Inside Eliot’s Critical Incident Response Team

Mental Health Awareness Month Feature | May 2026

Featuring insights from Deborah Garfield, Director of Clinical Training & Implementation; Nerissa McCormick, Director of Clinical Development; and Keith Wales, Senior Director of Strategic Program Development

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Eliot’s staff show up every day for some of the most vulnerable people in our communities, sitting with grief, witnessing trauma, holding space for people in crisis. They do it with skill, compassion, and selflessness.

At the same time, behavioral health work can carry a weight that doesn’t always lift at the end of the day. Secondary trauma and vicarious stress are occupational realities, not personal failures. Addressing this requires real infrastructure, which is why Eliot built its Critical Incident Response Team (CIRT).

CIRT is a fundamental component of Eliot’s intentional, in-house staff wellness infrastructure: a trained team of clinicians and leaders who provide structured, evidence-based support following serious incidents, alongside ongoing proactive wellness programming across the organization. As Mental Health Awareness Month invites us to focus on the mental health of our communities, it’s worth turning that lens inward toward the people doing the work.

A Gap That Needed Filling

CIRT didn’t emerge from a policy document. It grew from a recognized need, and from the honesty to name it.

“The organization formally recognized that there had been no formal mechanism from which we could respond when there was a client death or there was a suicide,” Deborah Garfield, Director of Clinical Training & Implementation, recalled. This became a catalyst. Eliot partnered with Riverside’s Trauma Center, an organization that has responded to events as significant as the Boston Marathon bombing and is contracted by the state to support school communities following suicides, to train a formal team in Critical Incident Response and Psychological First Aid. That was roughly 15 years ago.

Since then, CIRT has grown into a multi-faceted staff wellness program serving the full breadth of Eliot’s workforce.

Two Tracks, One Purpose

CIRT operates on two parallel tracks, each designed for a different kind of need.

The first is critical incident response: a structured, evidence-based team activation that follows events like client deaths, staff assaults, or other traumatic occurrences. When a manager submits a request, the coordination moves quickly: outreach to determine what staff need, volunteer responders identified, and a debrief session organized, often within 24 to 48 hours. In some cases, responders have arrived the same day.

The format follows the Psychological First Aid model: a structured sequence that moves through what happened, what people were thinking, what they were feeling, what they noticed in their bodies, and what they plan to do to care for themselves going forward.

“We normalize those thoughts and feelings, and we provide some psychoeducation around some red flags to look at — like if you notice that after a period of time you’re not going to the Zumba class you like, or you find yourself having challenges getting along with your family, or just anything outside of the ordinary,” explained Nerissa McCormick, Director of Clinical Development. “And there’s definitely some dialogue around how these kinds of incidents can bring up things we’ve experienced in our personal lives.”

Importantly, participation is always voluntary, and what happens in a CIRT response remains confidential. “We make it very clear that we’re not there in any kind of investigative capacity,” Keith Wales, Senior Director of Strategic Program Development, emphasized. “We want a team lead or even people in more senior roles to feel comfortable being their human selves in the forum.”

The second track is proactive wellness programming: the self-care groups that have now reached more than 50 programs across Eliot’s Mental Health Division, with expansion to the Homeless Services Division underway. These sessions aren’t tied to a specific incident. They’re designed to pause, acknowledge the ongoing weight of the work, and reconnect staff to the reasons they chose it in the first place.

What the Sessions Actually Do

Ask anyone on the CIRT team what surprised them most about the self-care group sessions, and you get a consistent answer: the pride.

“People were able to talk about some of the unique things each program does with such a sense of pride that I don’t think they have an opportunity or platform to do so,” Garfield reflected. 

The sessions also surface something that rarely happens in the rhythm of day-to-day work: the direct exchange of gratitude between staff and managers.

“So many staff talked about their relationship with their manager and how important that person was in their life,” noted Garfield. “I don’t think that happens very often, that the manager gets this personal feedback. But it was also so nice to see the manager being able to give that same praise and positive feedback back to the staff in an organized way.”

Staff have also repeatedly asked the team to come back, a signal the team noted that something real was happening in those rooms. “The feedback I got was that it was really helpful to say some of the things they were saying out loud, and to rethink how they care for themselves and be reminded of why they do the work,” McCormick said.

Sustaining the Capacity to Care

There’s a clinical logic at the heart of what CIRT is doing, and the team articulates it clearly.

Behavioral health staff spend their professional lives doing precisely what these sessions model: collaboratively developing coping strategies with the people they serve, normalizing difficult emotions, building resilience. The self-care groups ask a simple but meaningful question: what if we did that for the staff, too?

“We thought: how could this be translatable to what we’re doing to support our staff? What if we gave them a spotlight and made it about them?” said Garfield. “As a field in general, a lot of us are in our intuition to nurture, our intuition is to care for the people served. And we — I definitely include myself in this bucket — we oftentimes don’t focus on our own needs.”

That shift matters organizationally, not just individually. Staff who have space to process secondary trauma and reconnect to their purpose are staff who can sustain their commitment over the long term. The evidence is visible in Eliot’s own workforce: across the programs the CIRT team has visited, they’ve encountered staff who have been with the organization for 15, 20, 30, even 35 years.

“Almost universally across all the programs, I came across people who have been working for us for 15, 20, 30, 35 years — just like service with distinction — and still with that fire in the belly, that passion for making a difference,” Wales said. “It was really inspiring.”

What It Means to Feel Seen

Perhaps the deepest thread running through the CIRT work is something harder to measure than session counts or response times: validation.

In new staff orientation, Eliot communicates something that newer employees often say they’ve never heard from an employer before.

“One of the things I often say is: whenever you’re dealing with a really difficult situation, this is one way that you know you are not alone,” said Garfield. “People have said to me, ‘I’ve never heard an organization talk about it in that way — that they’ve acknowledged the work is not just a reflection of them, but a reflection of the entire organization.’ And that feels really comforting.”

For CIRT, that’s the point. As McCormick puts it: “This goes beyond the surface-level tasks that people have. It’s a validation of what else it takes.”

What it takes, in behavioral health work, is enormous. The willingness to sit with someone else’s pain, to hold steady through a client’s worst moments, to return to that work again and again over a career — that requires more than training and a job description. It requires an organization that sees the whole person, not just the worker.

Where It Goes Next

The Mental Health Division was, as the team put it, “just the start.” With the Homeless Services Division now requesting quarterly self-care groups, and a formal participant survey in development to track the program’s impact over time, CIRT is building toward something with amplified organizational reach.

The work has also drawn external validation: Larry Berkowitz, former head of Riverside’s Trauma Center and one of the leading figures in the psychological first aid field, recently trained Eliot staff and reflected on Eliot’s powerful commitment to expanding its evidence-based support response for staff. 

In a field that can ask workers to give more than organizations sometimes give back, that kind of commitment matters. It’s a statement about what Eliot believes behavioral health work actually requires and who deserves to be supported in doing it.

This Mental Health Awareness Month, that’s worth naming.

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Eliot Community Human Services provides behavioral health, human services, and supports to individuals and families across eastern Massachusetts. To learn more about careers at Eliot, visit eliotchs.org/careers.