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17 disaster response



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  • 1.  Chapter Seventeen
  • 2.  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
  • 3.  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
  • 4.  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
  • 5.  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
  • 6.  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
  • 7.  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
  • 8.  Microsystem Mesosystem • Primary Mesosystem • Super Mesosystem Exosystem Macrosystem Chronosystem • The Individual • The Society
  • 9.  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
  • 10.  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
  • 11.  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
  • 12.  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)
  • 13.  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
  • 14.  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
  • 15.  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