1. Anticipated Controversies
Critical Incident Stress Debriefing (CISD) – and efficacy of early intervention
Rural Mental Health Preparedness
Northwest Center for Public Health Practice University of Washington School of Public Health and Community Medicine

2. Rural Mental Health Preparedness
Lower perceived risk of BT (vs. we are the perfect demonstration project for a terrorist incident)
Evacuation issues – coming and going
Potential for terror induction may be greater
Northwest Center for Public Health Practice University of Washington School of Public Health and Community Medicine

3. HOW DO YOU DEVELOP RESILIENT COMMUNITIES?
Treat the public as a capable ally (pre-event)
Education – Public Service announcements
Risk Communication (post-event)
Provide training/drills/education for “First Responders”
Northwest Center for Public Health Practice University of Washington School of Public Health and Community Medicine

4. First Responder and Provider Disaster Training/Drills/Education enhances knowledge and confidence.
Good News
Northwest Center for Public Health Practice University of Washington School of Public Health and Community Medicine

5. “You can observe a lot by watching” (Berra, 1998)
Northwest Center for Public Health Practice University of Washington School of Public Health and Community Medicine

6. Dress rehearsal at Harborview
NDMS drill (May 13, 2004)
Dress rehearsal at Harborview
Northwest Center for Public Health Practice University of Washington School of Public Health and Community Medicine

7. NDMS drill (May 13, 2004) DeCon at Harborview
Northwest Center for Public Health Practice University of Washington School of Public Health and Community Medicine

8. DOD Preparedness Training for First Responders
Northwest Center for Public Health Practice University of Washington School of Public Health and Community Medicine

9. From Beaton & Johnson (2002)
Northwest Center for Public Health Practice University of Washington School of Public Health and Community Medicine

10. From Beaton & Johnson (2002)
Northwest Center for Public Health Practice University of Washington School of Public Health and Community Medicine

11. Systems Issues Gaps include:
Currently may not be able to meet community psychological needs in the event of a disaster
Gaps include:
Training and preparedness of mental health providers
Coordination of agencies and services
Northwest Center for Public Health Practice University of Washington School of Public Health and Community Medicine

12. Systems Issues continued
Identification of mental health preparedness competencies
Knowledge and evidence based services
Northwest Center for Public Health Practice University of Washington School of Public Health and Community Medicine

13. “Relationships are primary, all the rest is derivative.” (David, 2000)
Interagency
Cooperation
Coordination
Communication
Collaboration
Northwest Center for Public Health Practice University of Washington School of Public Health and Community Medicine

14. And Planning
Northwest Center for Public Health Practice University of Washington School of Public Health and Community Medicine

15. Level 1 Disaster
Localized disaster, the effects of which can be managed within existing resources (<20 referrals)
Caller referred to current provider or appropriate resource
-walk-in appt
-next day appt
-outreach
Red Cross responds &
notifies Crisis Services
Red Cross provides services & victims referral information
Victim calls Crisis Clinic
Needs Assessment:
-numbers?
-walk-ins?
-on site response?
-phone support?
Teams of 2-3 people dispatched to identified sites
Resource information communicated to Crisis Clinic
Northwest Center for Public Health Practice University of Washington School of Public Health and Community Medicine

16. Level 2 Disaster
MH needs exceed existing MH resources Presidential Disaster Declaration, FEMA grants
State MHD collects info on scope of disaster & needed response
Data collected: MH infrastructure damage; # of people served; # or visits provided; Types of referrals
Multi-county disaster, EOC activated
Needs assessment via EOC, Red Cross, State MH, etc
Providers mobilized, response teams assembled
Are out-of facility services needed?
Teams dispatched to identified sites-shelters, recovery centers, churches, clinics, schools
Services provided at designated provider sites (1-3 visit model)
Northwest Center for Public Health Practice University of Washington School of Public Health and Community Medicine

17. And Drills
Northwest Center for Public Health Practice University of Washington School of Public Health and Community Medicine

18. TopOff 2 State-Local-Federal Coordination
Law Enforcement vs. Human Services Response
Risk/Benefit Analysis
Northwest Center for Public Health Practice University of Washington School of Public Health and Community Medicine

19. TopOff 2
Northwest Center for Public Health Practice University of Washington School of Public Health and Community Medicine

20. A View from the Bottom
Northwest Center for Public Health Practice University of Washington School of Public Health and Community Medicine