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New York State County Disaster Mental Health Planning and Response Guide

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A Guide for County Directors of Mental Health and Community Services

© University of Rochester, 2005.

This publication was made possible by a grant from the Health Resources and Services Administration (HRSA), titled "Hospital Bioterrorism Preparedness Program," HRSA Grant No. 15-0205-02 and 15-0255-03, Department of Health and Human Services (DHHS) and administered by the New York State Department of Health (NYSDOH)and Health Research, Inc (HRI). The contents of this publication are solely the responsibility of the author and do not necessarily represent the official views of DHHS, HRSA, NYSDOH, or HRI. The University of Rochester has granted a royalty-free, nonexclusive, irrevocable license to the United States Government and the State of New York to reproduce, publish, or otherwise use this publication and to authorize others to do so for federal, state, and local training purposes.

During the Spring of 2004, the Conference of Local Mental Hygiene Directors surveyed the Full Membership to explore the number of counties with written disaster mental health plans and disaster mental health response teams, and to inquire as to specific county needs for DMH planning and training.  Of the responding counties, 68% had a written disaster mental health plan, and over 70% had a disaster mental health response team.  Many county directors also expressed interest in obtaining relevant information to enhance their disaster mental health plans. And they sought innovative training and educational opportunities for their mental health professionals.

Following this survey, staff from the University of Rochester Medical Center, New York State Office of Mental Health, the Conference, and the New York State Department of Health convened five disaster mental health forums across the state.  These forums brought together key individuals representing government and private agencies instrumental in providing mental health services during times of disaster.  Managers of local public health agencies, emergency medical services, public safety agencies, and county emergency management were also invited to attend.  During theses forums  participating agencies were asked to review their disaster mental health plans with particular attention to their county's methods for the recruitment, training, and deployment of mental health professionals during disasters.  Additionally, the agencies were asked to identify how special populations such as sovereign nations, prison populations, the presence of nuclear power plants, or the sharing of international borders were addressed in their plans.

The information gathered from these forums, combined with the review of other federal, state, and local mental health disaster plans, has resulted in the development of the enclosed County Mental Health Disaster Planning and Response Guide.  This guide is an informational resource which allows county directors to follow a set structure in the development of a comprehensive disaster management strategy. It can be used to complement current plans, serve as a guidepost with regard to disaster planning, or to develop new mental health disaster plans.  As a collaborative partner in this effort, we hope you find this advisory publication a useful tool for use in your county.

To further advance this goal, representatives from the original planning team will be available to meet with each county and assist the county director in the effort to develop or maintain the county's disaster mental health planning and response document.  Over the coming months OMH representatives will contact each county mental hygiene department to offer this assistance.

We would like to take this opportunity to thank the University of Rochester Medical Center and the New York State Department of Health for their contribution to the strong partnership with the Conference and the Office Of Mental Health which has resulted in the publication of this valuable resource.  We would like to especially thank Jack Hermann from URMC for his dedication to this work and the arduous effort he made to craft this guide.   Its successful development affirms the importance and necessity of building a comprehensive network encompassing community stakeholders for disaster mental health planning.  It will serve as an important tool to promote increased resiliency and effective recovery in the aftermath of disaster.

1. General Overview

1.1 Planning/Preparedness

1.2 Mitigation

1.3 Response

1.4 Recovery

1.5 Evaluation

2. Planning and Preparedness

2.1 Convene a Disaster Mental Health Advisory Committee

2.1.1 County/City Stakeholders

2.1.2 Regional/State/Federal Stakeholders

2.1.3 Other Public/Private Agencies and Organizations

2.2 Review Your County Disaster Plan

2.3 Review Disaster Plans for Local Disaster Response Agencies

2.4 Develop a Comprehensive Mental Health Disaster Plan

2.4.1 Mental Health Disaster Plan-Key Elements

2.5 Develop Disaster Mental Health Response Teams

A county disaster mental health response team provides a significant resource to the community. Following a disaster, the majority of those affected will experience a range of reactions that can be both stressful and impact personal functioning. Disaster mental health response teams provide important supportive mental health interventions that may mitigate both the acute and long-term psychological consequences of disaster. Consideration must be given to the key issues listed below in the development of a county disaster mental health response team:

2.6 Establish Memorandum of Understanding with Community Partners

2.7 Participate in County Disaster Drills and Exercises

3. Mitigation

3.1 Identify High Risk Areas and Populations

3.2 Develop Disaster-Related Informational and Educational Brochures

3.3 Develop Operational Protocols to Manage Spontaneous Volunteers

4. Response

4.1 Activate Response Protocols for Disaster Mental Health Team(s)

4.2 Coordination with Other Community Disaster Mental Health Teams

4.3 Assess the Mental Health Needs of the Impacted Population

4.4 Initiate Early Phase Supportive Interventions

Early Phase Supportive Interventions

4.5 Identify High Risk Populations and Implement Appropriate Early Phase Interventions

4.6  Distribute Public Mental Health Educational Materials

4.7 Collaborate with County Government in Risk Communication

4.8 Implement Supportive Interventions for Disaster Mental Health Teams

5. Recovery

5.1 Evaluate the Intermediate and Long-Term Mental Health Needs of the Community

5.2 Identify Community Resources to Provide Mental Health and Substance Abuse Services

5.3 Train Mental Health Professionals in Intermediate and Long-Term Mental Health Treatment Interventions

Intermediate/Long-Term Treatment Approaches

Efforts should be made to train mental health professionals in these treatment approaches prior to or shortly after disaster strikes the community.

5.4 Implement Supportive Interventions for DMH Teams and Other Disaster Personnel

6. Evaluation

6.1 Conduct Periodic Disaster Drills and Tabletop Exercises

6.2 Convene an "After Action" Committee Following the Implementation of the Mental Health Disaster Plan

7. Appendix A: References and Resources

7.1 Planning Tools and Technical Resources

CDC Public Health Emergency Response Guide for State, Local, and Tribal Public Health Directors, 2004

Department of Health and Human Services, Centers for Disease Control and Prevention
http://www.bt.cdc.gov/planning/pdf/cdcresponseguide.pdf Leaving OMH site (PDF)

Community Guidelines for Developing a Spontaneous Volunteer Plan

Illinois Terrorism Task Force Committee on Volunteers and Donations
http://www.state.il.us/iema/spontvol.PDF Leaving OMH site

Disaster Technical Assistance Center

U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Mental Health Services
http://www.mentalhealth.samhsa.gov/dtac/ Leaving OMH site

Early Intervention for Trauma in Adults: A Framework for First Aid and Secondary Prevention

Litz, B.T. and Gray, M.J., In "Early Intervention for Trauma and Traumatic Loss." Edited by Brett T. Litz. The Guilford Press, 2004.  Pp 87-111.

Mental Health All-Hazards Guidance Document, 2003

U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Mental Health Services
http://mentalhealth.samhsa.gov/dtac/FederalResource/Preparedness/1-All-Haz_Guide_with_covers_Screen.pdf Leaving OMH site (PDF)

Mental Health and Mass Violence: Evidence-Based Early Psychological Intervention for Victims/Survivors of Mass Violence

National Institute of Mental Health (2002)
http://www.nimh.nih.gov/health/publications/massviolence.pdf Leaving OMH site (PDF)

National Center for Post Traumatic Stress Disorder

www.ptsd.va.gov Leaving OMH site

National Institute of Mental Health

www.nimh.nih.gov Leaving OMH site

National Memorial Institute for the Prevention of Terrorism

www.mipt.org Leaving OMH site

New York State Education Department, Office of the Professions, Online Verification

http://www.op.nysed.gov/opsearches.htm Leaving OMH site

New York Office of Alcoholism and Substance Abuse Services

http://www.oasas.ny.gov/ Leaving OMH site

State mental Health Authorities' Response to Terrorism, 2004

National Association of State Mental Health Directors
http://www.nasmhpd.org/general_files/publications/med_directors_pubs/Med%20Dir%20Terrorism%20Rpt%20-%20final.pdf Leaving OMH site (PDF)

7.2 Risk Communication

Communicating in a Crisis: Risk Communication Guidelines for Public Officials

U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), 2002
http://www.riskcommunication.samhsa.gov/index.htm Leaving OMH site

7.3 Disaster-Related Agencies and Programs

American Red Cross

www.redcross.org Leaving OMH site

Department of Homeland Security

www.dhs.gov Leaving OMH site

Federal Emergency Management Agency (FEMA)

www.fema.gov Leaving OMH site

National Voluntary Organizations Active in Disaster (VOAD)

www.nvoad.org Leaving OMH site

New York State Office of Emergency Management

http://www.dhses.ny.gov/ Leaving OMH site

Project Liberty

New York State Office of Mental Health (OMH)
http://www.projectliberty.state.ny.us/

7.4 Special Populations

American Academy of Child & Adolescent Psychiatry

www.aacap.org/publications/factsfam/disaster.htm Leaving OMH site

Crisis Counseling Guide to Children and Families in Disasters

New York State Office of Mental Health
http://www.omh.ny.gov/omhweb/crisis/crisiscounselingguide.pdf

Developing Cultural Competence in Disaster Mental Health Programs: Guiding Principles and Recommendations (2003)

U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Mental Health Services.
http://www.mentalhealth.samhsa.gov/publications/allpubs/SMA03-3828/default.asp Leaving OMH site

Disaster Mental Health: Crisis Counseling Programs for the Rural Community (1999)

U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Mental Health Services.
http://www.mentalhealth.org/publications/allpubs/sma99-3378/default.asp Leaving OMH site

Psychosocial Issues for Older Adults in Disasters (1999)

U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Mental Health Services.
http://download.ncadi.samhsa.gov/ken/pdf/SMA99-3323/PsyIssues_OlderAdults_79p.pdf Leaving OMH site (PDF)

Responding to the Needs of People with Serious and Persistent Mental Illness in Times of Major Disaster (1996)

U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Mental Health Services.
http://www.mentalhealth.org/publications/allpubs/SMA96-3077/default.asp Leaving OMH site

Tips for Talking About Traumatic Events

U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Mental Health Services.
http://www.mentalhealth.samhsa.gov/cmhs/TraumaticEvents/tips.asp Leaving OMH site

The National Child Traumatic Stress Network

http://www.nctsnet.org/ Leaving OMH site

7.5 Intervention Resources

Early Intervention for Trauma in Adults: A Framework for First Aid and Secondary Prevention

Litz, B.T. and Gray, M.J., In "Early Intervention for Trauma and Traumatic Loss." Edited by Brett T. Litz. The Guilford Press, 2004.  Pp 87-111.

Grief Counseling Resource Guide

New York State Office of Mental Health
http://www.omh.ny.gov/omhweb/grief/

Mental Health Intervention for Disaster

National Center for Post-Traumatic Stress Disorders (NCPTSD)
http://www.ptsd.va.gov/professional/pages/early-intervention-disasters.asp Leaving OMH site

7.6 Training Resources

Disaster Mental Health: A Critical Response

University of Rochester Center for Disaster Medicine and Emergency Preparedness
www.centerfordisastermedicine.org Leaving OMH site

Field Manual for Mental Health and Human Service Workers in Major Disasters

U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Mental Health Services (2000)
http://www.mentalhealth.samhsa.gov/publications/allpubs/ADM90-537/Default.asp Leaving OMH site

Mental Health Response to Mass Violence and Terrorism: A Training Manual

U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Mental Health Services
www.samhsa.gov Leaving OMH site

National Disaster Mental Health Training Program

National Center for Post Traumatic Stress Disorder (NCPTSD)
http://www.ptsd.va.gov/about/training/clinical-training-program.asp Leaving OMH site

Triumph Over Tragedy: A Community Response to Managing Trauma in Times of Disaster and Terrorism

Edited by Evans, G.D., Wiens, B.A., The National Rural Behavioral Health Center, 2004.
http://www.nrbhc.org/news_detail.asp?ID=11 Leaving OMH site