Integrating Public Health and Mental Health Services in Disasters (1)

7/30/2019 Integrating Public Health and Mental Health Services in Disasters (1)

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Public Health Systems and PublicHealth Preparedness

Linda C. Degutis, DrPH, MSN


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Objectives

1. To provide a context for understandingthe relationship between public health

and mental health services inpreparedness planning and response

2. To describe the role of public health and

public health systems in disasterpreparedness, response and recovery


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Mission of Public Health

To promote physical and mentalhealth and prevent disease,

injury, and disability


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3 Core Public Health Functions1. Assessment and monitoring of the health of

communities and populations at risk to identify health

problems and priorities;

2. Formulating public policies, in collaboration withcommunity and government leaders, designed to solve

identified local and national health problems and

priorities

3. Assuring that all populations have access toappropriate and cost-effective care, including health

promotion and disease prevention services, and

evaluation of the effectiveness of that care


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10 Essential Public Health Services

1. Monitor health status to identify and solve community

health problems

2. Diagnose and investigate health problems and healthhazards in the community

3. Inform, educate, and empower people about health

issues

4. Mobilize community partnerships and action to identifyand solve health problems

5. Develop policies and plans that support individual and

community health efforts


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10 Essential Public Health Services

6. Enforce laws and regulations that protect health andensure safety

7. Link people to needed personal health services and

assure the provision of health care when otherwiseunavailable

8. Assure a competent public and personal health careworkforce

9. Evaluate effectiveness, accessibility, and quality ofpersonal and population-based health services

10. Research for new insights and innovative solutions tohealth problems


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Fundamental Obligation of Public

Health Agencies1. Prevent epidemics and the spread of disease

2. Protect against environmental hazards

3. Prevent injuries4. Promote and encourage healthy behaviors and

mental health

5. Respond to disasters and assist communities in

recovery6. Assure the quality and accessibility of health

services


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Public Health System

Complex network of:

People

Systems

Organizations

Working in:

public (local, state, and national)

private arenas


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From: CDC (Public Health Foundation, http://www.phf.org/infrastructure/
http://www.phf.org/infrastructure/phfpage.php?page_id=20http://www.phf.org/infrastructure/phfpage.php?page_id=21http://www.phf.org/infrastructure/phfpage.php?page_id=25


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To improve health within the population

Strive to enhance the effectiveness with which

health knowledge and technologies are appliedto address the health issues of individuals andpopulations

Value equity in health & strive to reducedisparities in health across different social,economic, ethnic, and cultural groups

Goals


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Characteristics of Public Health

Primary focus on population

Emphasis on prevention, health promotion for thewhole community

Employs a spectrum of interventions aimed at theenvironment, human behavior and lifestyle, andmedical care

Multiple professional identities with diffuse public

image Biologic sciences central, stimulated by major threats

to health of populations; move between laboratory andfield


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Specific Areas of Public Health

Expertise Risk communication

Surveillance

Community interface/collaboration

Access to services

Working with disadvantaged populations Environmental health


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Prevent epidemics and the spread

of disease Monitor water and food quality

Surveillance for emerging infectious

disease

Control disease vectors (rodents,mosquitoes)


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Protect against environmental

hazards1. Monitor disposition of hazardous waste

2. Monitor air and water quality

3. Ensure potable water is available

4. Maintain sanitation systems


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Prevent injuries

Ensure that workers are provided withappropriate protective devices and

clothing Identify injury risks for the population

and mitigate them


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Promote and encourage healthy

behaviors and mental health Early intervention and referral

Identification of persons at high risk for

developing mental health problems Affected population

Responders/volunteers

Access to mental health services andcrisis intervention services


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Role of Public Health in Disasters

Engage in planning for communityprotection and response

Respond to disasters and assistcommunities in mitigation and recovery


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Respond to disasters and assist

communities in recovery Ensure that essential public health

services are available and accessible

Rebuild services that have been lost

Engage community in plans for servicedelivery


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Assure the quality and accessibility

of health services Develop contingency plans for providing

essential public health services

Develop methods to ensure access tocare and health services

Ensure access to care for non-disaster

related conditions (acute and chronic)


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Host Agent PhysicalEnvironment

SocioculturalEnvironment

Pre-event Risk communica-tion

Immunization

Personalpreparednessplans

Monitoringweatherchanges

Levees

Flood control

Housing

considerationsEvacuation routes

Communitycollaboration,cultural concerns,risk communication,

Evacuation,workforce education

Event Workerprotections,

surveillance

Surveillance

Monitor risk

Sheltercommunications

Risk communication

Post-event Mental health,hospital care,rehab,surveillance

Surveillance

Removal oftoxic waste

Rebuilding, shelters,removal of hazards,water supply

Displacedpopulations returnto homeenvironment

Community change

Access to services

Haddons Matrix


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Haddons Matrix with 3rd Dimension


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Additions to Haddons Matrix

Value Criteria and Preparedness Community preferences

Feasibility

Equity

Evaluation for:

Cost

Effectiveness

Freedom


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Effectiveness

Planning and preparations

Evacuation

Shelter

Maintenance of access to care Community health resources

Hospitals

Medications

Home care Alternate care sites

Distribution of resources


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Cost

Community

State

Region

Private entities


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Preferences of Affected Community

Evacuation

Transportation

Shelter

Safety

Health care

Link to relatives/friends/pets


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Equity

Horizontal equity

Vertical equity

Equal chance of accessing servicesneed to ensure that all population groups

have equal access


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Freedom

Protection of freedom while protectingpublics health

May require compromise Depends upon community

norms/expectations


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Stigmatization

Failure to evacuate

Mental health problems

Homelessness

Poverty


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Feasibility

Adequacy of shelters

Plans for provision of food and water

Evacuation plans


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Advantages of 3rd Dimension

Brings important social and communityconcepts to the planning, intervention

and recovery phases of a disaster Allows for planning and response in a

way that takes into consideration

community values and priorities


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So what?


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Summary

Public health has unique skills and expertisethat it brings to disaster planning and

response. Because of its population-based focus, public

health is in a position to examine the impact ofdisasters on the population as a whole, and

work with others to incorporate the knowledgegained into planning for future responses.


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1. Mental health is an important componentof the communitys health

2. Smooth integration of the mental healthcomponent of health is critical to publichealth preparedness planning and

response


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The time to get to know eachother is not in the midst of a

crisis, but while planning for thehealth of the community


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Integrating Public Health and Mental Health Services in Disasters (1)

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