Preparing the Preparers: Educating Community Leaders in Emergency Preparedness & Planning

May 4, 2007May 4, 2007 www.mickmaurer.com mm152www.mickmaurer.com [email protected]@nyu.edu

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Preparing the Preparers: Educating Preparing the Preparers: Educating Community Leaders in Community Leaders in

Emergency Preparedness & Planning.Emergency Preparedness & Planning.

Michael T. “Mick” Maurer, PhD, MHAMichael T. “Mick” Maurer, PhD, MHA

Department of Applied Psychology, Department of Applied Psychology, NYU Steinhardt School of Culture, Education, and Human DevelopmentNYU Steinhardt School of Culture, Education, and Human DevelopmentAnd theAnd theBachelor of Science in Critical Infrastructure Protection degree programBachelor of Science in Critical Infrastructure Protection degree program(Homeland Security, Emergency Management, Business Continuity, and Strategic Intelligence)(Homeland Security, Emergency Management, Business Continuity, and Strategic Intelligence)

Paul McGhee Division Paul McGhee Division NYU School for Continuing & Professional StudiesNYU School for Continuing & Professional Studies

Special Populations


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AA Seriously injured victims • bereaved family membersSeriously injured victims • bereaved family members

BB Victims with high exposure to trauma • victims evacuated from the disaster zoneVictims with high exposure to trauma • victims evacuated from the disaster zone

CCBereaved extended family members and friends • rescue and recovery Bereaved extended family members and friends • rescue and recovery workers with prolonged exposure • medical examiner's office staff • service workers with prolonged exposure • medical examiner's office staff • service providers directly involved with death notification and bereaved familiesproviders directly involved with death notification and bereaved families

DDPeople who lost homes, jobs, pets, valued possessions • mental health providers People who lost homes, jobs, pets, valued possessions • mental health providers • clergy, chaplains, spiritual leaders • emergency health care providers • school • clergy, chaplains, spiritual leaders • emergency health care providers • school personnel involved with survivors, families, of victims • media personnelpersonnel involved with survivors, families, of victims • media personnel

EEGovernment officials • groups that identify with target victim group • businesses Government officials • groups that identify with target victim group • businesses with financial impactswith financial impacts

FF Community-at-largeCommunity-at-large

Population Exposure model


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Agency Type of Event Who is Eligible What is Provided When Provided

FEMA/CMHS Crisis Counsel-ing

Natural or human caused disaster. Must have Presidential declaration.

Anyone living, working, or in the declared area at the time of the disaster.

Outreach, short-term counseling, referral, and psychoeducational activities provided by mix of professionals and trained paraprofessionals.

Typically for about a year following a disaster. Does not provide long-term treatment.

Red Cross Mental Health Services

Any emergency. Special authorities in transportation emergencies.

Anyone in affected areas. Can provide services to families outside disaster area.

Counseling and referral by licensed mental health professionals.

Typically only for a few days/week following the event.

Office for Victims of Crime

Criminal acts only (including terrorism).

Crime victim's location not critical.

Variety of advocacy and other services including support for short- and long-term mental health services.

As long as necessary


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Natural vs. Human-Caused DisastersNatural vs. Human-Caused Disasters

Source: CMHS. Psychosocial Issues for Children and Families in Disasters. A Guide for Source: CMHS. Psychosocial Issues for Children and Families in Disasters. A Guide for the Primary Care Physician. Washington, D.C.: U.S. Department of Health and Human the Primary Care Physician. Washington, D.C.: U.S. Department of Health and Human Services; Publication No. (SMA) 96-3077, 1996.Services; Publication No. (SMA) 96-3077, 1996.

Natural Human-Caused

Causes Forces of nature Human error, malfunctioning

Examples Earthquakes, hurricanes, floods

Airplane crashes, major chemical leaks, nuclear reactor accidents

Blame No one Person, government, business

Scope Various locations Locations may be inaccessible to rescuers, unfamiliar to survivors, little advance warning

Post-disaster

Distress

High Higher, often felt by family members not involved in actual disaster


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Percentage Distribution of the Population Percentage Distribution of the Population By Race and Hispanic OriginBy Race and Hispanic Origin(Includes foreign and native-born (Includes foreign and native-born

populations)populations)

YearYear White White Black/ African Black/ African AmericanAmerican

American American Indian/ Indian/ Alaska Alaska NativeNative

****

Asian and Asian and Pacific Pacific

IslanderIslander

Hispanic/ Hispanic/ Latino Latino Origin*Origin*

19951995 73.673.6 12.012.0 0.70.7 3.33.3 10.210.2

20002000 71.471.4 12.212.2 0.70.7 3.93.9 11.811.8

20102010 67.3 67.3 12.512.5 0.80.8 4.84.8 14.614.6

20502050 52.8 52.8 13.213.2 0.80.8 8.98.9 24.324.3

21002100 40.340.3 13.013.0 0.70.7 12.612.6 33.333.3

* Persons of Hispanic/Latino origin may be of any race. Groups listed under “Race” are not of Hispanic origin.** Includes American Indians, Alaska Natives, and Aleuts.Source: U.S. Department of Commerce, Bureau of the Census. (2000). Projections of the resident population by race, Hispanic origin, and nativity: Middle series, 1999 to 2100. Washington, DC: U.S. Department of Commerce.


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Disaster Projects Confront Disaster Projects Confront DistrustDistrust

Several disaster crisis counseling projects supported by the Several disaster crisis counseling projects supported by the Federal Government have had to address the distrust of ethnic Federal Government have had to address the distrust of ethnic minority groups and their reluctance to use available resources. minority groups and their reluctance to use available resources.

For example, following the 1994 California earthquake, the disaster For example, following the 1994 California earthquake, the disaster crisis counseling project found that many immigrants’ distrust of crisis counseling project found that many immigrants’ distrust of government posed a barrier to their use of disaster services. government posed a barrier to their use of disaster services.

Likewise, some of the survivors of a hurricane in Alabama were Likewise, some of the survivors of a hurricane in Alabama were immigrants from Asian Communist countries who did not trust any immigrants from Asian Communist countries who did not trust any government and were not accustomed to receiving Government government and were not accustomed to receiving Government assistance.assistance.

California Final Report, 1995 • Alabama Final Report, 1999California Final Report, 1995 • Alabama Final Report, 1999


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Damage from Mississippi Damage from Mississippi Tornadoes UnequalTornadoes Unequal In the late 1950s, several tornadoes struck rural In the late 1950s, several tornadoes struck rural

Mississippi. Mississippi. The only persons killed were black. The only persons killed were black. A subsequent study found that many people in the A subsequent study found that many people in the

black community had great difficulty in coming to black community had great difficulty in coming to terms with this disaster. terms with this disaster.

They did not understand how a just God could They did not understand how a just God could discriminate in such a fashion between white and discriminate in such a fashion between white and black. black. Perry and Perry, 1959Perry and Perry, 1959


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Civil Unrest Causes Emotional Civil Unrest Causes Emotional Problems for RefugeesProblems for Refugees

The civil unrest and fires in Los Angeles that came The civil unrest and fires in Los Angeles that came in the wake of the Rodney King verdict affected a in the wake of the Rodney King verdict affected a community inhabited by many refugees from community inhabited by many refugees from Central America and Asia. Central America and Asia.

For immigrants who came from war-torn countries, For immigrants who came from war-torn countries, the Los Angeles disturbances reactivated fears the Los Angeles disturbances reactivated fears and emotions associated with their homeland. and emotions associated with their homeland.

Many experienced increased agitation, Many experienced increased agitation, depression, confusion, and recollections of prior depression, confusion, and recollections of prior bereavements. bereavements. California Final Report, 1994California Final Report, 1994


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Disaster Strikes a Highly Diverse CommunityDisaster Strikes a Highly Diverse Community On January 17, 1994, a major earthquake struck Los Angeles and On January 17, 1994, a major earthquake struck Los Angeles and

Ventura Counties. Ventura Counties. The Northridge earthquake was the largest and most violent to hit an The Northridge earthquake was the largest and most violent to hit an

urban area in the United States since the 1906 San Francisco quake. urban area in the United States since the 1906 San Francisco quake. The post-disaster recovery effort provided mental health services to 1.9 The post-disaster recovery effort provided mental health services to 1.9

million persons, representing myriad ethnic groups, special populations, million persons, representing myriad ethnic groups, special populations, and lifestyles. and lifestyles.

• The size and scope of the two affected counties, as well as the ethnic diversity of their residents, constituted a challenge to disaster mental health providers. • For example, Ventura County is home to many undocumented migrant farm workers, the majority of whom do not speak English and are mistrustful of government at any level. • Language and cultural barriers had to be overcome for persons from several Asian cultures as well. • The diverse population in the affected areas also included other special populations, such as physically challenged persons and runaway youth, two groups that required special outreach strategies. California Final Report, 1995


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Vulnerable Groups Vulnerable Groups Underserved by Science and Underserved by Science and TechnologyTechnology

• Elderly shut-ins during heat and cold Elderly shut-ins during heat and cold waveswaves• Illegal immigrants crossing southern border• Victims fearful of revealing identities• Publics vulnerable to terrorist attacks at home, in workplace, in mass transit, at play


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People with disabilities --

•are not currently included in emergency planning and little, if any, communication exists between planners and the disability community •have a wide variety of communication, support and health needs that differentiate them from persons without disabilities•tend to live in low income areas that include areas at higher risk for chemical emergencies


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Train response personnelTrain response personnel

There are very few materials available to use for information and There are very few materials available to use for information and training purposes, but the Red Cross (1998) has developed some training purposes, but the Red Cross (1998) has developed some materials on natural disaster sheltering and evacuation, and the materials on natural disaster sheltering and evacuation, and the Emergency Planning for People with Disabilities and Other Emergency Planning for People with Disabilities and Other Special NeedsSpecial Needs (Inclusion Incorporated, 1999) offer’s assistance in (Inclusion Incorporated, 1999) offer’s assistance in training personnel to deal with issues such as:training personnel to deal with issues such as:

TransportingTransporting Lifting or carrying people with disabilitiesLifting or carrying people with disabilities Assistance animalsAssistance animals Communication Communication Dealing with highly emotional people & appropriate languageDealing with highly emotional people & appropriate language


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Seven key principles should Seven key principles should guide disaster relief:guide disaster relief:

1.1. Accessible Disaster Facilities and ServicesAccessible Disaster Facilities and Services 2.2. Accessible Communications and AssistanceAccessible Communications and Assistance 3.3. Accessible and Reliable Rescue Accessible and Reliable Rescue

CommunicationsCommunications 4.4. Partnerships with the Disability CommunityPartnerships with the Disability Community 5.5. Disaster Preparation, Education, and Disaster Preparation, Education, and

TrainingTraining 6.6. Partnerships with the MediaPartnerships with the Media 7.7. Universal Design and Implementation Universal Design and Implementation

StrategiesStrategies


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Key Concepts of Disaster Mental HealthKey Concepts of Disaster Mental Health No one who sees a disaster is untouched by it. No one who sees a disaster is untouched by it.

There are two types of disaster trauma—individual and community.There are two types of disaster trauma—individual and community.

Most people pull together and function adequately during and after a Most people pull together and function adequately during and after a disaster, but their effectiveness is diminished by the effects of the event.disaster, but their effectiveness is diminished by the effects of the event.

Stress and grief in disasters are normal reactions to abnormal situations.Stress and grief in disasters are normal reactions to abnormal situations.

Many emotional reactions of disaster survivors stem from problems of Many emotional reactions of disaster survivors stem from problems of daily living brought about by the disaster. daily living brought about by the disaster.

Disaster relief assistance may be confusing to some survivors. They may Disaster relief assistance may be confusing to some survivors. They may experience frustration, anger, and feelings of helplessness related to experience frustration, anger, and feelings of helplessness related to Federal, State, and private-sector disaster assistance programs. Federal, State, and private-sector disaster assistance programs.

Most people do not see themselves as needing mental health services Most people do not see themselves as needing mental health services following a disaster and will not seek such services. following a disaster and will not seek such services.


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Survivors may reject disaster assistance of all types.Survivors may reject disaster assistance of all types.

Disaster mental health assistance is often more practical than Disaster mental health assistance is often more practical than psychological in nature. psychological in nature.

Disaster mental health services must be tailored to the culture of Disaster mental health services must be tailored to the culture of communities where they are provided.communities where they are provided.

Mental health workers should set aside traditional methods, avoid Mental health workers should set aside traditional methods, avoid mental health labels, and use an active outreach approach to mental health labels, and use an active outreach approach to intervene successfully in disaster. intervene successfully in disaster.

Survivors respond to active, genuine interest, and concern. Survivors respond to active, genuine interest, and concern.

Interventions must be appropriate to the phase of disaster.Interventions must be appropriate to the phase of disaster.

Social support systems are crucial to recovery.Social support systems are crucial to recovery.


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TrainingTraining

Independent Study Courses from Independent Study Courses from FEMA’sFEMA’s Emergency Management Institute. Emergency Management Institute. At this site find At this site find courses (in PDF files) for a number of emergency courses (in PDF files) for a number of emergency management topics. You may enroll in courses, take management topics. You may enroll in courses, take final exams or do independent study. final exams or do independent study.

Programs for Reaching Hearing Impaired.Programs for Reaching Hearing Impaired. The The Tennessee Fire Marshal’s office offers a course for Tennessee Fire Marshal’s office offers a course for safety educators in reaching people with hearing safety educators in reaching people with hearing disabilities in the event of fire.disabilities in the event of fire.http://www.state.tn.us/commerce/sfm/fireSafetyEducatihttp://www.state.tn.us/commerce/sfm/fireSafetyEducationResources.htmlonResources.html


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ArticlesArticles

Emergency Preparedness For People with Disabilities and other SEmergency Preparedness For People with Disabilities and other Special Needs: Another Look After Katrinapecial Needs: Another Look After Katrina Carl T. Cameron, Ph.D., Carl T. Cameron, Ph.D.,

Disaster!Disaster! This article in the November, 1994 issue of Mainstream This article in the November, 1994 issue of Mainstream Magazine deals with the gaps in emergency management related Magazine deals with the gaps in emergency management related to people with disabilities. to people with disabilities.

Coping With the Aftermath:Coping With the Aftermath: How Does Someone With An Anxiety How Does Someone With An Anxiety Disorder Cope In a Changed World? Kathleen Henning, 9/19/01. Disorder Cope In a Changed World? Kathleen Henning, 9/19/01.

Disaster Mitigation for Persons with Disabilities: Fostering a New Disaster Mitigation for Persons with Disabilities: Fostering a New Dialogue. A report by The Annenberg Washington Program in Dialogue. A report by The Annenberg Washington Program in collaboration with The President’s Committee on Employment of collaboration with The President’s Committee on Employment of People with Disabilities by Annenberg Senior Fellow Peter David People with Disabilities by Annenberg Senior Fellow Peter David Blanck. Blanck.


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WebsitesWebsites The Community Preparedness Website Project --The Community Preparedness Website Project -- www.preparenow.orgwww.preparenow.org. . This This

Website focuses on supporting the special needs of vulnerable populations in Website focuses on supporting the special needs of vulnerable populations in disasters. It includes a checklist for facility preparation & inventory of neighborhood disasters. It includes a checklist for facility preparation & inventory of neighborhood resources and information on how to prepare for disaster for people with special resources and information on how to prepare for disaster for people with special medical needs. medical needs.

Disaster Preparedness for Persons with Mobility Impairments-Disaster Preparedness for Persons with Mobility Impairments- www.nobodyleftbehind2.org/ www.nobodyleftbehind2.org/

American Red Cross.--American Red Cross.-- www.redcross.org/ -- www.redcross.org/ -- Disaster Preparedness for People With Disaster Preparedness for People With Disabilities Audio tapes. Educator’s information, Disaster Preparedness for people Disabilities Audio tapes. Educator’s information, Disaster Preparedness for people with disabilities, Curricula for schools, videos and more. with disabilities, Curricula for schools, videos and more.

The Disaster Preparedness and Emergency Response Association, International The Disaster Preparedness and Emergency Response Association, International (DERA). --(DERA). -- www.disasters.org/dera/dera.htmwww.disasters.org/dera/dera.htm “DERA was founded in 1962 to assist “DERA was founded in 1962 to assist communities worldwide in disaster preparedness, response and recovery, and to communities worldwide in disaster preparedness, response and recovery, and to serve as a professional association linking professionals, volunteers and serve as a professional association linking professionals, volunteers and organizations in all phases of emergency preparedness and management”. This site organizations in all phases of emergency preparedness and management”. This site also contains a calendar of conferencesalso contains a calendar of conferences

Federal Emergency Planning Agency (FEMA).Federal Emergency Planning Agency (FEMA). www.fema.govwww.fema.gov

Documents titled: Access to Agency Programs for People With Disabilities, Fire Documents titled: Access to Agency Programs for People With Disabilities, Fire Safety and the Disabled Program, Fire and the Elderly, and a Document titled Safety and the Disabled Program, Fire and the Elderly, and a Document titled Emergency Procedures for Employees with Disabilities in Office Occupancies atEmergency Procedures for Employees with Disabilities in Office Occupancies at http://http://janweb.icdi.wvu.edujanweb.icdi.wvu.edu


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Websites Websites

Emergency Preparedness Information Exchange (EPIX) Emergency Preparedness Information Exchange (EPIX) http://http://hoshi.cic.sfu.ca/epix/topics/training.htmlhoshi.cic.sfu.ca/epix/topics/training.html . Education, training, exercises and . Education, training, exercises and simulations.simulations.

United States Environmental Protection Agency (EPA). United States Environmental Protection Agency (EPA). www.epa.gov/ceppowww.epa.gov/ceppo . . Preparedness - Emergency Planning, Communities Right to Know. Preparedness - Emergency Planning, Communities Right to Know.

Occupational and Safety & Health Administration (OSHA). Occupational and Safety & Health Administration (OSHA). www.osha.govwww.osha.gov

National Organization for the Disabled. National Organization for the Disabled. www.nod.orgwww.nod.org. This website contains list of . This website contains list of websites addressing disabled and emergency planning and other useful websites addressing disabled and emergency planning and other useful information for planning.information for planning.

Disabled People and DP2 Disaster Planning. Disabled People and DP2 Disaster Planning. www.citycent.com/dp2/www.citycent.com/dp2/ This is a This is a California website that deals with disabled and access in earthquakes; however it California website that deals with disabled and access in earthquakes; however it is useful information for other situations.is useful information for other situations.

eSight. Emergency Plans That Include Workers With Disabilities eSight. Emergency Plans That Include Workers With Disabilities www.esight.orgwww.esight.org. .


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Websites Websites Emergency Power Planning for People Who Use Electricity and Battery Dependent Assistive TEmergency Power Planning for People Who Use Electricity and Battery Dependent Assistive T

echnology and Medical Devicesechnology and Medical Devices, June Kailes, 2006, June Kailes, 2006

Emergency Preparedness: Taking Responsibility For Your Safety - Tips for People with Emergency Preparedness: Taking Responsibility For Your Safety - Tips for People with Activity Limitations and DisabilitiesActivity Limitations and Disabilities. . (2006)(2006) Los Angeles County Emergency Survival Program, Los Angeles County Emergency Survival Program, posted 05/2/06 Making Community Emergency Preparedness and Response Programs posted 05/2/06 Making Community Emergency Preparedness and Response Programs Accessible to People with Disabilities (last accessed 08/12/06) Accessible to People with Disabilities (last accessed 08/12/06)

Serving and Protecting All by Applying Lessons Learned Including People with Disabilities and Serving and Protecting All by Applying Lessons Learned Including People with Disabilities and Seniors in Disaster Services, (March 2006), June Kailes and California Foundation for Seniors in Disaster Services, (March 2006), June Kailes and California Foundation for Independent Living, posted 05/2/06Independent Living, posted 05/2/06

Report on Special Needs Assessment for Katrina Evacuees (SNAKE) ProjectReport on Special Needs Assessment for Katrina Evacuees (SNAKE) Project , , National National Organization on Disability, 2005Organization on Disability, 2005

Saving Lives: Including People with Disabilities in Emergency Planning, National Council on Saving Lives: Including People with Disabilities in Emergency Planning, National Council on Disability, 2005Disability, 2005

Disaster Services and “Special Needs:” Term of Art or Meaningless Term?Disaster Services and “Special Needs:” Term of Art or Meaningless Term? June Kailes, 2005June Kailes, 2005

Survey of Hurricane Katrina Evacuees, September 2005, The Washington Post, Kaiser Survey of Hurricane Katrina Evacuees, September 2005, The Washington Post, Kaiser Family, Foundation, and Harvard University. Accessed 11/19/05 Family, Foundation, and Harvard University. Accessed 11/19/05