- 1. Building Disaster Health and Well-being Susan Earley State
Disaster BehavioralHealth Coordinator Hurricane Conference 2011
Pawtuxet Village 1938
2. Protect Your Health and Safety After a Hurricane or
FloodPrevent illness from FOODIdentify and throw away food that may
not be safe to eat. Prevent illness from WATERListen to and follow
public announcements.Avoid floodwater and mosquitoes.Follow all
warnings about water on roadways.If you are caught in an area where
floodwater is rising, wear a life jacket, or use some other type of
flotation device. 3. Prevent and treat OTHER ILLNESS and
INJURIESPrevent carbon monoxide poisoning. Dont use a gasoline- or
charcoal-burning device inside your home, basement, or garage.Dont
run a car inside a garage attached to your house, even if you leave
the door open.Dont heat your house with a gas oven.Beware of
electrical and fire hazards.NEVER touch a fallen power line.If
electrical circuits and equipment have gotten wet or are in or near
water, turn off the power at the main breaker or fuse on the
service panel. 4. Avoid unstable buildings and structures.Beware of
wild or stray animals. Take appropriate precautions to avoid animal
bites and rabies exposure.Get rid of dead animals according to
local guidelines. If possible, use flashlights or other
battery-operated lights instead of candles. Beware of hazardous
materials. Wash skin that may have come in contact with hazardous
chemicals.Clean up and prevent mold growth. Clean up and dry out
the building quickly. 5. To prevent mold growth, clean wet items
and surfaces with detergent and water. Throw away porous items (for
example, carpet and upholstered furniture) that cannot be dried
quickly. Fix any leaks in roofs, walls, or plumbing.Pace yourself
and be alert to physical exhaustion or strain. Set priorities for
cleanup tasks. Try not to work alone or get exhausted. Ask your
family members, friends, or professionals for support. Prevent
musculoskeletal injuries. Use teams of two or more people to move
bulky objects. Avoid lifting any material that weighs more than 50
pounds (per person). 6. Treat wounds. Clean out all open wounds and
cuts with soap and clean water. Apply an antibiotic ointment. Use
soap and water to wash your hands. If water isnt available, you can
use alcohol-based products made for washing hands.Stay cool. When
its hot, stay in air-conditioned buildings; drink water and
nonalcoholic fluids often.Wear protective gear for cleanup work.
Wear hard hats, goggles, heavy work gloves, and watertight boots
with steel toes and insoles.Wear earplugs or protective headphones
to reduce risk from equipment noise. 7. Whats wrong? Mental health
issues are among the largest public health issues following a
disaster. This must be considered in all phases of disaster
planning and management . 8. Objectives
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- Identify typical disaster reactions.
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- Describe the key concepts of disaster mental health.
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- Explain the importance of survivors connections to social
networks and to accurate, current information.
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- Identify current communication resources andtools.
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- Recognize Rhode Islands strengths in support of disaster health
and well-being.
9. Weather-related disaster: A disaster is the result of a vast
ecological breakdown in the relation between humans and their
environment, a serious and sudden event (or slow, as in a drought)
on such a scale that the stricken community needs extraordinary
efforts to cope with it, often with outside help. 10. Key
Concepts
- Risk FactorsPopulation Exposure Model
- Injured survivors; bereaved family members
- Survivors with high exposure to disaster trauma or evacuated
from disaster zones
- Bereaved extended family and friends; first responders
- People who lost homes, jobs, and possessions; people with
preexisting trauma and dysfunction; at-risk groups; other disaster
responders
- Affected people from the larger community
- Adapted from DeWolfe, 2002.
11. Key Concepts (cont.)
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- Everyone who experiences a disaster is affected by it in some
way.
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- People pull together during and after a disaster.
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- Stress and grief are common reactions to uncommon
situations.
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- Peoples natural resilience will support individual and
collective recovery.
12. Key Concepts (cont.)
13. Key Concepts (cont.)
- Typical Outcomes of Disaster
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- Some will have severe reactions.
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- Few will develop diagnosable conditions.
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- Most do not seek help or treatment.
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- Survivors often reject help.
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- education play important roles.
14. Fundamentals of Disaster MH
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- Work to help people foster their natural resilience and develop
positive coping skills.
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- Most disaster survivors have never received traditional mental
health or substance abuse services.
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- Overcoming stigma is a challenge
15. Fundamentals (cont.)
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- Based on an assumption of natural resilience and
competence
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- Conducted in nontraditional settings
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- Be calm, kind and, above all,
16. Goals of Disaster Mental Health Work with Individuals
- Serve as a supportive presence
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- Understand their own situations and reactions
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- Regain a sense of mastery and control
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- Identify, label, and express emotions
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- Adjust to the disaster and losses
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- Make decisions and take action
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- Develop coping strategies
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- Refer for MH treatment as needed
17. Community Support and Networking
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- Foster community resilience through improved connectivity
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- Promote familiarity with disaster relief resources
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- Create a seamless system for referral
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- Create opportunities for shared resources and training
18. Individual Reactions
- Types of Individual Reaction
These are normal and expected reactions to an abnormal event.
19. Individual Reactions (cont.)
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- Gastrointestinal problems
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- Headaches, aches, and pains
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- Tremors or muscle twitching
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- Clumsiness, increased accidents
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- Eased startle (more easily startled)
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- Chronic fatigue or sleep disturbances
- Positive responses can include alertness.
20. Individual Reactions (cont.)
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- Heroic, euphoric, or invulnerable feeling
- Positive responses can include feeling challenged, involved,
and pressured to act.
21. Individual Reactions (cont.)
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- Disorientation and confusion
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- Difficulty setting priorities or making decisions
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- Recurring dreams, nightmares, or flashbacks
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- Preoccupation with disaster
- Positive responses can include group identification and
sharpened perception.
22. Individual Reactions (cont.)
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- Alcohol and drug use or abuse
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- Increased use of over-the-counter medications
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- Difficulty communicating or listening
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- Irritability, anger, or frequent arguments
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- Declining job performance
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- Avoidance of triggering places or activities
- Positive responses can include unselfish and helping
behavior.
23.
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- The severity of reactions is affected by the type of, level of
exposure to, and casualties associated with the disaster.
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- Preexisting trauma may increase the risk of severe
reaction.
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- People experiencing severe reactions should be referred for
treatment.
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- Preexisting levels of support will affect the severity of
reactions.
Individual Reactions (cont.) 24. Collective Reactions
- Typical Phases of Disaster
Adapted from CMHS, 2000. 25. Resilience is:
- an ability to recover from or adjust easily to misfortune or
change
- one of the most important factors in fostering individual and
community recovery
26. Factors Affecting Resilience
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- Individual traits and coping styles
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- Disaster and trauma experience
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- Family and social support
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- Taking action to prepare and protect can help reduce fear,
anxiety, losses and if onlys
27. Factors Affecting Resilience (cont.)
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- Perceived presence of control and hope
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- Availability of accurate information
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- An effective and caring emergency response
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- There is strong evidence that the experiences of the population
subsequent to the disaster have direct relevance to recovery.The
more problems and life difficulties the affected persons experience
during the recovery phase, more persistent the emotional reactions
will be.
28. Objective
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- Identify at-risk populations
29. At-Risk Populations
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- Parents or caregivers of children
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- People with prior trauma history
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- People with serious mental illnesses
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- People with a history of substance abuse
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- Public safety workers (PSWs)
30. At-Risk Populations (cont.)
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- Less-developed cognitive skills
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- Limited experience coping with adversity
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- Lack of coping skills for managing stress
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- Dependence on adults for resources and psychological
support
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- Evacuation and relocation
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- Loss of a family member or a close friend
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- High levels of parental distress
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- Family members at risk (such as first responders)
31.
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- Dependence on medications
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- Disaster-related health risks
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- Reluctance to accept support
At-Risk Populations (cont.) 32. At-Risk Populations (cont.)
- Public Safety Workers (PSWs)
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- Exposure to the disaster event
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- View of selves as helpers, not persons who need help
33. Intervention Strategies for At-risk Adults
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- Be aware of unique needs.
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- Canvass communities to locate isolated survivors.
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- Educate those who work with at-risk populations about disaster
reactions.
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- Collaborate with community leaders and cultural brokers.
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- Partner with organizations that serve at-risk populations.
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- Consider cultural factors.
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- Reconnect individuals to pre-trauma treatment services (e.g.,
substance abuse, mental health, medical).
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- Ensure that services and materials are appropriate and
accessible.
34. Tools for Survivors
- Ten Ways To Build Resilience
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- Avoid viewing crises as insurmountable problems.
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- Accept change as a part of living.
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- Look for opportunities for self-discovery.
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- Nurture a positive view of self.
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- Keep things in perspective.
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- Maintain a hopeful outlook.
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- Practice effective self-care.
35.
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- Anger around the limits of governmental assistance and
insurance (e.g., the system, red tape)
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- Unaddressed trauma leading to diagnosable conditions such as
depression or posttraumatic stress disorder (PTSD)
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- Stress from financial hardship as resources diminish
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- Frustration and disillusionment at the lack of resources and
pace of repairs
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- Continued anxiety around dislocation and separation
Anticipated Reactions: Anticipated Reactions: 36.
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- The severity of reactions is affected by the type of, level of
exposure to, and casualties associated with the disaster.
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- Preexisting trauma may increase the risk of severe
reactions.
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- Stress can negatively impact physical health.
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- Preexisting levels of support will affect the severity of
reactions.
Anticipated Reactions: 37. Factors that affect survivors
resilience:
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- Individual traits and coping styles
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- Disaster and trauma experience
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- An effective and caring emergency response
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- Confidence that stress can be managed
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- Presence of perceived control, and hope
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- Family and social support
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- Availability of accurate information
38. Information Sharing and Social Networking as Recovery Tools
39. Follow FEMA, NOAA and American Red Cross on Facebook to learn
more about hurricanes and the steps you can take to ensure your
family or business is prepared.Post comments, share your stories
and keep track of the latest information.www.facebook.com/fema
www.facebook.com/redcross www.facebook.com/usnoaagov 40. In 140
characters or less, brief messages (aka tweets) provide followers
with specific information in a timely manner. Those who tweet can
stay up-to-date and by following on-going developments in a
disaster situation via their cell
phones.www.twitter.com/femainfocuswww.twitter.com/craigatfema
www.twitter.com/usnoaa.gov www.twitter.com/usoceangov 41. Watch
online video webisodes on topics such as how to prepare a disaster
kit, what to do and where to go in an emergency, how to apply for
disaster assistance and more. Tune in for informational videos
produced by FEMA, NOAA, and American Red Cross.
www.youtube.com/fema www.youtube.com/usnoaagov
www.youtube.com/user/AmRedCross 42. Cell phone users with internet
connectivity can access a basic easy-to-load webpage designed
specifically for fast downloads.Log on for information on what to
do before, during and after a disaster by visitingfema.govon your
mobile phone. For a complete list of social media links offered by
each agency/organization, visit www.fema.gov,
www.redcross.org/connect, www.noaa.gov/socialmedia 43. Add a WIDGET
or badge to your website which allows your audience to find
specific hurricane-related information .These predesigned tools
which include direct links, videos and updated disaster
information. www.fema.gov/help/widgets www.nhc.noaa.gov/widgets 44.
45. Available FEMA Widgets 46. Search for Red Cross Shelters Found
on website or iPhone app! Shows capacity and current use. 47.
www.rihope.ri.gov 48. www.nhc.noaa.gov 49. Health and Human
Services, Office of the Assistant Secretary for Preparedness and
Response (ASPR) 50. www.riema.ri.gov 51. Safe and Well site 52.
Questions?
- Disaster Behavioral Health Coordinator
- RI Department of Behavioral Healthcare, Developmental
Disabilities and Hospitals