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Disaster Mental Health Institute The University of South Dakota September 30, 2002 The Development of a Regional Disaster Mental Health Response Plan Using.

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Presentation on theme: "Disaster Mental Health Institute The University of South Dakota September 30, 2002 The Development of a Regional Disaster Mental Health Response Plan Using."— Presentation transcript:

1 Disaster Mental Health Institute The University of South Dakota September 30, 2002 The Development of a Regional Disaster Mental Health Response Plan Using Academic Medical Center, Local and State Governments : A Maryland Consortium Effort

2 September 30, A Collaborative Presentation Kathi Beauchesne, Ph.D, MBA, LCSW-C Director, Faculty and Staff Assistance, Student Assistance, and WORKlife Programs—Johns Hopkins University/Johns Hopkins Hospital Carrie Burmaster, LCSW-C Director, University of Maryland Baltimore Counseling Center Michael Kaminsky, M.D., MBA Vice Chairman for Clinical Affairs, Department of Psychiatry, Johns Hopkins Hospital Chair, Mental Health Disaster Planning Committee Disaster Mental Health Institute, The University of South Dakota

3 September 30, What we will do today… I.Setting the stage: Why Academic Medical Center? (Kaminsky) II.The story of a disaster plan process (Beauchesne) III.A systems analysis of a planning process (Burmaster) Disaster Mental Health Institute, The University of South Dakota

4 September 30, Special thanks for the guidance of… Clete DiGiovanni, M.D., Consultant for DOD and FBI George S. Everly Jr., Ph.D, Co-founder and Board Chair Emeritus, International Critical Incident Stress Foundation Tony Ng. M.D., Medical Director, Disaster Psychiatry Outreach Elizabeth Monahan-Gibson, Region III, FEMA Voluntary Agency Liaison Disaster Mental Health Institute, The University of South Dakota

5 September 30, The usual situation Hopkins and Maryland are institutional rivals Hospital Disaster Plans tend to be internal, to meet the needs of patients who present at the Emergency Room door Governmental bodies develop their own plans Disaster Mental Health Institute, The University of South Dakota

6 September 30, Wise Charges: Develop plans to meet the needs of faculty, staff, and students as well as their dependents in the event of a disaster Disaster Mental Health Institute, The University of South Dakota

7 September 30, Goals: Develop plans to minimize the impact of a disaster on the target populations Ensure that psychological sequela do not not impair the functioning of the institutions Train qualified professionals in state of the art disaster mental health response and management principles Provide a continuum of services from pre-event prevention through acute psychological first-aid and triage to post-event long-term surveillance and referral Disaster Mental Health Institute, The University of South Dakota

8 September 30, Goals cont’d: Participate in disaster response and relief locally and regionally Contribute research which evaluates the effectiveness of the plan and provides new insights into psychological responses to disasters and their management Integrate the plans of Hopkins and Maryland with the city of Baltimore and the State of Maryland Disaster Mental Health Institute, The University of South Dakota

9 September 30, Integration: Leadership has accepted Baltimore City mental health disaster training and have become volunteers Joint planning with the State of Maryland Department of Health and Mental Health is in process Projected appointments to MEMA ESF-8 with the creation of a subcommittee on mental health Disaster Mental Health Institute, The University of South Dakota

10 September 30, Academic Medical Center Potential strengths of involvement in local and regional disaster planning I.Ready access to large numbers of professionals in mental health II.Experience in emergency mental health, and the mental health of significant physical illness and injury Disaster Mental Health Institute, The University of South Dakota

11 September 30, Academic Medical Center, cont’d Potential strengths of involvement in local and regional disaster planning III. Multi-specialty mental health team orientation (clergy not sufficiently included) IV.Commitment to and focus on expertise building for career development Disaster Mental Health Institute, The University of South Dakota

12 September 30, Academic Medical Center, cont’d Potential strengths of involvement in local and regional disaster planning V. Historic mission of service, education and research Education and training strengths to achieve uniform standards of performance Critical assessments of knowledge and experience to determine best practices to employ Research orientation, aggressive seeking of funding to support research and dissemination of new knowledge Disaster Mental Health Institute, The University of South Dakota

13 September 30, Examples of research questions and needs Clarification of the relationship between normal responses to disaster trauma and standard DSM IV pathological nomenclature Is it appropriate; is it confusing to use the same language for people who will become patients and those who won’t? Use of standardized assessment tools in the field to correlate responses and risk factors Comparison trials of intervention techniques Evaluating the effectiveness of training Disaster Mental Health Institute, The University of South Dakota

14 September 30, Disaster Mental Health Institute, The University of South Dakota The Story Begins… Collegial relationships September 11 th, 2001 Two plans Hospital request Early Crisis Response training University invitation The Story of the Disaster Plan Process

15 September 30, Internal Strategy and Process Formed the Mental Health Disaster Planning Committee Partnership FASAP and Psychiatry Physician leader Institution-wide key group representation Literature review Developed a rationale Frequent meetings/subcommittee meetings Identified new members continuously Sought permission to respond Disaster Mental Health Institute, The University of South Dakota

16 September 30, Internal Strategy (cont.) Our Plan Integrate mental health disaster planning at the highest level of the institutions Incorporate mental health disaster planning within the Hopkins community Involve IT Intense focus on FEMA Region III Disaster Mental Health Institute, The University of South Dakota

17 September 30, Internal Strategy (cont.) Ensure allocation of resources and leverage resources Crisis Management for Supervisors class Work fluidly with both the administrative and academic communities, interlinking the two Understand collegial relationships and methods of communication Disaster Mental Health Institute, The University of South Dakota

18 September 30, External Strategy and Process Guided by external experts Developed a network of professional collaborations Academic medical centers Departments of Psychiatry Employee Assistance Programs Student Counseling and Student Assistance Programs Developed community relationships MD and DC VOADs Baltimore City State of Maryland FEMA SAMHSA Disaster Mental Health Institute, The University of South Dakota

19 September 30, External Strategy (cont.) Sought legitimacy and certification American Red Cross Disaster Psychiatry Outreach Disaster Mental Health Institute, The University of South Dakota

20 September 30, Co-evolving plans Two Organizations The Hopkins Institutions University of Maryland Baltimore Veterans Administration Medical Center The Ultimate Plan A Consortium of Academic Medical Centers working in concert with local and regional agencies and organizations Disaster Mental Health Institute, The University of South Dakota

21 September 30, What we have learned… Join and create communities of mental health disaster practice Develop, generalize and normalize the rationale Nurture co-evolving plans Identify and reach out to potential communities of practice Continuously connect and reconnect with those communities Disaster Mental Health Institute, The University of South Dakota

22 September 30, What we have learned…(cont.) Offer mutual aid and support Maximize and leverage resources Include a broad spectrum of mental health professionals Emphasize civic responsibility Create goodwill Relationships count Disaster Mental Health Institute, The University of South Dakota

23 September 30, Defining the Task Disasters represent non-linear human events—the systems perspective Existing statewide disaster plans and response agencies have wide variations in levels of organization and readiness Inclusion in the statewide disaster response system is dependent upon value of your contribution and ability to establish connections Disaster Mental Health Institute, The University of South Dakota

24 September 30, Systems principles Permeable boundaries allow for exchange of information and energy > increased levels of differentiation (expert functions) System behavior: steady state > stable oscillation > chaos System chaos increases a system’s response options and forces the system to renew itself > new learning Disaster Mental Health Institute, The University of South Dakota

25 September 30, Systems principles, cont’d Synergy: sum of parts greater than parts added together System meta-analysis facilitated by being inside and outside the system Disaster Mental Health Institute, The University of South Dakota

26 September 30, Chaos Serves evolutionary function Helps systems explore entire range of behaviors available Crisis and opportunity Disaster Mental Health Institute, The University of South Dakota

27 September 30, Negotiation principles Prepare Probe Propose The Power of Nice, Ron Shapiro Disaster Mental Health Institute, The University of South Dakota

28 September 30, Relationship building principles Be valuable—knowledge, attitudes, ability Build on interdisciplinary collaboration experience Have resources—time, money, personnel, intellectual resources Know your responsibilities 1. Participate in chain of command 2. Use established communication and documentation protocols 3. Understand national disaster declaration process and protocols 4. Be familiar with the roles and missions of other organizations Disaster Mental Health Institute, The University of South Dakota

29 September 30, Relationship building principles, cont’d Show humility—”This is what I know— teach me more” Baltimore Mental Health Systems training (ICISF) UMMC Freestate Mock Disaster Drill National Center for PTSD training DHMH Training—Trauma, Disaster and Resiliency MD VOAD Media Training Risk Communication Training Disaster Mental Health Institute, The University of South Dakota

30 September 30, Potential process contributions to disaster response system Contribute to the continuing development of a shared vision Participate in designing and supporting a system-wide learning architecture— learning feedback loops Provide safe space to incubate, hatch, and nurture new proposals Demonstrate value of rapid capacity to learn Disaster Mental Health Institute, The University of South Dakota

31 September 30, Using your contributions: Plant flowers rather than moving mountains! Use established relationships to nurture natural innovators Encourage early adopters Stand by the early majority Let nature take its course Disaster Mental Health Institute, The University of South Dakota

32 September 30, A Comforting Thought… “the…capacity to learn may be more important than experience” (L. Douglas Kiel, Ph.D) Disaster Mental Health Institute, The University of South Dakota

33 September 30, Slides will be provided on… Disaster Mental Health Institute, The University of South Dakota


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