Date of Change Recommended Change Change Number Initials May 2017 Updated Disaster Behavioral Health Fatality Management Annex pages 102-143 based on Bangor Airport Full Scale Exercise (May 2017) to include: Federal assistance program for transportation accidents, e.g. NTSB, family assistance center floor plans, transportation carrier resources Forms for psychological first aid services Role of State Department, Customs and Immigration, and FBI Victims Assistance Secondary traumatization symptoms- Responder Health and Safety capabilities 24 KW 5 July 2017 Updated Instructions for Telephonic Interpreter Services 25 KW 5 July 2017 Psychiatric advance directives (PADs) 26 KW 10 Aug 2017 Appendix A: Treating Survivors of Trauma Center for PTSD 27 KW 26 Jan 2018 DHHS Release of Confidential Information updated form Appendix B KW 26 Jan 2018 DBHRT training requirements to Crisis Counseling Core Content Training Appendix B KW
Hospitals begin to prematurely discharge BH patients Family members are separated at time of disaster and out of contact with children and senior members As a result of building damage or limited access, BH agencies and faith based organizations are closed and the population cannot gather for social support Reports on short supplies of BH medications General services are compromised and goods in short supply which increases anxiety and agitation. Work and school logistics become increasingly complex as schedules need to be adaptive to employee availability Triggers: 20% increase in law enforcement/social service reports Jail and alternative diversion programs at capacity 20% increased psychiatric presentations in ED 20% increased calls to Crisis Hotlines 10% increased waiting list for BH appointments 20 % BH providers report seeing only emergency cases. care threatens treatment systems 10% of workplaces and schools are closed Alternative care/diversion programs are at capacity and no more admissions Jails at capacity Crisis Triggers: Healthcare systems can no longer admit patients exhibiting acute anxiety and agitation Roads become impassable as a result of residents evacuating or searching for family members BH providers report they can no longer provide prescription medications due to supply line disruption ED’s threaten closure due to inability to manage BH cases, no beds, no referral options Hospital triage results in reduction of BH patients admitted Increased number of BH patients being maintained in ED or general medical treatment areas Specialty psychiatric units exceed capacity or experience damage to infrastructure BH problems increase in systems 20% decline in number and severity of new cases 10% reduction in reports from law enforcement, social services, schools and others regarding BH Pre-event BH capacity and admissions established
Faith-Based Initiatives Many different faith-based organizations provide mental health counseling to communities impacted by disasters. A list of organizations is at: Short Term Response Needs Coordination During a declared event, Disaster Behavioral Health actions and capabilities may include: Target Populations Acute Phase Response Recovery Phase Survivors and the Family Members Service Needs: Acute Care Protection Stabilization Direction Connection Case Mgmt. Triage Intervention site: Disaster impacted region/ shelters/hospitals Family Reunification Center Family Assistance Center Service Centers Providers: American Red Cross DBH Volunteers Crisis Agencies Service Needs: Outreach Assessments Referrals Psychosocial Education CBT-online or telephone Initial follow-up Large group activities Case Consult with other providers Assist w/ death notification Intervention sites: Shelters Hospitals Reception Centers Schools Homes/hotels Churches PODs Family Assistance Center Providers: BH community Red Cross VOAD DHHS Service Needs: Outreach Psychosocial ED Debriefings PTSD Assessments Referrals Individual, Family, Couple support Group Counseling Case Consult Advocacy Development Support Groups Memorial Services Long Term Recovery Case Management Providers: BH Community DHHS staff Disaster Case Managers Long Term Recovery Board Community Groups First Responder Service Needs: Triage/Needs Assessment Consultation Stress Mgmt. Crisis Intervention Referrals Service Needs: Assessment Consultation Initial Follow-Up Referrals Group Support Service Needs: Assessment Referrals Debriefings Behavioral Health services/treatment Commemoration/Memorials
Intervention Sites: Impacted region Work Rest sites Hospitals Providers: Crisis Response Teams In house/EAP Supports Intervention Sites: Work sites Rest areas Home offices Hospitals Providers: BH community Red Cross/VOAD Peer support Intervention Sites: Work sites Rest areas Home offices Hospitals Providers: BH community Community BH providers Employee Assistance Vulnerable Population Service Needs: Outreach Triage/Needs Assessment Protection Client movement Direction Connect w/Treatment Providers Medication Mgt. Assure provision of: food, clothing, shelter Service Needs: Outreach Triage/Needs Assessment CBT- online and telephone Referrals Psychosocial ED Medication Mgt. Transportation Case Coordination w/other providers Service Needs: Outreach PTSD Assessment Referrals Debriefings Psychosocial ED Case coordination/long term Advocacy Support Groups Commemoration events Intervention site: Homes and residential facilities Shelters Treatment sites Street Schools Elderly housing Providers: Local crisis agencies Nonprofits Churches DBH Volunteers Intervention site: Home/residential facilities Shelters Treatment sites Street Schools Elderly housing Providers: BH Community DHHS staff Red Cross/VOAD Peer-Recovery groups Intervention sites: Home/residential facilities Treatment sites Street Schools Elderly Housing Providers: BH Community Healthcare Providers Treatment Providers Recovery groups DHHS staff Long term Recovery Business Service Needs: Outreach needs Assessment Consultation Treatment sites Education Service Needs: Phone & on-site consultation Employee support Service Needs: Phone & on-site consultation Needs assessment Educational info Training w/ EAP staff General Public Service Needs: Information Education Providers: Service Needs: Psychosocial ED Reports, brochures re: stress reduction & coping Service Needs: Information & Education Providers:
Flashlight and batteries Portable radio (battery powered and receives weather/emergency announcements) Extra batteries Sleeping bag/bed roll/blanket and pillow Sewing kit Travel alarm clock _____________________________________________ Contact lens solution Prescriptions/medicines (including a list of all medication names, dosages, prescribing physician, telephone numbers.) Copy of medical insurance card Personal first aid kit Sunscreen Bug spray _____________________________________________ Appendix B Initial Community Needs Assessment Name __________________________ Date_________________ Town __________________________ County ________________ Fill out separate form for each town Estimated Impact Loss Categories Number of Persons Type of Loss Number Dead Hospitalized Non-hospitalized Injured Homes destroyed Homes “Major Damage” Homes “Minor Damage” Disaster Unemployed (Others—Specify)