1. Healing Joplin Ozark Center’s Mental Health Disaster Response

2. On May 22, 2011 at 5:41 pm our lives changed forever……..

3. Copyright Ozark Center 2012. All rights reserved. A perfect storm Two cells combine west of Joplin http://youtu.be/zamb5_Q111g

4. Copyright Ozark Center 2012. All rights reserved. Courtesy of CBS

5. Copyright Ozark Center 2012. All rights reserved. Courtesy of CBS

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7. Courtesy of CBS

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10. In Remembrance….. Copyright Ozark Center 2012. All rights reserved.

11. In Memory

12. Copyright Ozark Center 2012. All rights reserved. The Cost Death toll – 161 18,000 cars destroyed 6,954 residences destroyed 5,000 jobs affected 3,500 students displaced – 9 buildings damaged or destroyed 1,308 pets displaced 1,150 estimated injured 1,000 businesses and other offices destroyed 875 homes damaged 500 Businesses destroyed 150 medical and dental offices destroyed 28 churches destroyed 4 pharmacies destroyed 3 nursing homes and 1 senior center (251 nursing home patients evacuated) St. Johns Regional Medical Center destroyed (181 patients evacuated) 33% of day care facilities destroyed 45% of Joplin destroyed 3 million cubic yards of debris removed

13. Copyright Ozark Center 2012. All rights reserved. The Bad and The Ugly of Wide-Spread Disaster 20 suicides since May 22, 2011 20% increase in child sexual trauma Alcohol and drug use up 80% 50% increase in domestic violence Gambling increased 40%

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15. Multi-systemic approach… Our staff Our facilities Our clients The community The state and federal requests

16. Copyright Ozark Center 2012. All rights reserved. Ozark Center losses 8 of 14 facilities in Joplin destroyed or significantly damaged 47 employees lost homes/cars 0 employee deaths 330 consumers displaced 8 consumer deaths Records – lost 25 out of 14,000

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19. Personnel Response Kept all personnel whole for 2 weeks Relocated staff to other areas to ensure work available Employee Disaster Relief Program Employee Store Rental cars Assistance with home repairs Additional PTO days Debriefing Employee Assistance Services Increased personnel connectedness with supervisors

20. Our Clients Communication is key but difficult All services running within 48 hours Facility location changes Transportation Medications Options Copyright Ozark Center 2012. All rights reserved.

21. Our Clients - Tele-psychiatry Collaborative effort between: – UMC, DMH and Ozark Center Goals: – Enhances access to psychiatric services in the immediate aftermath – Reduce risk of trauma related complications Numbers: – Scheduling approximately 20 hours per week – 15 UMC psychiatrists (5 attending, 10 residents) – Intakes, 1 follow up – 90 days – Expanding to two tele-psychiatry units Success? – Lowest no show rate of any other psychiatric service – Client satisfaction reports are high

22. Copyright Ozark Center 2012. All rights reserved. Our Clients - ACT What is it? – Assertive Community Treatment – Evidence Based Practice – “Hospital without walls” Multidisciplinary team, meeting daily regarding each client 24/7 365 treat the client in their world Goals: – Increase available inpatient psych beds – Decrease admit/readmissions – Improve quality of life for clients with SPMI

23. Copyright Ozark Center 2012. All rights reserved. Community Response Overview Debriefings –provided debriefings to more than 27 businesses and organizations and more than 700 people Gun Safety Program Increased staff on ACI hot line – 1,500 additional calls over average in first 3 months Assigned OC licensed clinical staff to the FEMA DRC locations, Red Cross Shelters, FEMA Point of Distribution Center, Family Access Medical Care Facility, Family Assistance Center, Women Infant Children Center Active participation in COAD (Community Organizations Active in Disaster), Early Childhood Care committee, LTRC (Long Term Recovery Committee), Mental Health committee Grief counseling groups Public education

24. Copyright Ozark Center 2012. All rights reserved. Volunteers Problems Registry – Background checks – Primary source verification Volunteers assigned to Red Cross Shelter, FEMA DRC locations, Governors Resource Center, Family Assistance Center Governor’s Resource Event and Memorial Service with President Obama 73 total volunteers

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26. First Responder Support Critical Incident Stress Debriefing Grief groups John McCarmack, Ph.D., John Brown University Chief Stanley Wade – Psychological Readiness Combat Training Dan Diamond, MD – International Disaster Physician Education Linkage – Healing Joplin Basic needs

27. Copyright Ozark Center 2012. All rights reserved. Lafayette House Children’s Division Freeman Health System Ozark Center General Public Joplin Police Department Joplin Fire Department Joplin City Officials Joplin R8 School Systems

28. Copyright Ozark Center 2012. All rights reserved. Dan Diamond, MD International disaster relief doctor and professional speaker American Family’s “Building Hope in Joplin” campaign “How to stay in the game when your stuff is all gone” “Build your personal resilience and coping skills”

29. Copyright Ozark Center 2012. All rights reserved. Grants Awarded since May 22, 2011 – Missouri Foundation for Health Emergency Grant - $115,000 – SAMHSA Emergency Response Grant (SERG)-$990,335 – Assertive Community Treatment Team - $1,000,000 – Governor’s award - $2,000,000 – FEMA ISP, CCP and RSP - $4,060,000

30. Copyright Ozark Center 2012. All rights reserved. Missouri Foundation for Health $60,000 emergency funding award – Funding requested to provide school-based mental health programs – Syed Arshad Husain, MD, world renowned expert in child trauma – 3 day training for OC staff and school officials and lead teachers – 3 day training for up to 60 teachers – Train-the-trainer model – Offered to Joplin R VIII, Thomas Jefferson, Martin Luther, College Heights and St. Mary schools $55,000 emergency funding award – $10,000 for early childhood comfort kits – ¾ FTE to provide social/emotional competency project Training focused on social/emotional development On-site technical assistance Development of Classroom Action Plans Observation and Consultation

31. Copyright Ozark Center 2012. All rights reserved. S.E.R.G. Grant Therapy services for uninsured and underinsured adults Prevention Plan Signs of Suicide Project for Joplin R- VIII

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33. Children’s Trauma Treatment Center First year funded by Department of Mental Health ($2 million) Appling for SAMHSA grant in March, 2012 Leased new facility for prominence in the community and to relocate all child services to one facility Center of Trauma Excellence for southwest Missouri Governor issued 3 charges: – Treatment – School based team – Training/education Seek accreditation through National Children’s Alliance and become member of National Child Traumatic Stress Network.

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36. School Based Team Positions supported: – 5 licensed counselors – 5 community support workers Support for school system’s efforts in School Wide Positive Behavior Supports program to reduce drop outs, behavior referrals and in/out of school suspensions Evidence Based Practices: – TF-CBT (trauma focused cognitive behavior therapy) – AF-CBT (abuse focused cognitive behavior therapy) – TF-PCIT (trauma focused parent child interactive therapy) – TG-CBT (trauma grief cognitive behavior therapy) – CPP (child and parent psychotherapy)

37. Copyright Ozark Center 2012. All rights reserved. School Based Services

39. Presented by Gary Bandy, Chief Meteorologist In conjunction with Will’s Place, A Healing Center for Kids Joplin, Missouri

40. Copyright Ozark Center 2012. All rights reserved. FEMA Crisis Counseling Program Supported positions: – 65 community crisis workers – 10 team leaders – 1 project manager – 2 administrative assistants –.5 fiscal coordinator –.75 marketing and public relations – 2 crisis counselors for the ACI team Goals: – Educate and inform through outreach – Support survivors in problem solving – Help survivors manage stress and develop coping strategies – Help with needs assessment and prioritizing those needs – Facilitate referrals and remain solution focused Tools : – Psychological First Aid – Skills for Psychological Recovery – Healing After Trauma

41. Copyright Ozark Center 2012. All rights reserved.

45. Messaging and Communication What is Online Messaging? For today's i-Generation, it is much more than getting another phone line, it's the only form of communication they use. Due to this high usage of Online Messaging, it is also the best way to reach these individuals. That is where 'Talk About It'® comes in.

46. 12 month Recovery Stats 57% increase in crisis hotline calls 194% increase in psychiatric services consumers over previous 2 years No significant change in substance abuse services but lost 28 bed residential facility Suicide rates shows a 30% over the previous two years JPD reports number of suicidal subjects increased 29% over previous two years Sexual offenses increased 10% Overall crime decreased 6% Alcohol and drug crimes decreased 5% Child abuse reports decreased 29% Copyright Ozark Center 2012. All rights reserved.

47. The Anniversary – A Day of Unity Copyright Ozark Center 2012. All rights reserved.

48. 130,009 volunteers provided 810,476.5 hours of service

49. Recovery LTRC provided $150,000 in assistance to families with unmet disaster needs Disaster case managers (FEMA) provided assistance to 1,843 families and $650,000 worth of assistance for unmet disaster needs Joplin Area Habitat for Humanity has completed 20 hours and have 46 under construction 74% of homes that were affected are either “under permit” or have been rebuilt 85% of businesses are reopened and another 10% have plans for reopening with 5% under construction 21 NEW businesses have opened Upon advice from the Citizen’s Advisory Recovery Team, the City has hired a master developer for community development 10 major healthcare construction projects completed or underway Named #4 in Time Magazines “2012 Top 10 Comebacks” Copyright Ozark Center 2012. All rights reserved.

50. Healing Joplin …… A F-5 tornado can peel the bark from a tree, but it can’t prevent new growth. An F-5 tornado can tear a gaping wound through the heart of a community, but it cannot kill our…. Spirit Courtesy of Show Me, the Ozarks Magazine

51. Copyright Ozark Center 2012. All rights reserved. Our spirit survives