1. Topic 10: Principles of Psychological Needs Assessment Post-disaster i. Nature – Psychological Typology of Disasters, ii. Scope and severity of the disaster

2. Topic 10: Principles of Psychological Needs Assessment Post-disaster Natural Man-made TechnologicalBiological Unintentional Floods, Hurricanes, Earthquakes, etc. e.g., Bhopal, Haz-Mat, Nuclear Power plant accident Epidemic e.g., 1918 Influenza Pandemic Intentional “Act of God”Chemical, Nuclear, Radiological, Explosion, Acts of Terrorism Bioterrorism Types of Disasters

3. Topic 10: Principles of Psychological Needs Assessment Post-disaster (continued) DeWolf’s “Bulls-eye” Exposure Model

4. DeWolfe, see SAMHSA publication Topic 10: Principles of Psychological Needs Assessment Post-disaster

5. A. Seriously injured victims  bereaved family members B. Victims with high exposure to trauma  victims evacuated from the disaster zone C. Bereaved extended family members and friends  rescue and recovery workers with prolonged exposure  medical examiner’s office staff  service providers directly involved with death notification and bereaved families DeWolfe: A - C Topic 10: Principles of Psychological Needs Assessment Post-disaster (continued)

6. Topic 11: Vulnerable populations i. Current psychiatric patients ii. Prior psychological disorders iii. Prior traumatic exposures iv. The very young v. The elderly vi. Chronically ill vii. Native American tribes

7. Supporting Children at Times of Disaster Hot Topics in Preparedness archive by David J. Schonfeld, MD, Head of Developmental- Behavioral Pediatrics Yale University School of Medicine Online at URL: http://www.nwcphp.org/htip/20040913/

8. Topic 12: What are the goals of an All-Hazards Mental Health State Disaster Plan Reference URL: http://media.shs.net/ken/pdf/SMA03-3829/All- HazGuide.pdf

9. Topic 12: Goals of an All-Hazards State Mental Health Disaster Plan?  Serve as the basis for effective response to any hazard that threatens any jurisdiction;  Facilitate the integration of mitigation into response and recovery activities  Facilitate coordination with the federal government during catastrophic disaster situations.

10. Topic 13: Basic Principles of Post-Disaster Approaches to Mental Health NORMALIZE – most psych/behavioral reactions are “normal” and transient

11.  Shock/recoil/denial – momentary  Derealization – not real/feels surreal  Depersonalization – “out of body”  Difficulties concentrating, staying on task  “Some” anxiety and apprehension What are Normal Reactions to Disasters? Topic 13: Basic Principles of Post-Disaster Approaches to Mental Health

12.  “Some” distress and dysthemia  “Some” anger  Temporary increase in “Achilles heel” medical stress symptoms, e.g. headache, GI  Posttraumatic reactions – re-experiencing and staying away from reminders What are Normal Reactions to Disasters? (continued) Topic 13: Basic Principles of Post-Disaster Approaches to Mental Health

13. Topic 14: Basic principles of early interventions – PIE: proximity, immediacy, expectancy

14. Traumatic Incident Stress: Information for Emergency Workers: NIOSH Guidelines http://www.cdc.gov/niosh/unp-trinstrs.html Topic 15: Psychological “First Aid”

15. i. Support and presence ii. Screen/refer iii. Keep families together

16. Topic 16: Rural Mental Health Preparedness versus Urban Settings

17. Topic 16: Rural Mental Health Preparedness  Lower perceived risk of BT (vs. rural areas are the perfect demonstration project for a terrorist incident)  Evacuation issues  Potential for terror induction may be greater

18. Topic 17:  Benefits of Training and Drills for First Responders and Disaster Personnel

19. Pre-training 4 mo. Post-training Results of Domestic Preparedness Questionnaire From Beaton & Johnson (2002) Topic 17: Benefits of Training and Drills for First Responders and Disaster Personnel Total DPQ Score DP Trained?

20. Pre-training 4 mo. Post-training Topic 17: Benefits of Training and Drills for First Responders and Disaster Personnel Results of Domestic Preparedness Questionnaire From Beaton & Johnson (2002) Perceived Competency to Respond to Biological Disaster DP Trained?

21. Topic 18: Multiple Unexplained Physical Symptoms (MUPS) in the Aftermath of Trauma and Disaster

22. Idaho Health Districts District-Specific Training Needs?

23. Any Other Topics?

24. Please evaluate today’s session Please complete an online evaluation of this session – go to web page below & look for “Online Evaluation” www.nwcphp.org/edu/idaho_mh_prep.html

25. Wrap-Up & Next Steps Anonymous results of today’s needs assessment survey will be shared with all health districts Dr. Beaton will use these results and work with local health districts to plan a series of Mental Health & Preparedness trainings in first part of 2005

26. Thank You!