Introduction to Mental Health Preparedness Facilitator’s...

Introduction to Mental Health

Preparedness

Facilitator’s Guide

Developed by the University of North Carolina

Center for Public Health Preparedness

3rd Edition, October 2013

Introduction to Mental Health Preparedness

Facilitator’s Guide

Table of Contents

Program Overview……………………………….………………………………………………4 Options for Delivery ................................................................................................... …..4 Instructions for Using This Training Package .............................................................. ..6 Comments and Feedback ................................................................................................ 7

Facilitator’s Guide for Introduction to Mental Health Preparedness…………8 Appendix: Examples of the facilitator providing context and relevance……14 For more information about this program including the online and DVD version of the presentation, participant workbook with activities and instructions and the audio narration, go to: https://cphp.sph.unc.edu/trainingpackages/mental_health_prep/ For questions or comments regarding this program, contact: UNC Center for Public Health Preparedness North Carolina Institute for Public Health Gillings School of Global Public Health The University of North Carolina at Chapel Hill Campus Box 8165 Chapel Hill, NC 27599-8165 919-843-5561 [email protected] http://cphp.sph.unc.edu

https://cphp.sph.unc.edu/trainingpackages/mental_health_prep/mailto:[email protected]://cphp.sph.unc.edu/

Facilitator’s Guide: Introduction to Mental Health Preparedness 4

Program Overview

Learning Objectives 1. Describe the mental health consequences of natural disasters and terrorist events 2. Identify the mental health effects of disasters including issues related to anxiety,

stress, substance abuse and resilience 3. Recognize behaviors that can assist survivors immediately following a disaster 4. Identify additional resources for mental health preparedness and create an action

plan (optional)

Course Structure This course is divided into two modules to enable flexible delivery of the training to meet learner’s needs and schedules:

Module One: Mental Health Preparedness Concepts Including normal and problematic reactions to natural disasters and terrorism Duration approximately 2 hours

Module Two: Mental Health Preparedness Action Steps Including Psychological First Aid and recognizing behaviors to assist survivors Duration approximately 1 hour

Audiences This introductory training program is appropriate for professionals and volunteers who may respond to a disaster of any kind and who want to increase their awareness of the psychosocial consequences for disaster survivors and responders and the behaviors that can assist others immediately following a disaster. This can include people from the following fields: public health, nursing, medicine, emergency medical services, behavioral health and other health care fields, as well as emergency management, social services, education, faith, and others. Anyone who may be part of assisting disaster survivors can benefit from this program.

Options for Delivery The training can be implemented in two ways:

Computer-based self-study - Visit this training on the UNC CPHP Training Web Site (http://cphp.sph.unc.edu/training/HEP_MHP ). The online materials are identical to those included in this Guidebook and DVD.

Facilitated face-to-face training -Review the Facilitator’s Guidelines and materials contained in this Guidebook and on the accompanying DVD. You may also wish to reference the guided discussion questions provided for each module, though this is not required to receive continuing education credit.

http://cphp.sph.unc.edu/training/HEP_MHP


When training is completed, participants may access an online evaluation associated with each module to receive a certificate of completion and/or relevant continuing education credit. Specific information about completion requirements for certificates of completion and continuing education credit is provided at the end of each module.

Materials, Resources, and Equipment The materials and resources associated with this training package are:

Facilitated face- to-face training

Computer-based self-study

Training program video in DVD format (To order, contact [email protected] or 919-843-5563)

Online streaming modules (available at http://tinyurl.com/MHPonline )

Participant Workbook with instructions and activities

Participant Workbook with instructions and activities

Pre/post-tests (included in participant workbook)

Pre/post-tests (included with online streaming modules)

Facilitator’s Guide for small group training

Evaluation (available online at http://tinyurl.com/MHPevalonly)

Evaluation (included with online streaming modules)

Resources for further study (available on web page provided in workbook)

Resources for further study (included with online streaming modules)

NOTE: The following URL: http://cphp.sph.unc.edu/training/HEP_MHP/

Can also be accessed at: http://tinyurl.com/MHPonline The following URL: http://cphp.sph.unc.edu/training/HEP_MHPp/certificate.php

Can also be accessed at: http://tinyurl.com/MHPevalonly Facilitated face-to-face small group training requires the following equipment:

DVD player and TV monitor (with speakers if using with group) OR Computer with DVD drive and speakers (and projection screen and LCD projector if using with a group)

Training video (DVD) – copies may be obtained from the UNC Center for Public Health Preparedness (see contact info below). Duplicates of the DVD may be made for nonprofit educational purposes and only with written permission from the UNC Center for Public Health Preparedness.

Participant Workbook (with pre/post-tests, and small group learning activities with instructions)

This Facilitator’sGuide with information on how plan and conduct this training

http://tinyurl.com/8bvaeuhhttp://tinyurl.com/MHPevalonlyhttp://cphp.sph.unc.edu/training/HEP_MHP/http://tinyurl.com/8bvaeuhhttp://cphp.sph.unc.edu/training/HEP_MHPp/certificate.phphttp://tinyurl.com/MHPevalonly


Computer with Internet access to: o Download the workbook documents to copy prior to the training and view

the online training resources. The URL to access these documents and resources is: http://cphp.sph.unc.edu/trainingpackages/mental_health_prep/

o Access the online evaluation (http://tinyurl.com/MHPevalonly) to be completed by each participant following the program in order to receive a Certificate of Completion and, if applicable, Continuing Education Credit.

Continuing Education (CE) Credit Eligibility for all continuing education credit is determined on an annual basis. To learn what CE credit is currently available for this program, go to: http://tinyurl.com/MHPevalonly CE credit is awarded to participants who certify completion of the entire program including viewing the presentations, completing the activities, taking the pre/post-tests and answering the questions in the online evaluation.

Instructions for Using This Training Package Before the face-to-face training:

1. Obtain the DVD from the UNC Center for Public Health Preparedness 2. Download and print a copy of the Participant Workbook in PDF format from

http://cphp.sph.unc.edu/trainingpackages/mental_health_prep/ 3. Optional: Presentation thumbnails and audio narration scripts that may be

downloaded and used for reference by instructors or to supplement audio script for persons with hearing impairment. The video script is not intended to be used in place of the video.

During the training: 1. Review the Introduction and Module One Overview in the workbook. 2. Complete the pre-test for Module One in the workbook. 3. View the Module One training program video and watch the first segment of the

presentation. 4. Stop the video when instructed and complete Activity 1 in your workbook. 5. Re-start the video for the next part of the presentation. 6. Stop the video when instructed and complete Activity 2 in your workbook. 7. Re-start the video for the brief conclusion of Module One. 8. Complete the Module One post-test in the workbook. 9. Review the Module Two Overview in the workbook. 10. Complete the pre-test for Module Two in the workbook. 11. View the Module Two training program video and watch the first segment of the

presentation. 12. Stop the video when instructed and complete Activities 3 and 4 in your

workbook. 13. Complete the Module Two post-test.

http://cphp.sph.unc.edu/trainingpackages/mental_health_prep/http://tinyurl.com/MHPevalonlyhttp://tinyurl.com/MHPevalonlyhttp://cphp.sph.unc.edu/trainingpackages/mental_health_prep/


14. Optional: Re-start the video to continue watching the presentation. Stop the video when instructed and complete Activity 5.

15. Re-start the video and watch the final segment of the presentation. After the training:

1. Each participant must complete the online evaluation in order to receive a certificate of completion and, if applicable, continuing education (CE) credit. All components of the program must be completed before the evaluation is accessed. Participants of the face-to-face training go to http://tinyurl.com/MHPevalonly on the UNC CPHP Training Web Site to access the evaluation.

2. Optional: Web-based training and resources from many organizations for further study; http://cphp.sph.unc.edu/trainingpackages/mental_health_prep/resources.html

Comments and Feedback Please send your reactions, suggestions and evaluation results to the UNC Center for Public Health Preparedness (see contact information below). We appreciate your feedback.

Program Developer Contact Information: UNC Center for Public Health Preparedness University of North Carolina at Chapel Hill CB# 8165, Chapel Hill, NC 27599-8165 Phone: 919-843-5561 Email: [email protected] Web: http://cphp.sph.unc.edu/

http://tinyurl.com/MHPevalonlyhttp://cphp.sph.unc.edu/trainingpackages/mental_health_prep/resources.htmlmailto:[email protected]://cphp.sph.unc.edu/


Facilitator’s Guide for Introduction to Mental Health Preparedness Here are the basic steps to prepare and conduct the training program Introduction to Mental Health Preparedness:

a) Understand your role b) Get comfortable with the training materials c) Review the training delivery options d) Assess the audience you want to train e) Plan the training logistics f) Prepare the training materials g) Conduct the training session h) Evaluate and follow-up on the training session

a) Understand your role – As the facilitator of this training program, you are not

expected to be an expert in mental health preparedness. Your role is to conduct the training using the resources provided, including these guidelines to help you prepare to be the facilitator. You are strongly encouraged to identify a mental health preparedness expert in your state or local area (see the next step for suggestions on how to do this). The value you bring as a facilitator is to understand your audiences and provide the context for this training to make it relevant and appropriate.

b) Get comfortable with the training materials – As the facilitator of this session,

it is important for you to become familiar with the training materials before your conduct the training. The training materials include:

1. Presentation with slides and audio narration on video (DVD) 2. Participant Workbook with presentation slides, activities and pre-post tests 3. Additional resources for mental health preparedness (links to these resources

found: http://cphp.sph.unc.edu/trainingpackages/mental_health_prep/resources.html)

This training can be used as a small group training program as well as for independent study. The ideal class size is between 6 and 30 participants in order to facilitate the small group activities in break-out groups of 3 to 5 people. This program can be delivered in a number of different ways including in one half day session, as two consecutive sessions each about 2 hours long, or as a series of four sequential one hour sessions (for more information, see the next section (c) below).

http://cphp.sph.unc.edu/trainingpackages/mental_health_prep/resources.html


To become familiar with this training, you should complete the training yourself following the instructions for self-paced learning. At the beginning of each module in the workbook, you will find learning objectives and an outline for the delivery of the module. Pay special attention to the facilitation instructions for the five activities and review the directions for small group training which are provided at the beginning of each activity. Activities 1 and 4 have options to select the threat and/or population that are most relevant to your audience. You may select one optional activity and then encourage participants to complete other optional activities on their own. Review the answer key for each activity found at the end of the activity so you can be more familiar with the correct responses. Be sure to take the pre-test and post-test for Module 1 and 2 and review the answer key. It is also suggested that you review the training resources posted on the web page so that you can help make recommendations for additional training. Ideally you should complete at least one of the recommended training resources such as the modules offered by SAMHSA or the Johns Hopkins Center for Public Health Preparedness. Links are on the web page: http://cphp.sph.unc.edu/trainingpackages/mental_health_prep/resources.html In addition, here are resources (e.g. glossaries of relevant terms) you may want to review: National Child Traumatic Stress Network glossary

www.nctsn.org/nccts/nav.do?pid=gls_main FEMA glossary of mental health terms related to disasters

http://training.fema.gov/EMIWeb/edu/docs/terms%20and%20definitions/Terms%20and%20Definitions.pdf

Be sure to identify state or local resources for mental health preparedness expertise so that you can contact these resources if questions arise during your training. Suggestions for the types of organizations with this expertise are found on the web page. Again, you are not expected to be an expert in mental health preparedness, but you must know how to access expertise if you need it.

c) Review the training delivery options – This program can be delivered several

different ways depending on the needs of your audience. Delivery Options: 1) One 3 hour program – Cover all the training content and learning activities in

one three hour session (not including optional Activity 5. 2) Two consecutive sessions (about 2 hours and 1 hour) – Conduct Module

One (mental health preparedness concepts) first and then Module Two (action steps).

3) Four consecutive one hour “Lunch and Learn” sessions – If longer

sessions are not feasible, you can conduct this as four sessions, however each

http://cphp.sph.unc.edu/trainingpackages/mental_health_prep/resources.htmlhttp://www.nctsn.org/nccts/nav.do?pid=gls_mainhttp://training.fema.gov/EMIWeb/edu/docs/terms%20and%20definitions/Terms%20and%20Definitions.pdfhttp://training.fema.gov/EMIWeb/edu/docs/terms%20and%20definitions/Terms%20and%20Definitions.pdf


session builds on the previous sessions, so your audience needs to attend each session. Session A – Module One, Part 1 - Introduction, mental health preparedness

concepts presentation and Activity 1 (Case Study Part 1) Session B – Module One, Part 2 – Problematic reactions and terrorist

presentation and Activity 2 Session C – Module Two, Part 1 – Introduction to Psychological First Aid

presentation and Activity 4 (Case Study Part 2) Session D – Module Two, Part 2 – Activity 3 (role play), mental health

preparedness resources presentation, and Activity 5 (action plan) d) Assess the audience you want to train – Before you move ahead with

implementing this training in your agency or community, think carefully about the characteristics of the people you want to train before your decide on exactly how to conduct the training. Your role as facilitator is to understand your audiences and provide the context for this training to make it relevant and appropriate. The intended audiences for this training program are responsible for responding to natural disasters, technological disasters, epidemics, and terrorist events by staffing clinics, shelters and public offices, both in person and on hot lines, or other duties. The trainees can include:

Public Health department staff – all staff who may have contact with the public at the time of a disaster including health director, BT/preparedness coordinator, environmental health, nurse, administrative, etc.

Responders from other organizations – staff from medicine, nursing, emergency medical services, behavioral health and other health care fields, as well as emergency management, social services, education, faith, and others

Volunteers – community members with diverse ages and backgrounds who volunteer to assist local health departments in responding to emergencies but do not have a background in public health, healthcare or related fields

The audience will be familiar with basic concepts of disaster preparedness and his or her role in disaster response prior to participating in this training.

Identify your “target” audience and conduct a brief needs assessment to confirm your assumptions including:

1) What are skills and experience of your audience concerning the mental health consequences of disasters? (e.g. disaster responder or survivor)

2) Does your audience perceive a need for this training in their current work and/or express an interest in the topic?

3) How much time does your audience have to dedicate to this training?

4) Do the managers of your audience support their attendance at this training and their implementation of the skills back on the job?

5) Are there travel constraints or other logistics that you need to consider?


Based on the answers to these questions, decide how to conduct this training including:

Whether to conduct this training in one session, two consecutive sessions, 4 “Lunch and Learn” sessions or Self-Study (Review section (c) above).

When and where to schedule the training to be most convenient for your audience

How many people do you need to train and what size group are you comfortable with facilitating

How to tailor the agenda to your audiences needs (e.g. how much time for each activity)

How to invite your participants in order to gain their participation (e.g. clarify why the training is important for their job and if their manager supports their participation)

How to introduce the program and specific segments of content and activities to make it relevant and appropriate for the audience. This step is critical to the overall success of the program! (See examples in the appendix.)

e) Plan the training logistics – This includes the “nuts and bolts” of getting your training scheduled and ready to implement once you have decided how to conduct the training.

Determine possible dates that you and your audience are available for training.

Secure a training facility for the dates and size of your audience that meets your requirements (number and set-up of tables and chairs, TV, etc.) Take into consideration accessibility and convenience for your audience.

Invite your potential audience, including information such as the topic, date/time, location, registration deadline, overview of goals and reasons that the audience may want to attend, cost, etc.

Confirm your participants and create an attendance roster.

Obtain the equipment that you need to deliver the presentation – TV with DVD player or other set-up with adequate speakers. Have a back-up plan in case you experience a problem with this equipment (e.g. technical support person).

Decide if refreshments are needed and order.

Consider if others are needed to assist with room set-up, registering participants, refreshments, and other logistics.

Prepare a back-up plan in case of illness or bad weather and communicate this plan.


f) Prepare the training materials – The Participant Workbook (instructions, activities and tests) and additional optional resources (thumbnails of presentation slide and audio narration script) can be found at: https://cphp.sph.unc.edu/trainingpackages/mental_health_prep/

Once you have downloaded these documents to your computer, you can print them and make copies for your participants. We suggest that you make double sided copies of the workbook and put them in a 3-ring binder. You may also want to make copies of the evaluation form and certificate of completion. You may decide not to distribute the entire Participant Workbook during the training but just provide copies of the pre/post tests, activities and the evaluation. The workbook could be available after the training as a refresher. Again, this is part of the facilitator’s job to understand the audience and determine what will be most effective.

g) Conduct the training session – We will review a few essentials for delivering an effective training program. However, this Facilitator’s Guide is not a complete “how to” for facilitating an effective session or for responding to in-depth questions about mental health preparedness.

Have everything set up and ready to go before the session so you can greet people as they enter the room. (e.g. test the equipment well in advance to have time to address problems)

Start with a persuasive introduction to let your audience know why this topic is important and how it relates to their jobs and lives. If the group doesn’t know each other, be sure to have everyone introduce themselves

Introduce each segment of the video and each activity with strong, clear statement of purpose or context to help the audience understand the purpose of the content or activity and “WIIFM” (What’s in it for me). See the appendix for ideas on how to do this.

Manage discussion effectively by encouraging everyone to participate (and no one to dominate). Keep focused on your goals and make sure your audience gets the connection between what you are doing in the activity and why it is important.

Build in brief “check-in” times to gauge how the session is going. This doesn’t mean just asking “Are there any questions?” It is better to ask more specific questions to elicit information such as “How do you see this relating to what you do on the job?” If you need to spend more time on an activity than you had planned, remember it is better to meet the needs of a majority of the learners than to satisfy your desire to cover all the content. Take a 3 minute “stretch break” if you need to reconsider how to proceed.

Maintain control of the time. If you are going over your expected timeframes, figure out how to adjust the content (e.g. ask participants to complete an activity

https://cphp.sph.unc.edu/trainingpackages/mental_health_prep/


after the program on their own time). Don’t extend the training session unless you get everyone’s agreement to end the session later.

Be sure to be familiar with the Activity Answer Keys and have them available to refer to as questions arise. Encourage the participants to come up with their own answers before referring to the Answer Key. Remember, in many cases there is not right or wrong answer. Your role as facilitator is to use the materials to raise awareness of the concepts and behaviors covered in this introductory course.

In case your participants raise in-depth questions or issues that are not covered in these materials, be sure you know the local or state mental health preparedness experts that you can call on. This is a sensitive topic and you don’t want to raise awareness without a plan for addressing questions and concerns that might arise during or after the training (see step b for more information).

h) Evaluate and follow-up on the training – There are two types of evaluation

instruments included in this program:

Pre and Post Test measures what your participants learned during the session. The pre-test (found in the workbook) is administered at the very beginning of each module before you review the objectives and start delivering the content. The post-test is administered at the very end of the session. To assist with the analysis of the Pre/Post Test, an Answer Key has been provided. Participants can use the answer key to find out if they answered the questions correctly. You may decide to collect the Pre- and Post-Test Answer Key if you want to see how the group performed, however, clarify the purpose is for you to see is learning is taking place in the overall group. These forms are designed to collect anonymous results.

Evaluation measures how satisfied the participants were with the session. This is administered after the full training has been completed. Each participant will go online to complete the evaluation (http://tinyurl.com/MHPevalonly) and upon completion will receive a certificate of completion and, if applicable, CE credit.

Follow-up Activities that you might want to consider with your audience after the training session help you assess the longer term results in terms of learning, skill application and overall value of and satisfaction with the training. For example, you could contact participants in 2 months to see how many people had followed through on their action plans and taken additional online training or reviewed technical assistance documents. You could recognize the people who completed their action plans and ask them to share what they learned with others.

http://tinyurl.com/MHPevalonly


Appendix: Examples of the facilitator providing context and relevance

As a facilitator, your role is to provide context and relevance for your audience to get the most out of the training. By knowing your audience – their jobs, background, concerns, motivators, etc – you can tailor the training to help your audience see the significance of the program and offer motivation for them to learn. Here are a few examples of how to provide context and relevance. Audience question: Why do I have to take this training? Suggested facilitator responses: We have learned from recent disasters that the mental health consequences of

disasters are actually larger then the physical consequences, so we want everyone to be able to anticipate what to expect and give guidance on what to do. This is a critical part of all our jobs – being able to recognize and respond to the needs of disaster survivors as well as our own needs.

This training provides some practical techniques that we can use for everyday “disasters” that might occur in our department, such as handling an angry or upset person.

Everyone in our department is required to take this training so we are prepared for the consequences of disasters both large and small. It fits into our larger preparedness efforts (provide other information about preparedness work underway).

Audience question: Why do we have to learn about the serious psychological reactions of disasters (e.g. Dr. Everly’s video segment after Case Study 1)? Suggested facilitator responses: While you will not be expected to diagnose or treat these serious consequences (e.g.

Post Traumatic Stress Disorder), we want you to realize that survivors can have disabling illnesses following a disaster. While most people are able to rebound over time, there are long-term mental health consequences for some people.

We usually focus on physical diseases, but mental health is often neglected or simply not a part of our everyday work.

Some of Dr. Everly’s language is a bit technical and over our heads… don’t worry… just pick up his main ideas about PTSD, depressions and grief.

Audience question: The role play of Psychological First Aid is beyond anything I am able to do (or want to do). Why are we watching it?


Suggested facilitator responses: We want you to see an example to help you understand what it is and what others

trained in PFA will be doing at a disaster scene. Some of the techniques shown in the role play are things that everyone can do, like

listening without judging a person’s experience and encouraging people to take small steps to help themselves.

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