Chapter Seventeen: Disaster Chapter Seventeen: Disaster ResponseResponse

Natural Disasters with a Significant Natural Disasters with a Significant Impact on Disaster ResponseImpact on Disaster Response

San Fernando, CA, earthquake of 1971• “Quake-proofing kids”

Severe Flooding in 1972:• Rapid City, South Dakota• Wilkes-Barre, Pennsylvania

• Operation Outreach

• Logan County, West Virginia

Hurricane Katrina, 2005• FEMA

WorldwideWorldwide Disaster Mental Disaster Mental HealthHealth

The European Network for Traumatic Stress (TENTS)• Funded by the European Union• Provides services, expertise, and support to areas of the Union

that lack resources and availability of trained personnel

United Nations’ Inter-Agency Standing Committee (IASC)• Published IASC Guidelines on Mental Health and

Psychosocial Input Support in Emergency Situations

International Terrorism and International Terrorism and Human-Made DisastersHuman-Made Disasters

September 11, 2001• Homeland Security Act

Murrah Federal Building in Oklahoma City Violence in Schools:

• Columbine, CO• Virginia Tech University

International Events:• Suicide bombs in Israel• Hostage situation in a Russian theatre and school• Drug related guerrilla warfare in Mexico

Hyper-vigilance Repetitive and Graphic Media Coverage

Ecosystemic CrisesEcosystemic Crises An ecosystemic crisis is any disruptive or destructive

event that occurs at a rate and magnitude beyond the ability of the normal social process to control it.

• Impacts an entire community, region, nation, or the entire world• Sudden• Slow buildup• Human-made• Natural disaster• One intense episode• Several compounding incidents

Principles of a Principles of a Crisis Intervention EcosystemCrisis Intervention Ecosystem

Multiple/financial interventions are needed

The process is cooperative, collaborative, and consultative

There is a full range of targeted interventions aimed at individuals, institutions, communities, and nationals

The service characteristics of credibility, acceptability, accessibility, proactivity, continuance, and confidentiality should be adopted as “cast in stone” goals for service delivery in disaster-stricken areas

Response TeamsResponse TeamsNational Crisis Response Teams

• Development of Crisis Response Teams (CRTs)• National Organization for Victim Assistance (NOVA) CRTs• The Red Cross• Federal Emergency Management Agency (FEMA) • National Institute of Mental Health (NIMH)

Professional Organizations

Constructing an Outreach Team

Local Emergency Management Local Emergency Management SystemsSystems

Vertically and Horizontally Integrated Local Emergency Management Systems

• Role of Local EMA Directors• Background and Training• What Do Emergency Managers Do?• Planning for Disasters

Mental Health Components of Local EMAs• Personnel• Transdisaster (0–14 Days)• Postdisaster (15–365 Days)

What Happened With What Happened With Katrina?Katrina?

Lack of efficient communication Poor coordination plans Ambiguous authority relationships Who’s in charge? Everyone shifts the blame Counterterrorism versus all-hazards response Ambiguous training standards and lack of preparation Where is the “learning” in lessons learned? Performance assessment was not integrated into the process The geography of poverty Rumor and chaos Personal and community preparedness Disaster mental health and the role of mental health

professionals

Psychological First AidPsychological First Aid Psychological First Aid and Psychosocial Support as

Applied to Disaster Survivors• Make initial contact in a respectful manner• Gather and provide information regarding immediate physical and

safety concerns• Provide and direct people in regard to practical assistance needed• Provide for their safety and comfort by linking them with social

services• Teach them basic coping skills if requested• Get information and help that will connect them to social supports

Focus on the WorkerFocus on the WorkerDebriefing

• An intervention designed to assist workers and survivors in dealing with intense thoughts, feelings, and reactions that occur after a traumatic event, and to decrease their impact and facilitate the recovery of normal people having normal reactions to abnormal events

Debriefing Emergency Workers• Critical Incident Stress Debriefing (CISD)• Informal Defusing• Formal Debriefing

Debriefing Crisis Workers• The Need for Debriefing• Precautions• Dynamics of Debriefing• Confidentiality• Understanding