Disaster Deployment Guidelines

## Everyone who experiences a disaster is touched by it, including crisis response workers and managers.  Good planning can limit health and psychological consequences, minimize disruptions to daily life, and contribute to the growth and empowerment of the individual experiencing the disaster.

# During Operations

1. Make sure you **know your assignment**, mission, and goals before you go out.  If changes happen on the ground, stop to make sure you understand them and review them with your supervisor.  **Check in** with your assignment lead daily; keep clear on the scope of your assignment at all times.

2. **Identify the chain of command** and your direct report in the chain.  Lone rangers cause more trouble than help.  Be respectful of the decision making chain and remember that even though something may not make sense to you, you may not have all the information or the full picture.  Accept decisions of the leadership and learn.  If you have a solution to offer, there may be several opportunities to present and use it.  It may not happen the first time or may be better received based on another context or based on varying relationship-building efforts that need to occur first. 

3. Do not enter areas where you are not assigned to go without permission.  Your mission is not that of rescue and recovery.  **Stay out of danger or “hot” zones** unless specifically assigned there and trained to be there.  Wear protective gear when and where appropriate.

4. Be flexible.  You need to **tolerate chaos, change, and ambiguity with good grace** and good humor.  The goal is to be helpful, doing your best to make the lives of others better and easier.  Learn to be resourceful and find necessities to help others.

5. Logistics will be problematic.  Accept that and roll with the changes.  Do your best to assist in all arrangements on your behalf with the advice and consent of your lead contact.

6. Be culturally sensitive and aware.  **Be respectful** of the practices of others and adapt to the rhythm of the disaster areas.  Practices vary between north, south, east, and west between uniformed officers, civilians, faith-based leaders, local community leaders, and various ethnic groups.  Local workers are considered the experts in the rules, rituals, and innuendos of their communities.  If you are a visitor, then accept these rules and try to be helpful in any way appropriate to your assignment.  Disaster areas are not tourist sites.  Restrict photos and playful behavior to the limited contexts in which they might be appropriate.  When in doubt, don’t do it or don’t say it! 

7. **Practice only within the scope of your competence**.  If you don’t know something, find someone who does.  Consult with others whenever you get a chance. There can be more to do and to learn in 1 day on a disaster assignment than in many months of traditional life, so be humble and expand your options.

8. Always remember you are part of a team. **Partner with your buddy** and access your teammates. Whenever you need help, just ask for it.

9. Plan to **stay in touch with loved ones** daily and listen to their concerns about your functioning.  Practice stress reduction and self-care.  Share stories (respecting confidentiality) with family members and colleagues as a way to let them know what you are doing and to help yourself acknowledge your work.

10. Appreciate the hard work of those around you.  Everyone is doing extraordinarily difficult tasks and it is energizing to be noticed.  Take time to say thank you and smile.

# Disaster Deployment Guidelines

## Clinical

1. Do no harm!

2. Practice only within the scope of your training, licensure, and assignments (except in a life threatening situation when no other help can be procured—do not attempt to treat other conditions).

3. **Normalize**. Do not overpathologize stress reactions that can mimic longer term serious mental and emotion or substance misuse conditions. 

4. Remember, substance misuse can mimic serious mental and emotional conditions.

5. Also, physical conditions can cause symptoms that mimic psychiatric or substance misuse symptoms.

6. **Promote recovery and resilience** by helping individuals and communities enhance their natural coping strategies.

7. Help families and community members **reconnect**.  Help community providers reconnect with their clients and vice versa. 

8. Perform in a manner representative of your agency and your willingness to help, projecting a positive, competent, effective, and supportive manner. 

9. Be careful of advocacy efforts that may be sending a message of hopelessness, helplessness, or lack of support.  Be aware that sometimes doing something FOR someone instead of empowering to doing WITH, can give a message that you think they are incapable or incompetent.  Be sensitive to the chaos and need for organizational systems to work through a process. 

10. Respond to opportunities for **prevention,** particularly with respect to substance misuse.  There is an increased likelihood that individuals who have used alcohol and illicit drugs as a coping mechanism in the past will do so again.  Reinforce healthy prevention coping skills such as returning to AA and NA meetings or getting in touch with a sponsor.

11. Supportive and case management services require linking with the individuals and agencies that are charged with providing these services.  It is at least as important to provide these linkages as it is to provide crisis counseling.  When you have the opportunity to **provide linkages** and referrals, do so.

12. **Refrain** from conducting any “fitness for duty” assessments.  This should be done by the professionals assigned to do so. 

13. Complete your paperwork **daily**.

# Mitigating Stress/Practicing Self Care

1. Be aware that the chaotic nature of disasters can be **disturbing and disorienting**.  Pay attention to your own needs—get adequate rest so that you are capable of quick decision making and the safe, rapid action that is required. 

2. Respond to your work shift assignments.  When your shift has ended, go off duty and offsite unless asked by your team leader to do otherwise. 

3. When off duty, be sure to make ***REST*** a priority.  Go back to your accommodations area or go home as appropriate.  Even if you feel you cannot sleep, rest your body. 

4. **Exercise only lightly** after a stressful, emotionally intense and/or physically exhausting day.  Refrain from using heavy weights.  WALKING, STRETCHING, and BREATHING exercises are most effective.  Integrate exercise several times into each day whenever you are able. 

5. **Eat lightly and healthfully** during and especially after a stressful, emotionally intense and/or physically exhausting day.  Know that some individuals suffer with stomach ailments such as constipation or diarrhea during or right after a deployment.  This is not unusual, but if it persists, see your physician.

6. Know that **some individuals suffer with sleep problems** after an intense or tiring day (unable to fall asleep, unable to remain asleep, waking in the early morning hours and unable to go back to sleep). Some tips for helping with sleep problems include: 

a. Only go to bed when you are ready to go to sleep. Don’t read, watch TV, or engage in other activities when you are trying to tire yourself enough to sleep. 

b. Use soothing music to relax you or relaxation tapes that help with cognitive messages that assist in going to sleep.

c. Use sleep balms with relaxing aromas such as lavender that help induce sleep.

d. Try a relaxing tea an hour before sleep, such as chamomile or lavender.

e. Avoid eating (especially sugar) or drinking (especially alcohol) at least 1 hour before retiring. 

f. Try massage oils or balms on your feet, hands, calves, and temples to induce sleep.

g. Ask your health care provider if you might use a sleep aid, supplement, mindfulness-based stress reduction, or other relaxation technique to help you get some rest.

7.  When exposed to the trauma of disasters such as destruction, injury and death, some people may suffer with nightmares and flashbacks during or after a disaster deployment.  These symptoms will likely decrease over time as you talk to your team leader, buddy, or family member.  Request a debriefing if you want additional assistance or see your physician or therapist if such sleep disturbances persist.

8. **Prepare your loved ones** to expect that you may be more tired, less active, less talkative and requiring more support while working in the disaster environment.  Some individuals may even become irritable and short tempered upon returning from a difficult, intensely emotional or exhausting assignment.  While this is not an excuse to be unpleasant to family members, it may be helpful for them to know that you need some time to quiet yourself, resettle, and rest.  Family members may need to lower their expectations of your desire and/or ability to be social at these times.  **You may need to lower your expectations of yourself** as well.

9. Know that alcohol and illicit drugs may have an enhanced effect, making them more potent and having the potential to make an individual more impaired both physically and cognitively.  Additionally, **alcohol may intensify feelings of being down,**depressed, or in despair.  It is recommended to avoid alcohol (and mood-enhancing drugs) when working in a disaster assignment and post deployment as well. 

10. Be aware that individuals who work in disaster response often have close working relationships and may feel a more intense level of “false intimacy” than would normally occur in traditional work settings.  This is often because defenses are down and individuals may feel more vulnerable or more heroic than normally.  **Be cautious of “instant intimacy”** feelings.  They are most often false and may create discomfort or embarrassment once individuals return to their “real life” if acted upon.

11. **Engage in activities that provide soothing comfort** to you when time allows (e.g., take a long, hot bath; swim; walk; read a book; watch a movie—do something you enjoy. Think about journaling as a way to help discharge energy or concerns about the work you have done or events you have witnessed.  Consider working with a supervisor or therapist to assist in processing difficult experiences or exposure.

12. **Avoid overexposure or overprocessing events** especially with co-workers who have had dissimilar experiences and/or more exposure than you.  Follow the old crisis counseling rule, “Don’t look at what you don’t have to see.  And don’t listen to more intense or gruesome experiences that you have had yourself.” 

13. **Know when it is time for you to end working in the disaster environment.**  Many people work in the field for 2-week deployments.  Others may participate in crisis counseling programs that go on for 2 months, 9 months, or more.  Individuals are not expected to remain throughout the entire mental health disaster response if they need to remove themselves from the intensity of the work, to rest, or to move on to their previous employment.  Be mindful of how you are doing the longer you remain working in the disaster environment.  Target your end date and work towards your goal. 

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