1. WEAVING CONNECTIONS: DISASTER BEHAVIORAL HEALTH PLANNING SUMMIT 1 Missouri’s 2011 Disaster Experience Arizona, 2014

2. 2 Before After Joplin, Missouri May 22, 2012 When a catastrophic disaster this size happens in your state…

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4. 4 SO WHAT HAPPENS WHEN YOU HAVE AN EF5 TORNADO? Deadliest tornado since Weather Service started tracking tornadoes in 1950. 8 th deadliest in U.S. History

5. 5 THAT TAKES OUT… THE MEDICAL COMMUNITY St. John’s Mercy Hospital Greenbriar Nursing Home Autism Center

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7. 7 PREPAREDNESS VS. RESPONSE Red Cross Relationships VOAD Role Definition Exercises CCP

8. 8 WHERE THE RUBBER MEETS THE ROAD

9. 9 AND DID I TELL YOU THAT…

10. 10 Original Federal Declaration: FEMA 1980 DR-MO, May 9, 2011 – flooding in Southeast Missouri May 23: Added EF 5 tornado to Existing Declaration: DAY 0: for CCP ISP Development; Due June 6, 2011 Search and Rescue still underway 1 week into timeframe before correct numbers for CCP formulas MO awarded ISP Joplin addendum June 30 Still ends at the same time as original CCP ISP: July 7 Answered ISP conditions and amended ISP; June 7 Joplin conditions response, June 15. Requested ISP Extension July 1, 2012 Began work on RSP and submitted it July 7, 2011. It takes a TEAM! Request funding for key people to write the CCP grant and formulate the budget.

11. THE RESPONSE Initial Response: CMHCs – Volunteers: 73 DMH Staff Liaison ISP: Healing Joplin: Team of 46 C.C. 6 T.L. RSP: Healing Joplin: Team of 60 C.C. 10 T.L. 11

12. 12 Types of Disaster Reactions: Collective Reactions Typical Phases of Disaster

13. 13 CC & REFERRAL MONTHLY AVERAGES

14. 14 Communications DMH Liaison Team approach Liaison Checklist Linkage with MO National Guard Family Assistance Center FEMA CCP – Healing Joplin Hiring and Laying off considerations Formalizing relationships – Letters of agreement LESSONS LEARNED

15. 15 LESSONS LEARNED Anticipated that referred would have their trauma- related behavioral health needs successfully resolved and terminate services in one year or less. – Incorrect for majority – Reasonable assumption if no previous significant trauma – 84% had at least one traumatic event prior to the tornado. – Previous traumas created complex dynamics and longer treatment needs – Only 23 of 204 had completed by end of grant Tele-health - significant role – University of Missouri, School Of Psychiatry – Very popular - lower no-show rate

16. 16 PLAN FOR RECOVERY Substance Abuse Treatment Services for the Developmentally Disabled Will’s Place Children’s Services Psychiatric Services Adult Treatment Services (SERG) Community Care Program Local Resources Autism Services Housing/ Placement Access Crisis Intervention Team CCP Healing Joplin Team

17. 17 BEST PRACTICES Hiring Practices Grid/Map areas of service Planning calls: children and seniors Additional training: Skills for Psychological Recovery, children and seniors www.nctsn.com Daily meetings; weekly trainings Planning areas: travel, identification, access and functional needs Partnerships: FEMA Case Management Services; DOC partnership; Meals on Wheels; Using the FEMA List http://dmh.mo.gov/docs/opla/StoriesfromHealingJoplin.pdf

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19. 19 D ON ’ T LET ONE DISASTER L EAD TO ANOTHER

20. 20 CONTACT INFORMATION Jenny Wiley Missouri Department of Mental Health Office: 573-751-4730 Personal: 573-418-3477 Jenny.wiley@dmh.mo.gov