2. PLANNING FOR COMMUNITY MENTAL HEALTH NEEDS DURING DISASTER AND TRAGEDY EVENTS Joseph W. Hill, M.S. Ed., Chief Office Disaster Service Initiatives 1

3. A disaster or tragedy event is: A disaster or tragedy event is: “ an occurrence such as a tornado, flood, earthquake, explosion, hazardous material accident, war, transportation accident, fire, famine, or epidemics that causes human suffering or creates collective human need that requires assistance to alleviate”. “ an occurrence such as a tornado, flood, earthquake, explosion, hazardous material accident, war, transportation accident, fire, famine, or epidemics that causes human suffering or creates collective human need that requires assistance to alleviate”. Maybe natural or human caused. Maybe natural or human caused. 2

4. Causes Causes Examples of natural disasters Examples of natural disasters Blame Blame Scope Scope Post Disaster Distress Post Disaster Distress Forces of nature Forces of nature Severe Storm, floods, tornadoes, Severe Storm, floods, tornadoes, No one, acts of God No one, acts of God Various Various High High 3

5. Causes Causes Examples Examples Blame Blame Scope Scope Post disaster Stress Post disaster Stress Human or technology errors, purposeful act Human or technology errors, purposeful act Plane crash, Terrorism Biological, Chemical Plane crash, Terrorism Biological, Chemical Person, government or a business Person, government or a business localized or broad, little advance warning localized or broad, little advance warning Very High Very High 4

6. No one is untouched by it No one is untouched by it Individual Trauma Individual Trauma Community/Collective Trauma Community/Collective Trauma Diminished effectiveness Diminished effectiveness Normal response /abnormal situation Normal response /abnormal situation Assistance is often confusing Assistance is often confusing 5

7. Non -traditional approach and methods Non -traditional approach and methods Active genuine interest and concern. Active genuine interest and concern. Intervention must be appropriate Intervention must be appropriate Social support systems are crucial Social support systems are crucial 6

8. Children Children Elderly Elderly Severely Mentally ill Severely Mentally ill Recent Health Problems Recent Health Problems Prior unresolved trauma Prior unresolved trauma 7

9. Recently Divorced/Widowed Recently Divorced/Widowed Lower socio-economic status Lower socio-economic status Refugees/recent immigrants Refugees/recent immigrants Cultural and Ethnic Groups Cultural and Ethnic Groups Single Persons Single Persons 8

10. CULTURAL SENSITIVITY CULTURAL SENSITIVITY CULTURAL DIVERSITY CULTURAL DIVERSITY CULTURAL COMPETENCY CULTURAL COMPETENCY Cultural Competence is a continuous learning process that builds knowledge, awareness, skills and capacity to identify, understand and respect the unique beliefs, values, customs, languages, abilities and traditions of all Ohioans 9

11. “Next week there can’t be any crisis. My schedule is already full”. - Henry Kissinger. - Henry Kissinger. While secretary of state. 10

12. 11

13. Local MH Board/Agencies Local MH Board/Agencies State Mental Health Authority State Mental Health Authority Federal Assistance (FEMA) Federal Assistance (FEMA) Presidential Declaration Presidential Declaration 12

14. Assures development of emergency MH plan Assures development of emergency MH plan Ensures integration of local MH plan and local EMA preparedness plan Ensures integration of local MH plan and local EMA preparedness plan Ensure Implementation of local plan Ensure Implementation of local plan Develops MOU and interagency agreements Develops MOU and interagency agreements Coordinate local MH resources Coordinate local MH resources 13

15. Agency designates a coordinator Agency designates a coordinator Develops agency disaster MH plan Develops agency disaster MH plan Develop a response team Develop a response team Identify key decision makers Identify key decision makers Informational and training needs Informational and training needs Participate in local disaster drills Participate in local disaster drills 14

16. Specifically trained to provide emergency mental health services Specifically trained to provide emergency mental health services Participates in MH Emergency response training Participates in MH Emergency response training Education and Consultation Education and Consultation Assistance to special populations Assistance to special populations Participate in drill and exercises Participate in drill and exercises Implements local response plan Implements local response plan 15

17. Director authorizes utilization of state MH resources and assistance to mitigate event Director authorizes utilization of state MH resources and assistance to mitigate event Disaster Service administrator receives request for assistance from local authority Disaster Service administrator receives request for assistance from local authority Administrator assess need w/community Administrator assess need w/community Identify available state resources. Identify available state resources. Coordinates MH assistance to impacted area Coordinates MH assistance to impacted area Provide response and support to State EOC Provide response and support to State EOC 16

18. Implement plan and steps to improve Implement plan and steps to improve Integrate MH emergency plans with state emergency management and other community emergency response partners Integrate MH emergency plans with state emergency management and other community emergency response partners Monitor, adjust response with local mental health authority, state agency partners and federal emergency response agencies. Monitor, adjust response with local mental health authority, state agency partners and federal emergency response agencies. Debrief, Review and Assess response. Debrief, Review and Assess response. 17

19. Assess and determine damage Assess and determine damage Protect life and property Protect life and property Assist state in its recovery process Assist state in its recovery process Funding via Robert T. Stafford Act Funding via Robert T. Stafford Act Individual Assistance Program Individual Assistance Program Public Assistance Program Public Assistance Program Other funding ASPR, HRSA, SAMHSA Other funding ASPR, HRSA, SAMHSA 18

20. “ The President is authorized to provide professional counseling services, including financial assistance to state or local agencies or private mental health organizations to provide such services or training of disaster workers to victims of major disasters in order to relieve mental health problems caused or aggravated by such major disaster or its aftermath” 19

21. Technical Assistance Technical Assistance Human resources Human resources Funds Funds TA in developing local plans TA in developing local plans Federal Grant application support Federal Grant application support Collaborative Partnerships Collaborative Partnerships Behavioral Health Volunteers Behavioral Health Volunteers Housing, Special pop., Diversity Housing, Special pop., Diversity Research and Evaluation Research and Evaluation Inpatient care/community based care Inpatient care/community based care

22. 1. ODMH Behavioral Health Disaster Curriculum 2. ODMH Psychological First Aid http://mentalhealth.ohio.gov/what-we- do/provide/emergency-preparedness http://mentalhealth.ohio.gov/what-we- do/provide/emergency-preparedness 1. Ohio Emergency Management http://ema.ohio.gov/ 2. National Incident Management System (NIMS) and Incident Command System (ICS) www.fema.gov/emergency/nims Ohio Association of County Behavioral Health Authorities www.oacbha.org www.oacbha.org

23. The Ohio Council of BH Family Providers The Ohio Council of BH Family Providers www.theohiocouncil.org Following Disaster Following Disaster http://publicsafety.ohio.gov/NPM/index.s tm http://publicsafety.ohio.gov/NPM/index.s tm http://publicsafety.ohio.gov/NPM/index.s tm http://publicsafety.ohio.gov/NPM/index.s tm Center for Study of Traumatic Stress http://www.center forthestudyoftraumaticstress.org Center for Study of Traumatic Stress http://www.center forthestudyoftraumaticstress.org Communicating in A Crisis: Risk Communication Guidelines Communicating in A Crisis: Risk Communication Guidelines http://www.riskcommunication.samhsa.gov

24. SAMHSA Resilience and Stress Management Resource collection www.SAMHSA.gov SAMHSA Resilience and Stress Management Resource collection www.SAMHSA.gov www.SAMHSA.gov National Center fro Posttraumatic Stress Disorders http://www.ptsd.va.gov National Center fro Posttraumatic Stress Disorders http://www.ptsd.va.govhttp://www.ptsd.va.gov Blindsided: A managers Guide to Catastrophic incidents in the Workplace Blindsided: A managers Guide to Catastrophic incidents in the Workplace http://www/cmiatl.com Mental Health Response to Mass Violence Mental Health Response to Mass Violence https://store.SAMHSA.gov/SMA04-359 23

25. When preparing for crises, it is instructive to recall that Noah started building the ark before it began to rain When preparing for crises, it is instructive to recall that Noah started building the ark before it began to rain 24

26. Disasters are a complex, human bureaucratic and political event. Routine procedures and resources are not enough to manage the changes caused by the disaster. Planning and Coordination of identified resources is required to address the physical and mental health needs of impacted persons and communities…... Disasters are a complex, human bureaucratic and political event. Routine procedures and resources are not enough to manage the changes caused by the disaster. Planning and Coordination of identified resources is required to address the physical and mental health needs of impacted persons and communities…... joseph.hill@mh.ohio.gov 614-644-6996 joseph.hill@mh.ohio.gov 614-644-6996 joseph.hill@mh.ohio.gov 25