Week 8: Reflection & Summary

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 Women’s movement in the 1960s and 1970s  Community Mental Health Act, 1963  Disaster Relief Act, 1974

• Section 413  Federal Emergency Management Agency (1978)  Classification of PTSD as a personality disorder in the

DSM-III (1980)  American Red Cross establishes a mental health

certification program (1990s) • Hurricane Hugo • Loma Prieta earthquake

 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

 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

 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

 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

Types of Ecosystemic crises: • Metastisizing Crises

• Start small but, if not contained both physically and psychologically, can quickly turn into large-scale crises

• Large-Scale Crises • At a minimum affect whole communities or regions

either directly or vicariously

• Mega-crises • Affect entire countries or the world, either directly or

vicariously

Microsystem Mesosystem

• Primary Mesosystem • Super Mesosystem

 Exosystem Macrosystem  Chronosystem

• The Individual • The Society

 Systems must be interdisciplinary

 The system must be multitheoretical

 Individuals are part of the ecosystem

 Multiple contexts must be considered

 Time is of the essence

 Meaning is important

 Parsimonious 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

 National 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

 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)

 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 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

 When More Than PFA Is Needed

 The Current State of Affairs

 Debriefing • 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