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Learning From The Past and Planning For The Future
MENTAL HEALTH MOMENT August 9, 2002 "We are not permitted to choose the frame of our destiny. But what we put into it is ours." - Dag Hammarskjold
Short Subjects
LINKS Mental Health Moment Online CONFERENCES AND WORKSHOPS:
Seventh World Congress
on Stress, Trauma & Coping,
"Crisis Intervention in Baltimore, MD
a Changing World"
February 12-16, 2003
Call For Papers:
http://www.icisf.org/cfp.pdf Deadline: September 3, 2002
Proposal Form:
http://www.icisf.org/ presentation%20proposal%20form.docFifth Annual Innovations in Disaster Psychology Conference
"Psychosocial Reactions to Terrorist Attacks"
Sept. 29-Oct 1
Location: Radisson Hotel
Rapid City, South Dakota
4th World Congress on Stress
September 12-15, 2002
Edinburgh, Scotland
UNITED KINGDOM
Contact: Northern Networking Ltd
1 Tennant Avenue
College Milton South
East Kilbride, Glasgow G74 5NA
Scotland, UK
Tel: 44 (0) 1355 244966
Fax: 44 (0) 1355 249959
E-mail:
stress@
glasconf.demon.co.uk89th International Conference:
Stress and Depression
October 20, 2002
Milan, ITALY
Contact:
Istituto di Psicologia
Clinica Rocca-Stendoro
Corso Concordia 14
Milan 20129, Italy
Tel/Fax: 39-02-782627
E-mail: ist.roccastendoro@libero.itTENTH ANNUAL
SANTA FE SYMPOSIA
nine different weekend symposia
on a variety of mental
health topics.
October 11-27, 2002
Faculty includes:
Institute for Meditation &
Psychotherapy: Bill O'Hanlon,
Donald Meichenbaum,
Peter Tanguay and others.
For more information
and a brochure, contact:
New England
Educational Institute
92 Elm Street APA502
Pittsfield, MA 01202
Tel: (413) 499-1489
Fax (413) 499-6584
E-mail: educate@neei.org; Web: www.neei.org
PUBLIC BROADCASTING TO HELP PARENTS, TEACHERS WITH "NAMING THE NIGHTMARE"
In an effort to help parents and teachers guide children through the aftermath of Sept. 11, especially as media coverage focusing on its first anniversary begins to arrive, the award-winning "What's in the News" team with Penn State Public Broadcasting will offer a four-part video series on "Naming the Nightmare: The Journey Back from 9/11" as a free satellite feed for classroom and community use on Sunday, Sept. 8, from 7:30 to 9:30 p.m. EDT. In addition, "What's in the News" will host a live call-in program about terrorism targeted to middle-school students on Sept. 11. For the full story by Tracy Vosburgh, visit http://tango.outreach.psu.edu/Tango/OutreachNews/NewsRelease2.taf?function=detail&FullInfo_uid1=33854
"WHAT'S IN THE NEWS LIVE: Kids Ask About Terrorism" is live national call-in program hosted by Katie O'Toole, the writer and host of the award-winning program. The one-hour special will air on Wednesday, September 11, from 12:30 to 1:30 p.m. EDT.
The "What's in the News" broadcast team will unravel the mystery and message of terrorism, explore the social, religious and political factors of Islam, investigate how war and politics affect families, and take an insider's look at the public service agencies keeping the nation safe. Lesson plans and discussion guides, along with series transcripts, are available through the "What's in the News" Web site, http://www.namingthenightmare.org.
THE DEEPER ISSUES IN THE HOMELAND SECURITY REORGANIZATION
The rush to create a Department of Homeland Security has almost hidden a deeper issue: what direction the U.S. will take in designing and managing public organizations. In a new op-ed, Jeremy F. Plant, professor of public policy and administration at Penn State Harrisburg, writes that differences in House and Senate bills concerning the department illustrate two competing models of public management -- one much more business-oriented than the other. "What is needed is a model that takes the best parts of each and melds them in a way that maximizes their advantages," Plant says. "Business models are based on bottom-line decisions that are not appropriate for the public sector. Going to business methods to solve public administration problems is a bit like asking a dentist to perform open-heart surgery: much of the science is shared, but the specifics are profoundly different." For the full op-ed, visit http://www.psu.edu/ur/2002/jeremyplantoped.html
FEMA Funds Authorized For Colorado's Panorama Fire
The Panorama fire, burning in Garfield and Eagle Counties, is the latest to qualify for fire suppression assistance from the Federal Emergency Management Agency (FEMA).
Relief Operation Underway for Russia Flood Victims
Nearly one month after the worst flooding to strike southern Russia in 70 years took the lives of at least 110 people, some 332,800 affected residents are struggling to recover.
American Red Cross Aids Venezuela Flood Victims
The American Red Cross is working with the Venezuela Red Cross to bring immediate disaster relief to thousands of affected flood victims in the southwest region of the country.
VITAMIN C MINIMIZES RESPONSE TO PSYCHOLOGICAL STRESS
Vitamin C supplements may provide beneficial effects for people under stress, according to the results of a new study.
DISPATCH FROM MONTANA: TEAM BUILDS RELATIONSHIPS
Here are a series of dispatches about Penn State students who are at work in Montana helping build a literacy center for the Northern Cheyenne tribe using straw-bale architecture. The third dispatch is written by Christa Scott, a senior in Integrative Arts: "We are coming to the end of our first week and much progress has been made. The walls were completed by Wednesday evening and the trusses were placed Thursday. It is amazing to see how all these hands can contribute and make such fast progress. Our days are full and hot, however it has been nice at the end of each day to get to hear words and music from some of our friends in the tribe. They are sharing so much of their culture and we are all honored. As the straw-bale building is constructed, we too are building relationships and expanding our own knowledge." For the full dispatch, visit: http://www.psu.edu/ur/dispatch/montana/
THE ROLE OF MENTAL HEALTH IN EMERGENCY RESPONSE AND RECOVERY
Disasters are complex human, bureaucratic and political events. The numbers and types of responding agencies, groups, and jurisdictions increase tremendously. The relationships among organizations change. Alterations in the traditional divisions of labor and resources increase the need for multi-organizational and multi-disciplinary coordination among all responding participants. Without such coordination, the resources may not be shared or distributed according to need. Insufficient communication and control may result in a duplication of effort, omission of essential tasks and possibly even counterproductive activity.
PLANNING
A mental health disaster plan is essential for coordination of mental health emergency response efforts with other emergency response organizations during and following disasters. Each state department of mental health should have a mental health disaster plan which is a component of the state emergency management plan. In many states, the governor mandates a mental health disaster plan by executive order. Each department of mental health (municipal, county, or regional) should also have a mental health disaster plan. The plan should be a well-integrated component of the comprehensive emergency management plan of the jurisdiction. Some states have mandated this by legislation.
Purpose
The purpose of the mental health plan is to ensure an efficient, coordinated and effective response to the mental health needs of the affected population during times of disasters. It will enable mental health to maximize the use of structural facilities, personnel, and other resources in providing mental health assistance to disaster survivors, emergency response personnel, and the community (California Department of Mental Health, 1989; New Jersey Department of Human Services, 1991). The mental health disaster plan should specify the roles, responsibilities, and relationships of the agency to federal, state, and local entities with responsibility for disaster planning, response, and recovery.
Plan And Response
The mental health plan must also specify roles, responsibilities, and relationships within the mental health agency in responding to disasters (South Carolina Department of Mental Health, 1991). The plan should be organized so that it reaches each level and each component of the agency. It should also identify the respective individuals (by position) who are responsible for carrying out the functions. Individuals should all have back-ups, preferably three deep.
Mental health services to disaster survivors must be provided in community locations where survivors congregate, such as meal sites and shelters. Such sites are often operated by the Red Cross in cooperation with social services or other organizations. For long term recovery, mental health efforts must be integrated with other human services to survivors. Close cooperation with these agencies is necessary. Therefore, the mental health disaster plan is often a component of, or an attachment to, the social services/shelter plan. In some areas, mental health agencies have found it beneficial to include in their plan a Memorandum of Understanding (MOU) with the Red Cross, delineating roles and responsibilities of the two agencies. Mental health services to survivors may also be provided at hospitals, first aid sites, and the coroner's office. Consequently, the mental health plan requires coordination and integration with the emergency medical plan, the public health plan, and the coroner's plan.
Exercises
Mental health disaster teams should participate in the regular, official disaster drills of the jurisdiction. The role of mental health response in disasters is very new in some areas. Working side-by-side with more traditional disaster response agencies will increase the knowledge of mental health personnel regarding roles of other disaster responders. In addition, it will increase the knowledge of other disaster agencies regarding the roles and capabilities of mental health in disasters. It will help establish mental health as a regular and essential part of the response team.
If mental health has disaster responsibilities agreed upon with specific agencies, such as schools, special exercises of the conjoint disaster response will be important. If mental health has agreed to respond to incidents such as a school suicide or other tragedy, mental health response to those scenarios should be practiced before the event occurs.
ROUTINE EMERGENCIES
Management of day-to-day non-catastrophic emergencies in the United States is influenced by a national preference for local control. Because of this, tasks are divided among a multitude of community organizations (public and private) and individuals. Roles and responsibilities are determined by tradition, laws, contracts, and charters (Auf der Heide, 1989; Drabek, 1987; Quarantelli, 1981). Allocation of tasks and resources is fairly standardized and there is relatively little confusion (Auf der Heide, 1989). Community mental health agencies routinely interact in well-defined and understood relationships with other agencies such as social services, schools, law enforcement, probation, etc. In disasters, things change.
Management
The Federal Emergency Management Agency (FEMA) defines disaster as:
"An occurrence of a severity and magnitude that normally results in deaths, injuries, and property damage that cannot be managed through the routine procedures and resources of government. It...requires immediate, coordinated, and effective response by multiple government and private sector organizations to meet human needs and speed recovery" (FEMA, 1984).Disasters differ from routine emergencies in that they cannot be adequately managed merely by the mobilization of more personnel, equipment, and supplies. Disasters often create demands that exceed the capacities of single organizations. This requires them to share tasks and resources with other organizations that use unfamiliar procedures. As Auf der Heide (1989) has reported, disasters may cross jurisdictional boundaries. They change the number and structure of responding organizations, and may result in the creation of new organizations. They create new tasks, and engage participants who are not ordinarily disaster responders. Disasters also disable the routine equipment and facilities needed for emergency response.The complexity of government in the United States compounds the difficulty in understanding "who does what" in disaster responses. The 1982 Census of Governments found over 82,000 separate governments operating in this country. This decentralization results in a lack of standardization in disaster planning and response. It complicates coordination in times of disasters (Auf der Heide, 1989).
Additionally, organizations inexperienced in disasters often respond by continuing their independent roles, failing to see how their function fits into the complex, total response effort. Auf der Heide (1989) describes this as the "Robinson Crusoe syndrome" ("We're the only ones on the island").
This isolation occurs not just in response, but also in planning. Too often, private sector groups and different levels of government may not have plans that realistically consider the roles and resources of other groups.
Due to the complexities and challenges of disaster environments, key factors in an organization's effectiveness are flexibility and the ability to improvise. It is crucial, however, for responding agencies to educate themselves about the roles and responsibilities of other local, state, and federal agencies in times of disasters. They must plan for disaster response based on a solid knowledge of the organizational environment.
COMPREHENSIVE EMERGENCY MANAGEMENT
In order to manage disasters efficiently and predictably, a concept called Comprehensive Emergency Management (CEM) has been developed. It applies mitigation, preparedness, response, and recovery activities to all types of hazards in a municipal/county/state/federal partnership.
Mitigation is any activity aimed at reducing or eliminating the probability of a disaster. Zoning, land use management, and public education are examples of mitigation activities. Inspection and proper maintenance of mental health facilities include fire mitigation activities.
Preparedness includes endeavors that seek to prevent casualties, expedite response activities, and minimize property damage in the event of an emergency. Pre-disaster training of a specialized mental health disaster response team is an example pf preparedness activities.
Response activities occur immediately before, during, and after an emergency or disaster. Examples include search and rescue or implementation of shelter plans. Mental health response activities include providing mental health staff at shelters, first aid stations, meal sites, morgues, or command centers.
Recovery includes short and long-term activities. Short-term activities attempt initially to compensate for damage to a community's infrastructure and quickly return its vital life-support systems to operation. Short-term recovery assistance includes providing temporary housing, welfare, and unemployment assistance. Psychological first-aid, crisis intervention, and shift- change defusing (mini-debriefings) are short-term mental health recovery activities. Long-term mental health recovery activities include outreach, consultation and education, individual and group counseling, support groups and referral/information services. Both short and long-term mental health programs may be funded by a grant from the Federal Emergency Management Agency (FEMA) in a presidentially-declared disaster. The program is authorized by Section 416 of the Disaster Relief Act, Public Law 100-707 (FEMA, 1988).
INTEGRATED EMERGENCY MANAGEMENT SYSTEM
The second concept which currently helps to define roles and responsibilities of emergency management is the Integrated Emergency Management System (IEMS). Drabek and Hoetmer (1991) point out that Comprehensive Emergency Management (CEM) provides an inclusive framework that encompasses all hazards and all levels of government. It include the four phases of mitigation, preparedness, response and recovery. IEMS shows how the framework can be operationalized. It spells out the details of CEM. IEMS requires that a community carry out a hazard and risk analysis. The community then must assess its capabilities in the areas of mitigation, preparedness, response, and recovery. The shortfall between existing and required levels of capability leads to the development of a multiyear development plan. The plan usually covers a five-year period so that projects can be properly scheduled and funded, with annual work increments. Thus, IEMS supports the development of emergency management capabilities based on functions that are required for all hazards (e.g., warning, shelter, public safety, evacuation) (FEMA, 1983).
SUMMARY
Because the field of disaster mental health is highly specialized, mental health jurisdictions should have disaster plans that are thoroughly integrated with the Comprehensive Emergency Management (CEM) plan for their jurisdiction. It is advisable that in a disaster of any magnitude a mental health representative with decision-making authority should be present in the Emergency Operations Center (EOC). Mental health staff can also play a vital role in providing stress-management functions for EOC personnel during and after EOC operations.
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REFERENCES Auf der Heide, E. (1989). Disaster response: Principles of preparation and coordination. St. Louis, MO: C.V. Mosby Co.
California Department of Mental Health. (1989). Mental health disaster plan. Sacramento, CA.
California Department of Mental Health. (1989). California basic emergency plan. Sacramento, CA.
Drabek, T.E. (1985). Managing the emergency response. In Petak, W.J. "Emergency management: A challenge for public administration" (special issue). Public Administration Review 45: 85.
Drabek, T.E. and Hoetmer, G.J. (Eds.). (1991). Emergency management: Principles and practice for local government. Washington, DC: International City Management Association.
Federal Emergency Management Agency (1983). The Integrated Emergency Management System: Process overview. CPG 1-100. Washington, DC.
Federal Emergency Management Agency. (1984). Objectives for local emergency management. Washington, DC.
Federal Emergency Management Agency. (1985). National plan for federal response to a catastrophic earthquake: Basic plan (Draft 4). Washington, DC.
Federal Emergency Management Agency and National Institute of Mental Health. (1987). Student manual: Crisis counseling in emergency management. Washington, DC.
Federal Emergency Management Agency. (1988). Disaster assistance programs: Crisis counseling program: A handbook for grant applicants. DAP-9. Washington, DC.
New Jersey Department of Human Services, Division of Mental Health and Hospitals (December, 1991). Responsibilities and programs manual. Newark, NJ.
Quarantelli, E.L. (1981). Sociobehavioral responses to chemical hazards: Preparations for and responses to acute chemical emergencies at the local community level. Newark, DE: disaster Research Center, University of Delaware.
South Carolina Department of Mental Health (1991). State mental health disaster plan. Columbia, SC.
To search for books on disasters and disaster mental
health topics, leaders, leadership, orgainizations,
crisis intervention, leaders and crises, and related
topics and purchase them online, go to the following url:
https://www.angelfire.com/biz/odochartaigh/searchbooks.html
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Contact your local Mental Health Center or
check the yellow pages for counselors, psychologists,
therapists, and other Mental health Professionals in
your area for further information.
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George W. Doherty
O'Dochartaigh Associates
Box 786
Laramie, WY 82073-0786
MENTAL HEALTH MOMENT Online: https://www.angelfire.com/biz3/news
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