1. Responding to Critical Incidents in Schools A Behavioral Health Plan October 22, 2010 Paul Deignan Department of Health and Human Services

2. Scenario You are in your office on a quiet Monday It's early morning. School has just begun for the day. One school bus is late arriving due to ice on the roads.

3. Details of the Incident The bus has 26 students from the middle and high schools on board (ages 10 - 17). As the bus arrives, the driver is unable to stop the bus. The bus skids and then crashes through the wall of the music room. There are 25 students in the music room. Two students are killed and 19 students are injured - four of them severely.

4. What steps would your school would take to activate your emergency response plan? Which students & staff are most at risk? What types of services would facilitate the recovery process? How would they be delivered?

5. Purpose of the Plan To enhance existing school emergency response plans To expedite the assessment and response to a critical incident To clarify roles of responders/helpers To enhance a school`s capacity to respond to critical incidents in an effective and compassionate manner.

6. “Critical Incident” “Any incident that might impact the emotional functioning of members of the school community :” Students Faculty Parents

7. “There cannot be a crisis this week… My schedule is already full.” -Henry Kissinger

8. Types of School Events Student deaths Staff deaths Accidents Suicides Violence in schools or community (assaults, murders, drive-by shooting) Natural disasters (tornado, earthquake, hurricane, ice storm, etc.) School shootings Probability of Event

9. Goals for Managing a Critical Incident Planning Phase: Have a school or district-wide behavioral health response team in place Identify external community behavioral health resources and b uild relationships Provide staff training on ……………………….. Include behavioral health issues in school based exercises and drills Update contact information regularly

10. Goals for Managing a Critical Incident Response Phase: Ensure safety of staff and students Maintain stability of school operations Maintain consistency of information Address the emotional needs of students, parents, faculty and staff Collaborate with external resources

11. Recovery: Key Components Physical/Structural Recovery Business/Fiscal Recovery Academic Recovery Psychological/Emotional Recovery

12. Academic Recovery Youth exposed to violence and trauma have been shown to have: Lower grade point averages ( Hurt et al., 2001 ) Decreased reading ability ( Delaney-Black et al., 2003 )* More negative remarks in their cumulative records More reported absences from school ( Hurt et al., 2001 ) Increased expulsions and suspensions ( LAUSD survey ) Decreased rates of H.S. graduation ( Grogger,1997 ) *Source: Delaney-Black, V., Covington, C., Ondersma, S.J., Nordstrom-Klee, B., Templin, T., Ager, J., Janisse, J., & Sokol, R.J. (2002). Violence exposure, trauma, and IQ and/or reading deficits among urban children. Archives of Pediatrics and Adolescent Medicine, 156 (3), 280-285.

13. Restore the Learning Environment Act to re-establish a sense of safety Return school to routines & schedules Support the emotional stabilization of students, faculty and parents

14. Psychological/Emotional Recovery: Internal and External Resources Consider local mental health resources Develop a structure for support "Outside" vs. "Inside" help School District Public Health Law EnforcementPublic Safety Emergency Management Local Government Mental Health COMMUNITY

15. Needs of Various Groups Administrators Faculty Students Parents Community

16. Strategic Assessment Assessment Tool (Appendix A) Assess damage Assess internal and external resources Create a strategic plan of response

17. Responding to the Critical Incident Day One Day Two Day of the Funeral Post-Memorial Services Anniversary

18. Memorialization Policy for memorials Temporary memorials Living memorials Scholarship funds Candlelight vigils On-line memorials Pictures/plagues Memory books

19. Checklists  Superintendent  Principal  School based response team  Public Information Officer

20. Sample Letters/Phone Calls Letter to Faculty – death of student Letter to Faculty – student suicide Phone call to Parents – suicide or murder Phone call to Parents – suspected suicide Phone call to Parents – sudden student death

21. Other Issues Addressed In Plan Sample After Action Report Working with the Media Military Kids Suicide considerations Resources  Community resources  Handouts  Web sites

22. First we have the test and then we have the lesson

23. CONTACT INFORMATION Paul Deignan, DBH Coordinator Paul.Deignan@dhhs.state.nh.us Cell: 419-0074, Work 271-4462 Mark Lindberg, DBH Liaison Cell: 991-3366, Work 444-5358 Joan Haskell, DBH Liaison Cell: 566-3523, Work 889-6147