1. CBRN mass decontamination
Understanding and improving relationships between responders and the public using crowd psychology:
CBRN mass decontamination
Dr John Drury

2. CBRN (Chemical, Biological, Radiological, Nuclear)
Procedure:
quarantine (not dispersal) for
decontamination

3. Overview Background to CBRN decon research: the nature of the problem
The social identity approach in social psychology
Applying social psychology to CBRN decon: the research

4. Background
Increased risk of incidents involving chemical, biological, radiological, or nuclear (CBRN) agents.
Planning for incidents has neglected public psychology and behaviour.

5. Quarantine and decon: A stressful emergency response procedure
Decon may be more stressful for the public than the incident itself (e.g. Holloway et al., 1997).
Significance: lack of compliance, risk!

6. The research
A unique collaboration between Public Health England and social psychologists
Using crowd psychology to improve practices
Enhancing relationships between crowd and responders

7. The problem – what we found
Decon guidance instructions:
Crowd ‘panic’ and ‘disorder’ assumed as endogenous
Communication neglected
Management strategy emphasises ‘control’ of the public instead
Field exercises (drills)
Emphasis on technical aspects (equipment) over social relationships
Small decon incidents
Public complained of lack of information, lack of concern for their dignity
These concerns made them less willing to comply with decontamination!
Increased risk of spreading contaminants!

8. CBRN Objectives: To change practices ->
To motivate the public to self-organize
Why?
Issues of legitimacy in use of coercion
There may not be enough ES personnel in the right place to enforce the order!

9. The social identity approach
The dominant model in the psychology of groups and crowds in Europe and North America

10. ‘Social identity’
‘those aspects of an individual's self-concept based upon their social group or category memberships, together with their emotional, evaluative and other psychological correlates’ (Tajfel, 1978, p. 63)
A social identity is defined and evaluated in relation to other groups

11. We all have personal identities
‘SOCIAL IDENTITY’
We all have personal identities
We also each have multiple social identities
Social identities are based on
SOCIAL CATEGORIES
Turner et al. (1987)

12. That which makes me unique, different from you My ‘personality’
Personal identity:
That which makes me unique, different from you
My ‘personality’
Social identities:
English
Man United fans
Psychologists
Crowd specialists
Men
Tajfel & Turner (1979)

13. Variability of identity according to group context
More inclusive
Faculty
Science faculty Psychologists John
Science faculty
Arts faculty
Clerical staff
Psych
Biology
Physics
John
Hani
Biologists
Physicists
Bill
Fred
More exclusive

14. Consequences: When there is shared social identity in a crowd…
There is more likely to be social support
People give social support
People expect social support
Drury, Novelli & Stott (2014) Euro J Social Psych

15. Shared social identity makes coordination in a crowd easier
Because there is shared understanding and expected support for valued group behaviour…
Mexican wave Queuing crowd

16. Developing hypotheses: Research on policing of football crowds
Portugal Euro 2004: A natural experiment:
Coercive vs facilitative policing
Fans perceived facilitative policing as more legitimate than they expected
Fans maintained strong bonds with fans from other countries
After the event, but not before, identification with England fans correlated with ‘similarity to police’ in match cities

17. Portugal Euro 2004: A natural experiment
Results: qualitative/PSP
Self-regulation:
“I feel that the majority of fans who follow England now do so to support the team and will not tolerate their enjoyment as supporters curtailed by people out for trouble”
“One guy had a go at a Portuguese supporter when they scored… there were looks of derision toward the England fan from everyone else”

18. Applying social psych to CBRN decon
Testing our hypotheses:
Effective responder communication – respecting needs 
reduce anxiety
increase cooperation
increase compliance
Why? Good communications enhance the legitimacy of the responders’ actions and increases identification with them

19. Observation and survey at a field exercise
‘Big city’ multi-agency exercise
115 volunteers completed a pre-exercise and post-exercise questionnaire.

20. Observation and survey at a field exercise
Results
Good coms enhanced legitimacy and enhanced identification and compliance
Practical
information
Privacy
Legitimacy
Good
communication
Low
anxiety
Co-operative
behaviour
Compliance
.37
.23
.30
.67
.62
.33
.52
.38
.03
.29 e4 e6 e5 e1
Shared identity
responders
public
.42
.18
.45 e2 e3
.72
.34

21. Mass decontamination experiment
112 volunteers
Three different communications conditions:
Theory-based (respect needs)
Standard-practice
Brief
Four different types of data collected:
Timings for how long each group took to go through decontamination
Observational data
Quantitative questionnaire data
Qualitative questionnaire data

22. Mass decontamination experiment
Procedure
Participants listened to a scenario
Then removed outer clothing and showered in mock incident 22

23. An experiment: Results
Effective responder communication 
Enhanced the legitimacy of the responders’ actions 
Increased identification with them 
Reduced anxiety, increased cooperation, less confusion, increased compliance, better decon
Carter, H., Drury, J., Amlôt, R., Rubin, G. J., & Williams, R. (2014). PLoS One 9(3): e DOI: /journal.pone

24. Recommendations
1. Emergency responders should communicate openly and honestly with members of the public about the actions they are taking. 24

25. Recommendations
2. Emergency responders should communicate in a health-focused way about decontamination. 25

26. Recommendations
2. Emergency responders should communicate in a health-focused way about decontamination.
WHY decontamination is necessary 26

27. Recommendations
2. Emergency responders should communicate in a health-focused way about decontamination.
WHY decontamination is necessary
HOW decontamination will protect someone, and their loved ones 27

28. Recommendations
2. Emergency responders should communicate in a health-focused way about decontamination.
WHY decontamination is necessary
HOW decontamination will protect someone, and their loved ones
WHAT the process will involve 28

29. Recommendations
3. Emergency responders should provide members of the public with sufficient practical information during the decontamination process. 29

30. Recommendations
4. Emergency responders should respect public needs for privacy and modesty. 30

31. Conclusion
Effective communication increases legitimacy increases compliance
These four recommendations could improve behavioural and psychological outcomes – could save lives
Applicable across a range of mass emergencies and disasters

32. Key message and implications
Use of ‘soft skills’ (communications, respect) can change social identification in emergencies and save lives
These ideas are being recognized and used by CBRN responder organizations 32

33. References
Biomedical Advanced Research and Development Authority (2016) Primary Response Incident Scene Management (PRISM) Guidance for Chemical Incidents. Volume 1: Strategic Guidance for Mass Casualty Disrobe and Decontamination. BARDA; Washington.
Carter, H., Drury, J., Rubin, G. J., Williams, R., & Amlôt, R. (2012). Public experiences of mass casualty decontamination. Biosecurity and Bioterrorism, 10(3),
Carter, H., Drury, J., Amlôt, R., Rubin, G. J., & Williams, R. (2013c). Perceived responder legitimacy and group identification predict cooperation and compliance in a mass decontamination field exercise. Basic and Applied Social Psychology, 35(6),
Carter, H., Drury, J., Rubin, G. J., Williams, R., & Amlôt, R. (2013a). Communication during mass casualty decontamination: highlighting the gaps. International Journal of Emergency Services, 2(1),
Carter, H., Drury, J., Rubin, G. J., Williams, R., & Amlôt, R. (2013b). The effect of communication on anxiety and compliance during mass decontamination. Disaster Prevention and Management, 22(2),
Carter, H., Drury, J., Rubin, G. J., Williams, R., & Amlôt, R. (2014a). Effective responder communication improves efficiency and psychological outcomes in a mass decontamination field experiment: implications for public behaviour in the event of a chemical incident. PLoS One, 9(3), e89846.
Carter, H., Drury, J., Rubin, G. J., Williams, R., & Amlôt, R. (2014b). Emergency responders’ experiences of and expectations regarding decontamination. International Journal of Emergency Services, 3(2),
Carter, H., Drury, J., Rubin, G. J., Williams, R., & Amlôt, R. (2015a). Applying crowd psychology to develop recommendations for the management of mass decontamination. Health Security, 13(1),
Carter, H., Drury, J., Amlôt, R., Rubin, G. J., & Williams, R. (2015b). Effective responder communication, perceived responder legitimacy, and group identification predict public cooperation and compliance in a mass decontamination visualization experiment. Journal of Applied Social Psychology, 45,
Hanley, C. (1999, December 7). Residents sickened by pesticide cloud; ag officials insider changing rules. Latino News.
Harvard School of Public Health Emergency Preparedness and Response Exercise Program. (2013). Proposed minimum decontamination capabilities for hospitals in Massachusetts. Boston, MA: Harvard School of Public Health.
NATO (2009). Psychosocial care for people affected by disasters and major incidents: A model for designing, delivering and managing psychosocial services for people involved in major incidents, conflict, disasters and terrorism. Brussels: NATO.
United States Fire Administration. (1997). Fire department response to biological threat at B'nai B'rith headquarters. Washington, DC: United States Fire Administration.
US Department of Homeland Security, US Department of Health and Human Services. (2014). Patient decontamination in a mass chemical exposure incident: National planning guidance for communities. Washington, DC: US Department of Homeland Security, US Department of Health and Human Services.
Vogt, B. M., & Sorensen, J. H. (2002). How clean is safe? Improving the effectiveness of decontamination of structures and people following chemical and biological incidents. Tennessee: Oak Ridge National Laboratory.

34. Acknowledgements Dr Holly Carter (PHE) Dr Richard Amlôt (PHE)
Dr James Rubin (King’s College London)
Professor Richard Williams (University of South Wales)