisis intervention and people suppose that the state is the main sponsor of all related activities both concerning daily incidents and major disasters, the reality is drastically different. In fact, most crisis intervention initiatives are launched and promoted by volunteers and private sponsors interested in particular problems like the prevention of suicide or relief campaigns to victims of natural disasters all over the world. Crisis intervention would be impossible without active participation of social activists and volunteers willing to undergo special training and constantly improve their skills while receiving no or diminutive monetary rewards for their activities. In fact, “more than three-quarters of all crisis centers in the United States indicate that they rely on volunteer crisis workers and that such volunteers outnumber professional staff by more than 6 to 1” (James & Gilliland, 2013, p. 5). Nevertheless, nowadays crisis intervention may be deemed an institutionalized field of study that receives some support from the government and continues developing both in terms of theoretical and empirical researches as well as the scope of activities and target crises managed by professionals. Apparently, this significant evolution of the field is proved by availability of a vast variety of researches and specialized literature, for instance, periodicals like “Crisis Intervention, Journal of Interpersonal Violence, Victimology, Violence and Victims, Journal of Traumatic Stress, Suicide and Life Threatening Behavior, Child Abuse and Neglect, Journal of Child Sexual Abuse, Aggression and Violent Behavior, and Violence Against Women” as well as numerous textbooks, handbooks, and manuals, among others. (James & Gilliland, 2013, p. 5).

Literature Review of Crisis Intervention Strategies

Since crisis intervention in all its forms and in all real-life situations stipulating professional assistance is currently a topical issue, there is a vast amount of literature available relating to all aspects of crises and intervention. Researchers develop various models and strategies and then apply them to real-life incidents and simulations with a view to testing their effectiveness and publishing respective studies. Other field specialists analyze and systematize all available information and publish different textbooks and manuals both for students specializing in crisis intervention and common persons interested in the topic and perhaps in volunteering for some crisis agencies. Thus, there are countless books and articles dedicated to the topic under consideration. The current paper uses several publications that seem to encompass major aspects of crisis intervention after a major international incident. Moreover, several mass media publications available online have been used to evaluate crisis intervention in the MH17 incident.

A book Crisis Intervention and Prevention seems to be a valuable source of information on the history of crisis intervention, its major models, possible reactions to crisis situations, skills required by crisis intervention specialists, and detailed study of several crises like homicide, suicide, sexual assault, and emergency, among others. The book gives a comprehensive overview of basic crisis intervention theories and advocates for a holistic approach to assessment of a crisis and subsequent intervention. It provides “underpinnings of working with clients in crisis”, giving valuable pieces of advice on how crisis intervention specialists should approach objects of intervention (Puleo & McGlothlin, 2010, p. 23).

Crisis Intervention Strategies by Richard K. James and Burle E. Gilliland has been referred to with a view to learning in detail about the history of crisis intervention and understanding why it should be institutionalized and why it should gain state support in order to be effective. The book offers personal and systemic crises definitions, thereby allowing one to distinguish different kinds of interventions required under different circumstances. Authors state that despite the popularity and acknowledgement of crisis intervention as a peculiar field of study, it still remains underdeveloped and understaffed as volunteers and private agencies play a crucial role in insuring that incidents are responded to adequately in terms of psychological support. Many people underestimate the importance of crisis intervention, especially in non-Western countries, as they suppose that people affected by crises should cope with consequences on their own. Therefore, they believe that the establishment of professional crisis intervention agencies is a waste of time, money, and human resources. Although the importance of crisis intervention is recognized in the USA, it is still underfunded and lacks comprehensive support at all levels in the country.

There are many different crisis intervention models and strategies, all of which are united by their “focus on resolving immediate problems and emotional conflicts through a minimum number of contacts” (Roberts, 2000, p. 15). Some of the most frequently applied models include Gilliland’s Six-Step Model, Triage Assessment System, Seven-Stage Model, and many others with their own particular strengths and weaknesses (Dass-Brailsford, 2007). In her book A Practical Approach to Trauma: Empowering Interventions, Priscilla Dass-Brailsoford offers an empowering crisis intervention model that she has developed as a synthesis of key models and has implemented in a number of real-life situations. In fact, her model comprises three major steps, which are “pre-intervention, assessment, and disposition” (Dass-Brailsford, 2007, p. 103). Pre-intervention consists in gathering as much background information as possible in order not to traumatize objects of intervention by asking too many questions about the crisis itself and the precipitating event. Moreover, a crisis intervention specialist benefits from learning about the incident that has led to the crisis as this way they can develop the most efficient strategy for coping with the situation with regard to individual peculiarities of intervention objects and the incident itself. The specialist also seems to be professional and supportive when approaching individuals in the crisis with sufficient background data. Assessment consists in learning concerns of intervention objects as well as identifying sources of potential help and support. At this stage, specialists seek information on how similar crises have been handled in the past and choose the most efficient strategies to be applied in their particular situation. The assessment stage should be swift, all-encompassing, and very accurate for achieving success of the overall crisis intervention. Disposition consists in active interaction with intervention objects aimed at bringing relief to them and assisting with their return to normal functioning. At this stage, specialists should decide whether to encourage intervention objects to talk about the precipitating event and crisis or let them keep silent on the matter. Furthermore, this stage presupposes “active client participation” and emphasizes importance of referring intervention objects “to other sources of help as soon as stability is established” as crisis intervention is usually short-term (Dass-Brailsford, 2007, p. 104).

The current paper uses seven strategies of crisis intervention developed by Albert Roberts and applied by the prevailing majority of crisis intervention specialists since the emergence of this Seven-Stage Model in the 1990s. These are the following:

1. Plan and conduct a thorough assessment…
2. Make psychological contact, establish rapport, and rapidly establish the relationship…
3. Examine the dimensions of the problem in order to define it…
4. Encourage an exploration of feelings and emotions.
5. Generate, explore, and assess past coping attempts.
6. Restore cognitive functioning through implementation of action plan.
7. Follow up and leave the door open for booster sessions 3 and/or 6 months later. (Roberts, 2000, p. 16)

The above strategies are evaluated on the example of MH17 incident based on relevant publicly available information in the next subsection of the paper.

After Action Evaluation of the Use of Crisis Intervention in Response to MH17 Incident

Immediately after the MH17 flight disappeared from radars and the Ukrainian authorities announced that a civilian plane was shot down, worried relatives and friends of MH17 passengers started arriving at Schiphol airport and Kuala Lumpur International Airport to wait for any news. Once the Dutch and the Malaysian authorities realized that the MH17 flight was shot down and there were no survivors, they stationed crisis counselors and psychologists at both airports and nearby hotels where some of the anxious relatives were staying. After another Malaysian airlines tragedy, the Malaysian government seemed to be better prepared in terms of launching an immediate crisis intervention campaign as they approximately knew what to expect. Medical teams were waiting in close proximity to rooms where airline officials announced to gathered relatives and friends the tragic news. The situation seemed to be worse for those who were informed of the tragedy by phone as there was no opportunity to offer them immediate counseling and support. Tension and anxiety of all parties involved were complicated by intense media attention and journalists’ improper activities aimed at interviewing grieving relatives after the announcement. Once some journalists obtained a list of supposed flight passengers, they started gathering information about them, and some families were contacted first by journalists rather than officials, which meant that they received the news not from specially trained professionals but from imprudent and intrusive media sharks fishing for sensations. Photos and gathered information as well as pictures of grieving relatives shot at airports and hotels were released continuously in the Internet on social platforms and in various newspapers, thereby depriving people of the possibility to grieve and come to terms with the news in privacy and under the supervision of professional counselors.

In Malaysia, all activities aimed at counseling persons affected by the tragedy were coordinated by the Malaysian Crisis Intervention Team under the guidance of the Ministry of Women, Family and Community Development. Moreover, about 20 psychologists were stationed at several locations, and the majority of them were sent to the Kuala Lumpur International Airport and the Marriot Hotel in Putrajaya where most relatives of victims were gathered. Minister Datuk Seri Rohani Abdul Karim announced that two crisis counselors were dispatched at once to Sarawak where families of seven victims lived (BorneoPost Online, 2014). On the day following the tragedy, Dr. Hariyati Shahrima Abdul Majid announced on behalf of Mercy Malaysia that this NGO intended to station about 50 trained crisis intervention specialists and volunteer counselors at the KLIA to offer support to families of the plane crash victims. Thus, the response to the crisis by the Malaysian authorities seems to be adequate and timely, which may be partially explained by its recent experience with the similar incident. Talking about the Dutch authorities, they sent police psychologists and some crisis intervention counselors to the Amsterdam airport to offer initial support to victims’ relatives waiting for news there. Moreover, they announced that each family of the Dutch passengers would be sent one counselor for obtaining professional assistance. Concerning relatives of victims from other countries, the Malaysian airline’s officials claimed that they were ready to offer any help these relatives needed and would provide them with counseling on request. Moreover, the airline transferred $5,000 to families of all deceased passengers and crew members for urgent needs.

• The first strategy of the Roberts’s model stipulates that it is necessary to “plan and conduct a thorough psychological and lethality assessment” (Roberts, 2000, p. 16). On the one hand, it is relatively easy for crisis intervention teams to assess the state of persons affected by the death of their loved ones in a plane crash since such incidents are not rare and there occurred a similar incident with the same airlines in March. However, this case was peculiar due to the fact that the plane did not simply crash but rather was shot down over the territory where there were raging active military actions. Counselors had to take into considerations that relatives requiring crisis intervention would experience a complicated mixture of feelings as they would also be angry at the guilty persons and worried because of the impossibility to access the crash site and take bodies of victims for proper burial. Their grief was accompanied by anger, anxiety, worry, and in some cases, despair because of the injustice and unexpectedness of the tragedy. Counselors had also to be aware that Ukrainians started uploading pictures and videos of the plane crash and crash site immediately after the crash. For instance, a gruesome picture of a dead baby lying in the open field by the plane remains was posted in Facebook by Anton Gerashchenko, a senior government advisor, with a comment directed at Vladimir Putin: “This baby’s death is on your conscience” (Corcoran et al., 2014). Thus, employing the first strategy, counselors had to assess how media responses and posts affected relatives emotionally in addition to gathering background information about relatives and their deceased. On the one hand, the media aided in promptly gathering information that could be valuable for counselors to better understand each particular case. On the other hand, counselors had to deal with repercussions of live streaming of victims’ photos and data, which could severely impact some grieving persons. Thus, especially thorough assessment had to be made for persons who lost entire families and children in this tragedy as people with no one left might display suicidal tendencies. At this stage, counselors also assessed whether some persons required medical attention, which was provided on site at the airports in Amsterdam and Kuala Lumpur to people fainting and feeling sick after hearing the news. However, there were no reports about hospitalization of affected persons.
• The second strategy urges to “make psychological contact and rapidly establish the relationship” (Roberts, 2000, p. 18). In fact, this stage was successfully implemented in the prevailing majority of cases as most counselors arrived at the airports prior to the announcement of the news and had an opportunity to somehow cushion the blow for most people affected by the crisis. Families that had not arrived to the airports were provided with counselors who arrived on the next day after the tragedy. Taking into consideration some logistics difficulties, this timespan may be deemed adequate under the circumstances as no one could have predicted the tragedy and sent crisis intervention teams in advance. However, there are some reports that contact was not established with some persons. Thus, a family of two victims told journalists that they had not been provided with counseling for more than a week after the crash and until they had repeatedly insisted on receiving one (The Times of India, 2014). On the whole, rapport with affected persons was successfully and timely established in the incident under evaluation.
• The third strategy states that counselors have to “examine the dimensions of the problem in order to define it” (Roberts, 2000, p. 18). There was no need to learn what precipitating event caused crisis as it was evitable. However, counselors had to take into consideration that crisis might be multidimensional for some affected persons like for the family of a victim that had already lost two members in a previous incident of the Malaysian airline in March of the same year. Counselors had to account for the fact that this particular family had to face the crisis for the second time within a short time span. Crisis intervention was also offered in the Netherlands at schools that killed children had attended, for instance, in the De Klimroos school in Roosendaal that “opened specially on the first day of the holidays to provide counseling for those who were close to the children” (Chazan, 2014).
• The fourth strategy urges to “encourage an exploration of feelings and emotions” (Roberts, 2000, p. 18). Thus, this strategy was successfully implemented by all counselors. Families, friends, colleagues, and all other affected persons openly expressed their feelings and emotions. Moreover, entire nations were mourning together with families. In fact, many of these emotional expressions occurred with the help of the media and social platforms like Twitter and Facebook. Counselors were with grieving families at all times and allowed them to direct their anger toward them as angry relatives had to express it to feel better. For instance, one victim’s father openly told his story:

You think you’ve got problems and then something like this happens and it all just takes over. I can’t even bring myself to look at a photograph of him. We are beyond devastated. It is such a beautiful sunny day, but our lives have been torn apart. (Corcoran, Boyle, McTague, & Linning, 2014)

Counselors managed to encourage all families to talk about their feelings, which might be deemed the first step toward emotional recovery as active listening played a crucial role in the process of crisis intervention.

• The fifth strategy stating “explore and assess past coping attempts” was also successfully implemented in the process of crisis intervention as there had been a similar incident several months before that, and crisis intervention teams already had experience of coping with the incident. Apparently, counselors could analyze and evaluate effectiveness of past coping attempts and develop tactics and employ approaches that suited each particular case. Counselors’ work in this particular incident was a bit easier as the plane did not disappear and families had a chance to bury their loved ones after a period of waiting required for retrieval of bodies and DNA identification in the Netherlands. Moreover, families of passengers from the MH370 missing flight who had already come to terms with their grief offered support to the MH17 victims’ relatives as “Right now they [the MH17 bereaved] are like we were in the beginning: quiet and wanting their space. But we are here for them, we actually know what they’re going through, we know this is so painful, so hard” (Hodal, 2014).
• The sixth strategy relating to the action plan was implemented as well. Counselors aided affected persons to make short-term plans on how to live after the incident and offered counseling throughout the entire timeframe from the news of the crash till burial of the deceased and even afterward if it was necessary. Some intervention objects felt like their life was over and counselors had to help them find a purpose in life even if for some this purpose was to demand justice to the perpetrators of the crime. Investigation has already announced some results, but the guilty party has not been brought to trial yet. While waiting for justice, persons undergoing therapy can develop other action plans and find other purposes in life. Counselors also advised religious persons to seek consolation in their faith.
• The seventh strategy emphasized the importance of follow-ups, but currently, there is no information available relating to the implementation of this strategy in the MH17 incident. In fact, follow-up is essential on anniversaries of the precipitating event. The wound is too raw and counseling is far from finished for many affected persons whose life has been turned upside down by the crisis. However, further counseling would be provided by psychologists rather than crisis intervention teams as their task was to offer initial support and short-term relief to affected persons, which they have managed to achieve based on available information and judging from commentaries and interviews of victims’ families. According to Dr. Abdul Jalif Hassan from the Malaysian Crisis Intervention Team, “the Malaysian families are mostly stable, and have come to terms with their loss” (KiniTV, 2014). As to the Dutch and other victims’ families, they receive all-encompassing support from their fellow citizens and counselors and gradually restore normal functioning levels in the new reality.

Recommendations

Although major seven crisis intervention strategies have been successfully applied in the MH17 incident, there are several recommendations how they could be improved with a view to increasing their efficiency in the future. First and foremost, media interference has to be regulated and significantly limited. Undoubtedly, the media play an essential role in drawing public attention to topical events, but in this particular case, affected persons have been deprived of the right to privacy. Their pictures have been published at all stages of the crisis intervention and constant publication of information about their loved ones may have complicated the process of coping with the crisis. Not all families consent to intrusion in their lives, particularly at such difficult times, and counselors have to cope with consequences of media interference in addition to the aftermath of the crisis itself. However, this recommendation is not only for counselors but for governments as well. Still, crisis intervention teams may explain their positions to the mass media representations in a bid to limit the exposure of their clients. Second, there is information that not all families have received appropriate counseling immediately after the incident and some of them had to insist on their right to obtain professional assistance. Third, the number of counselors stationed at the airports seems to be inadequate in comparison with the number of persons affected by the crisis. It is obvious that not all families received proper counseling, though it is the counselors’ fault as they had to manage with the limited resources. Thus, it is recommended to train more crisis intervention specialists and volunteers so that all persons requiring help would receive it in case of a similar incident. Fourth, there is no information whether victims’ families that live in countries other than Malaysia and the Netherlands have received any counseling at all. Although counselors were stationed in airports and hotels where the majority of families stayed, the airlines may have failed to provide support to the ones who did not wish to come either to the KLIA or Schiphol airport and decided to stay at home. Finally, there is no information about follow-ups in terms of crisis intervention and referral of some persons needing further counseling to other psychologists for long-term treatment. Perhaps, it is too early to organize follow-ups, yet officials should insure that this strategy will be implemented in the future.

Conclusion

After considering each element, it is possible to state that crisis intervention in the MH17 incident has been successful, efficient, and timely as most persons affected by the crisis were provided with professional assistance. Counselors adopted approaches that suited cases of each particular client. The prevailing tactic employed consisted in active listening and showing empathy to the clients. Counselors did not try to guide clients but simply listened to their stories as they were encouraged to talk about their feelings and emotions since the suppression of feelings might have been otherwise harmful in the long run. It was vital not only to make clients accept the tragedy but also realize that their loved ones were dead. Counselors did not advise clients to see disfigured remains of the MH17 victims, but some families still resolved to do that before burials, which in some instances, called for intervention by counselors to help them cope with anger and grief. In general, crisis intervention measures have been adequate and crisis intervention teams have proved their competence in dealing with effects of the plane crash. However, there are some recommendations how to improve crisis intervention measures in case a similar incident occurs in the future. One of the key recommendations is to increase the number of specially trained crisis intervention team members and volunteers as currently their number seems to be too insignificant to deal successfully and efficiently with large-scale crises.