MODEL FOR IMPLEMENTATION OF A COMPREHENSIVE DISASTER BEHAVIORAL HEALTH PROGRAM IN THE LOCAL MENTAL HEALTH AUTHORITY

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MODEL FOR IMPLEMENTATION OF A COMPREHENSIVE DISASTER BEHAVIORAL HEALTH PROGRAM IN THE LOCAL MENTAL HEALTH AUTHORITY Cathy Stout, LMSW, Disaster Behavioral Health Coordinator James Turnage, LPC-S, Clinical Director MHMR of Tarrant County

PURPOSE: This presentation will provide a model for centers to develop and implement a comprehensive disaster behavioral health response and recovery program for the agency, consumers, and community.

GOALS Identify Phases of Model for Disaster Behavioral Health Response and Recovery Program Identify Roles of Disaster Behavioral Health for the Local Mental Health Authority (LMHA) Identify Benefits for Consumers, Staff, and the Community.

HOW TO This model demonstrates best practices to strengthen alliances and collaborations with Emergency Management Centers and community stakeholders.

HOW TO This presentation will provide information regarding our current status of development, and future goals.

PHASES OF MODEL FOR DISASTER BEHAVIORAL HEALTH RESPONSE AND RECOVERY PROGRAM

HOW TO Agency Consumers Community Plan Communication Building Capacity Coordination BE FLEXABLE

Phases of Emergency Management

Mitigation Identify Partner Agencies and Groups Identify Situations Develop Strategies Build Capacity Galveston, TX, October 10, 2008 -- Food prepared by Southern Baptist Convention volunteers is loaded onto a Red Cross IRV for distribution in Galveston. Working with The Salvation Army, this kitchen has prepared over one million meals since September 14, the day after Hurricane Ike struck. FEMA photo by Greg Henshall

Coordinate responsibilities with other agencies and groups Assess strengths and resources Share Training Develop / coordinate communication procedures Preparedness

Assess Situation Develop Action Plan Activate Teams Deploy Engage Re-Assess Houston, TX., September 2, 2005 -- A Red Cross volunteer comforts a survivor from hurricane Katrina in the Houston Astrodome. FEMA photo/andrea Booher Response

Recovery Assess continued needs of survivors Develop plans for continued services or link to longer term care providers. Coordinate Recovery activities with other Human Services groups When appropriate deactivate teams Coordinate with TMOC Evaluate Mitigate

RECOVERY Bolivar Peninsula, 12.6.08 FEMA Photo: Mike Moore They have been performing their tasks during extraordinary circumstance while they or their families may have also been impacted by the event.

NIMS IS A comprehensive nationwide systemic approach to incident management A core set of doctrine, concepts, principles, terminology, and organizational processes for all hazards. It is not a detailed operational or resource plan.

Organizational Commander Incident Commander MHMR Title MH Clinical Director NIMS Title Incident Commander Command Staff Incident Manager Officer General Staff Officer Chief Branch Officer Director Division/Group Leader Supervisor Unit Leader Leader Strike Team/Task force Leader Leader

INCIDENT TYPES Categorized into 5 Types : Rated from an Isolated Incident (Type 5) to the most complex (Type 1) Example: Type 5 Chisholm Trail Red Cross requests DBH assistance at a Shelter resulting from a large Apt fire. Type 1 Surge of evacuees from a coastal evacuation.

Much like the NIMS structure this document is a flexible framework that may be adapted to fit the specific incident. Itemizing: Objective Intended Methods Identified Needs and potential Resolutions Contingency planning After Action Procedures ACTION PLAN TEMPLATE

ROLES OF DISASTER BEHAVIORAL HEALTH FOR THE LOCAL MENTAL HEALTH AUTHORITY

HOW TO Agency Consumers Community Plan Communication Building Capacity Coordination BE FLEXABLE

ROLES OF DBH FOR LMHA Mitigate Psychological Impact of event on persons who are; survivors, evacuees, responders, and / or providers. Provide continuum of services for priority population; ECI, IDD, Child and Adolescent, Adult MH, and Substance Abuse.

ALLIANCES AND COLLABORATIONS Emergency Management Operations and Community Stakeholders Bridging the Gap

BRIDGING THE GAP Houston, TX, September 20, 2008 - - Disaster victims of Hurricane Ike wait patiently at a Disaster Recovery Center (DRC) to register for help. FEMA PHOTO Photographer: Leif Skoogfors 9.21.08

Tarrant County Emergency Operations Model

TMOC MHMR-TC CISM School Crisis Programs: FWISD, AISD, Birdville ISD DBH Groups/Orga nizations: MHA, Chisholm Trail ARC Human Services: Tarrant DHS, Homeless Services, Safe Haven Police Based Units: APD Victim Assistance, FWPD-CISM UTA School of Social Work Tarrant BH-CRT

Strengths in Consortia Maximize Strengths Consolidate Resources Common Language Known Expectations Similar Training Multi-Disciplinary Teams Minimize Duplication Minimize Burnout

EXERCISE Implementing a Phase Model while developing a comprehensive DBH Response and Recovery Program MHMR Of Tarrant County

Tuscaloosa, AL. 4.29.11l Photo: NOAA

NOAA

BENEFITS FOR CONSUMERS, STAFF, AND THE COMMUNITY

HOW TO Agency Consumers Community Plan Communication Building Capacity Coordination BE FLEXABLE

MCOT staff canvassed the flooded area over a 4 hour period engaging and providing psychological first aid to 41 adults and 21 children. Through collaborative efforts with FEMA, local EOCs, and VOAD / LTRC we were able to have a presence in the local Disaster Recovery Center for several weeks. HALTOM CITY, TX, JUNE 21, 2007 -- MEMBERS OF THE FEDERAL/STATE PRELIMINARY DAMAGE ASSESSMENT TEAM SURVEY DAMAGES IN A MOBILE HOME PARK DAMAGED BY FLOODING ON JUNE 18, 2007. FEMA/EARL ARMSTRONG

Hurricane IKE County Impact 2000 evacuees were sheltered in 20 shelters county wide Personnel 70 MHMR of Tarrant County personnel were trained in Psychological First Aid utilizing the Disaster Behavioral Health power point presentation 109 total staff were utilized in the Disaster Response Services Provided 170 Evacuees received individual services (duplicated) 100 Evacuees received individual services (non-duplicated) 387 Evacuees received brief educational and /or supportive services 43 Evacuees received physician appointments 87 Prescriptions were provided 3 Family groups received specialized support through MR services 2 Evacuee was hospitalized at Trinity Springs Pavilion

SUPER WEEK First development of Tarrant DBH- CRT 1 day training 120 DBH personnel Trained in PFA, TMOC, Delivering Bad News, and the DBH Super Week Action Plan Pre-roster teams

Knowing people will not request behavioral health services strategica lly place the workers in their way. Knowing people who are stressed cannot cognitively process as well provide basic information. Place DBH workers in the intake centers, shelters, DRCs, information meetings, any place where the survivors or folks impacted will be. Use brightly colored forms with clear concise information. Best Practices Lessons Learned

NEXT STEPS Develop Strategies with DBH-CRT and Tarrant DBH-CRT Continue to work with TMOC Continue work with VOAD / LTRC Develop Preparedness plan for consumers Train Staff and Consumers with Consumer Based Personal Preparedness Train Staff-Personal Emergency Preparedness Plan for staff and their families

QUESTIONS MHMR Of Tarrant County

RESOURCE CENTER http://www.fema.gov/emergency/nrf/ www.youtube.com www.ready.gov www.samhsa.gov/dtac www.badgeoflife.com www.noaa.gov