DISASTER MENTAL HEALTH SERVICES. Nancy Schneider, MA, NCC,LPCC Jo Hillard, RN, MSW
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1 DISASTER MENTAL HEALTH SERVICES Nancy Schneider, MA, NCC,LPCC Jo Hillard, RN, MSW
2 Neutrality Independence Voluntary Service Unity Universality AMERICAN RED CR0SS *****************END AGENT COMMUNIQUE***************** Please Store In A Safe Environment For Future Reference
3 DMHS MISSION DHMS has a dual mission to provide mental health support to disaster survivors/clients and workers accross the disaster continuum of preparedness, mitigation, response and recovery.
4 Disaster Relief Services Sheltering Feeding Distribution of bulk supplies Emergency aid stations Outreach Safe and Well Web Sites
5 (ont (ont (ont (ont (ont Client Casework - Information and referral Disaster Health Services Integrated Care Teams Disaster Spiritual Care Disaster Mental Health Services
6 Disaster Mental Health Activities Problem Solving, accessing resources Intervene with both staff and others Staff involvement - Psychological First Aid Works with staff at all levels to reduce stress and mitigate adverse outcomes
7 Psychological Impact of a Disaster Wide Range of Responses Dependent on age. culture, previous involvement with disasters/relief operations All domains of functions (emotional, cognitive, physical, behavioral, spiratual
8 Psychological Impact of a Disaster Most people are resilient over 50% of polulation reilient after 9/11 On average 30-40% will experience PTSD, depression or anxiety Children at greater risk
9 ARC Three-Element Intervention Strategy Intervention Strategy Intervention Strategy Triage and mental health survellance - Psy Start Promotion of resilience and copying skills Timely interventions to mitigate psycholgical complications of disaster
10 Element 1: Triage and Mental Health Surveillance Based on exposure-based risk factors Individual Psychological Triage Identify high risk clients, prioritize intervention and make rapid referrals Mental Health Surveillance for Incident Management Areas with high risk clients, exposure to additional symptoms, monitor worker exposure and keep state and local MH informed.
11 Psychological First Aid: All workers trained PsySTART triage - saw/heard death or serious injury Predictive DMH worker her higher risk survivors and more difficult tasks
12 Element 2: Promote Resilience and Coping Resilience and Coping Resilience and Coping Make a connection Help people be safe, encourage good coping, community information Listen, meet people s basic needs, psychoeducation Give accurate and timely information Take care of yourself
13 Element 3: Disaster Mental Health Interventions Assessments - community resources Crisis Interventions Casualty and grief support Advocacy
14 What We Don t Do Psychotherapy (Long or Short Term Individual Child Group Formal Evaluations ( Pick up Orders ) Critical Incident Stress Debriefings
15 Why Not Work is Short Term Some Interventions have concerns ab out efficacy or secondary trauma Best Time to Talk - is when you feel like it Difficulty doing pre-screening for groups
16 Working with Disaster Survivors/Clients Survivors/Clients Survivors/Clients Remember Maslow s Hierarchy Serivice are not always welcome Culture issues - both clients and workers Help Clients Help Themselves AA, NA Connect people with existing supports
17 Working with Disaster Survivors/Clients Survivors/Clients Survivors/Clients Remember that volunteers are relatively a homogenous group Offer realistic reassurances Be aware of disaster phases (threat, heroic, honeymoon, disillusionment and reconstruction.
18 DMHS Supports Individuals with disabilities - communication, medical health and/or mental health needs (appropriate level of care) Maintaining Independence (Coordinate with shelter staff) Supervision (assist with finding help) Transportation (assist with locating public services
19 DMHS Supports Work with State and Local Agencies Public Health Faith and Community Based Organizations NASW ARCA
20 Staff Mental Health Role Making self available Participate in orientations - issues of stress and coping skills Out Processing Post Deployment support ARC S Zero Tolerance Policy
21 Self Care!!! Not evey task is an emergency Often workers think their needs pale in comparison to others Self Care gets lost Chaotic environment -? who is driving the boat.
22 DMH Self Care Strategies Be a flexible worker End of day/shift review Provide your own structure -high tolerance to ambiguity Set Boundaries, accept what is yours and tolerate what is not. Contribute/build collaborate work environment Stay connected to family and friends
23 Disaster Relief Operation (DRO) Challenges (DRO) Challenges (DRO) Challenges Infrastructure and basic services impaired Hardship working conditions and staff shelters Working along side of strangers - staff conflicts Inexperienced workers and supervisors
24 Disaster Relief Operation (DRO) Challenges (DRO) Challenges (DRO) Challenges Workers constantly transitioning in an out The structure is complex. what is today will be different tomorrow Mentoring and teaching opportunities can be limited and infrequent What happens in life happens on a DRO
25 Challenges Unique to DMHS/DHS DMHS/DHS DMHS/DHS Informed Consents Multiple Roles Confidentiality HIPAA Ethics Mandatory Reporting Responsibilities not always understood by others
26 Local Chapter Involvement Take Core Courses Criminal Background Check Support for returning workers Relationship building Disaster Planning and Drill Participation
27 DMHS Questions and Hopefully Answers Jim Harvey at ARC
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