Tip:
Highlight text to annotate it
X
Moderator: Let's begin with Promising Practices in Disaster
Behavioral Health, Plan Scalability.
The webinar will feature Ms. Terri Spear, Emergency
Coordinator of the SAMHSA Office of
Policy Planning and Innovation.
Ms. Lori McGee, Training and Curriculum Manager of SAMHSA
DTAC and Dr. Anthony Spire, Interim Assistant Secretary for
the Louisiana Office of Behavioral Health.
We will start today with Ms. Terri Spear.
Ms. Spear serves as Emergency Coordinator in the Substance
Abuse and Mental Health Services Administration,
Division of Policy Coordination where she coordinates the SAMHSA
response in emergency situations, including ensuring
cross SAMHSA coordination regarding terrorism and
mass trauma events.
She serves as the primary SAMHSA liaison with counterparts in
other federal, state, local and voluntary agencies,
organizations and governments participating
in crisis response operations.
Ms. Spear earned a masters of education in counseling
psychology from the state University
of New York at Buffalo.
Please welcome Ms. Terri Spear.
Ms. Spear: Thank you.
SAMHSA wishes to welcome all of those accessing this webinar.
The development of the series of which this webinar is one is
directly linked to the efforts SAMHSA included in its March
2011 document, Leading Change, A Plan for SAMHSA's
Roles and Actions 2011-2014.
SAMHSA introduces eight new strategic initiatives that will
guide SAMHSA's work to help build strong communities,
present behavioral health problems and
promote better health.
This initiative falls under trauma and justice.
Research has shown that 8.9 percent of men and 15.2 percent
of women in the U.S. reported a lifetime
experience of natural disasters.
We also know that over the past ten years the number of
disasters occurring across the country ranges between 65 and
100 federally declared disasters and many more that
occur that are not declared.
A critical component of planning of disaster response is
planning and it is of utmost importance.
This series is focused on disseminating the best of what
is known to equip the best response possible
with the resources at hand.
I look forward to hearing from Dr. Spire
as we continue this webinar.
Moderator: Thank you, Ms. Spear.
I would now like to introduce Ms. Lori McGee.
Ms. McGee serves as the Training and Curriculum
Manager for SAMHSA DTAC.
She has more than 11 years experience working with
program and curriculum developers to improve services
using evaluation findings.
At SAMHSA DTAC she supervises the development of training,
both in person and web based.
She is also the lead on the Crisis Counseling Assistance and
Training Program activities.
Ms. McGee has worked with at risk and delinquent youth
populations, populations receiving mental health
services, women and families in crisis and minority student.
She has prior experience in providing counseling and legal
services to survivors of domestic violence and in
developing programs to reduce and prevent violence in schools.
Ms. McGee holds a bachelors in psychology from Barnard
College and a masters in criminology and criminal justice
from the University of Maryland, College Park.
Please welcome Ms. Lori McGee.
Ms. McGee: Thank you and welcome to
the last webinar in this series.
We are grateful for all of you who have joined us and we look
forward to hearing your feedback on the series.
I want to take a couple of minutes for those that are
joining us for the first time to tell you
a little bit about SAMHSA DTAC.
Our mission is to support states, territories and tribes
to prepare for and deliver an effective behavioral
health response to disasters.
When we say behavioral health we include both mental health and
substance abuse in this response.
We do that by providing several types of services.
One of those is consultations and trainings.
These are on disaster preparedness and response, acute
interventions, promising practices, can be geared
towards special populations.
We do that in a variety of ways.
We also provide dedicated training and technical
assistance to disaster behavioral health response
grants such as FEMA's crisis counseling
assistance and training program.
I know many of you are familiar with that, CCP.
We also do identification and promotion of promising practices
in disaster preparedness and planning.
Obviously this webinar falls in to that category.
Also, identification and promotion of promising
practices and integration of DBH into emergency
management and public health fields.
We have those services and we also have resources.
One of them is listed here.
We provided disaster behavioral health information series.
We referred to that as our DBHIS series which contained themed
resources, toolkits on these kind
of topics that you see here.
DBH preparedness and response, specific disasters such as a
flood or tornado or more timely, a hurricane; specific
populations, there may be resources geared toward children
and youth or public safety workers.
All of that can be found on our website.
You can go to our website and look up by topic area and get a
multitude of resources, pamphlets, handouts,
brochures, links, etcetera.
In addition to those resources we have a few e-communications
that help everyone stay abreast of
what is going on in the field.
We have the SAMHSA DTAC Bulletin, that is a monthly
newsletter that contains resources and upcoming
events and you can subscribe by emailing us at the address seen
here, DTAC@SAMHSA.hhs.gov .
We also produce The Dialogue that is a quarterly journal of
articles that are written by professionals in the field.
You can subscribe by going to the SAMHSA website and
entering your email address and go through the process on
selecting SAMHSA's Disaster Technical Assistance Newsletter
as your preferred publication.
Finally, we have the discussion board, SAMHSA DTAC discussion
board where we post resources and upcoming events, we ask
questions of the field, get discussion going on various
topics or things that have come to light in the field and you
can subscribe by registering at the web address
listed here on your slide.
Finally, here is our contact information.
If you have any feedback regarding the webinar series
itself or you find yourself in any need of training or
technical assistance related to disaster behavioral health,
we encourage you to call us.
We have a toll-free number, email
and a website all listed here.
Our project director, Dr. Amy Mack; she always looks forward
to hearing from those of you that have
questions or needs in the field.
Her phone and email are listed here as well.
Thanks for joining us.
Moderator: Thank you so much Ms. McGee.
I would now like to introduce Dr. Anthony Spire.
Dr. Spire serves as the Interim Assistant Secretary for
Development in the Louisiana Office of Behavioral Health.
He has served as Deputy Assistant Secretary for the
Office of Mental Health and chair of the adult services
division of the National Association of State
Mental Health Program Directors.
He is also currently overseeing the Deep Water Horizon
Oil Spill Recovery Operation.
Please welcome Dr. Anthony Spire.
Dr. Spire: Good afternoon everyone.
Thank you for joining us.
As Terri said, this is the last in the series of webinars and
our topic today is scalability.
We have four very straightforward goals that build
on a number of the other seminars as well.
The first is increasing the awareness of the national
incident management standards and its relationship to disaster
behavioral health planning.
This has been an ongoing theme and another example of how
that integration is essential.
The second goal is to demonstrate ways to integrate
your disaster behavioral health plan with either your state,
your territory or your tribal emergency response plan; always
remembering that the DBH plan is in a disaster a subset of a
larger response strategy in your state,
territory, or tribal area.
The third is to share approaches about
planning and lessons learned.
Planning is a dynamic process.
It is always changing and it is always getting better by its
ability to be more responsive to the current structure
in your state and community.
Finally, provide an overview of services and resources that are
available from various disaster behavioral health sources within
SAMHSA and DTAC and elsewhere to assist in disaster
behavioral health planning.
The indicators of scalability are the following four items:
written instructions, procedures for planning and future
readiness as expressed in your operational plan.
You will see throughout all of this an emphasis on
memorializing or formalizing your planning and its
scalability features because you can't count on the
same people always being around.
Second, is the standard operating procedures for
implementing a disaster response and later on in this webinar
you will see a very specific description of how to build
a standard operating procedure.
The NIMS guidelines associated with it and adaptability of
plans to disaster type and scope.
Additional indicators are having separate sections and annexes
specific to high probability events.
Take for example the latest storms
we had up the eastern seaboard.
For some of those states a hurricane is not a high
probability response where in a gulf state a hurricane would
be a high probability event.
Chain of command is emphasized or specified; that is essential
at each level of the response.
Your communication plan has these three major components: it
is inclusive of the situational assumptions, alternate
communication methods and equipment needed.
When you are thinking of alternative communication
methods you need to be thinking about
texting and also about couriers.
If no electronic method is available to you, what
are some other physical means?
Do you have vehicles and staff assigned to do just
that, courier information?
Then your scalability of your plan should show the cascade of
authority among the different agencies and hierarchical
as well as lateral manner.
Your plan also should describe concept of operations.
Concept of operations you will find is a term used in the NIMS
model and it basically includes the following: your goals and
objectives, the strategies and tactics,
policies and constraints.
Being clear on these are really the boundary conditions that you
have to be clear upon because the lines of authority and
responsibility get blurred in the chaos of a disaster event.
Going forward with these other areas of a concept of
operations, you need to recognize who the organizations
are, activities and what the interactions are among
participants and stakeholders.
Oftentimes it is the interaction that creates
the quality of the response.
You also need to consider the statement of
responsibilities and lines of authorities is delegated.
This could be done through a cooperative endeavor
agreement, clear ways of setting responsibility.
Then the operational process for implementation; how do you move
from the plan to implementation and the process for initiating,
developing, maintaining and retiring the plan and you will
hear throughout the day an emphasis on the
concept of retiring the plan.
Again, look to your most recent disasters on the eastern
coast to see how that was done in front of all of us.
The term scalability is becoming used more widely and oftentimes
when that happens people lose the true meaning of a word and
what it was intended to reflect.
In our context here it means that your plan should be very
detailed with pre-identified actions, steps and strategies so
you know the most likely events that are going to have to happen
or what generic processes happen that have to happen with greater
intensity or less intensity and you can pre-identify those.
Keeping in mind that your plan is just that, a basic
framework for activation and response, it should be an all
hazards plan that speaks to all types and sizes of disasters,
from manmade to radiological to human and of course natural
caused disaster or combinations of the three has we have
experienced and elsewhere you often have a tornado and a
hurricane combined event or in some cases you may have an oil
spill or some chemical incident that is spawned by
a series of natural disasters.
Then again, the essential feature of any plan is your
chain of command, your communication and who the
authorities are within the plan structure.
In summary, your concept of operations really tells you how
exactly things are supposed to work and they
do it at these multiple levels.
Facility, municipal or sub-municipal level, your
county, region and state and federal levels.
It is important-- a lot of plans overlook this-- the facility
level training and planning that needs to go into place.
You could deal with something as simple as a-- it sounds simple
but something like an anthrax scare in receiving the
powdered substance in the mail.
Here is a very dramatic picture which emphasizes, following
hurricane Rita, what scalability is all about.
You could have a small-- on your left side of the screen you
could have a power outage, a microburst of a little tornado
that would wipe out two or three houses or you could have total
and absolute devastation, like you see on the right.
Your plan should be able to accommodate those because the
resources are very different and the people you have to depend
upon for resources becomes very different.
The important thing with planning and knowing what needs
to be scalable is knowing what your
mandated responsibilities are.
This requires pulling together your leadership and thinking
through who is our population that we are serving.
Is it seriously mentally ill?
Do we have a child population?
Are we responsible for an addictive disorder
population, forensic population?
All of the various facets of your populations that you all
are serving, both institutional, as in 24 hour facilities, in
secure facilities such as forensic facilities and a wide
range of residential programs that your agency may be
operating or responsible for through contract.
In addition you have all of the persons and the infrastructure
associated with community run clinics.
They could be addiction clinics, mental health clinics or a
combination or in our case here, behavioral health clinics and
other community based services.
What about persons who are served by intensive case
management or assertive community treatment teams and
what is the responsibility for that staff and
for the clients they serve?
Then your general population requirements as a state of
behavioral health authority that you have in your state
constitution or through your mental health or addiction
enabling legislation a responsibility to the
general population; understanding what that is and
the expectations and where early interventions are necessary.
Then the delegated duties within the emergency response framework
as it relates to the emergency support functions.
In this case ESF-8 is the primary function.
Then of course, any regulatory and legal mandates which
prohibit or demand certain action from you in your agency.
When you are looking at how you ensure scalability if you make
sure your plan is interlaced and cascades from
local, state to federal roles.
Interlaced means that it is interlaced across agencies and
that the assumption is always to provide services at the
level closest to the incident.
From local then to the state and then what federal
responsibilities are planned for so they
can be activated when necessary.
Interoperability and bidirectionality means that many
times-- and it has certainly been our experience that a plan
must be able to move in two directions, getting feedback
locally and then also knowing what kind of resources and
actions are taking place from the helping agencies, either the
state level or federal level.
Continuous and dynamic planning.
Planning should accompany every part of your actions and if
actually part of your intervention is planning.
While you are implementing your plan
you are also revising your plan.
Then of course, knowing your collaborative partnerships.
We have had other webinars speaking about partnerships.
Your plan components also must address-- after you have done
all of the stuff that I have just spoken about you must think
about it differently in terms of each phase of the disaster.
Of course, those are your preparedness or phase where you
are looking at your activation capabilities.
Then your response and recovery phases and response phases can
range from usually a shorter period
of time than your recovery.
They are very different phases but they do overlap.
Then your phase down of operations and maintaining
continuity of operations for your activities that you have to
provide services with throughout all of the incident phases.
This is a staffing and resource issue
one has to attend to and plan.
Two tools that we use-- I think they were provided to you as the
response readiness checklist assessment tools provided as an
attachment to your registration.
This is a simple tool that we have developed that helps your
agency at whatever you would want to use it.
It identifies your actions for consideration in preparation for
all hazards or a specific event and then there is the simple
response readiness scale which ranges from no preparation to
number five meaning that resources have been identified,
simulation exercises conducted and you are well on your way to
addressing any particular issues.
The hazards vulnerably analysis, many of you may be familiar
with; it is something that is required in the JCAHO
accreditation process and other accreditation processes.
Having some sort of objective way that your staff can
routinely assess their capacity, capability and readiness gives
you a lot of indication on how scalable your plan actually is.
Some of the federal planning tools if you are interested in
the things I have been speaking of can be found at these three
particular federal websites.
These three are good places to get you started, the NIMS
website, the CONOPS or concept of operations site and then
the national response framework.
A lot of times you can use the positive macro level
thinking that has happened at the federal level and adjust
that thinking to our local and state level planning.
It is always good to steal from others when you can to not have
to reinvent all of those good ideas
that are already out there.
Your traditional basis for response scalability is that
one, it makes a lot of sense and then you think about it in terms
of that all disasters are local, both in impact and in
response and as the local spreads-- and I guess I keep
referring to the hurricane Irene as it went up the coast,
this is a one state impact and as it rolled from one state to
the next it was all about scalability, local impact then
becoming regional and then becoming a national incident.
This activated many mutual aid agreements and I bet all of
those states and counties are revisiting their mutual aid
agreements right now; seeing what worked and what was left
out that may have caused them some kind of problems.
Then, what triggers the activation of state capability
and the federal resources.
If you will remember in the Irene example there was a
federal declaration before landfall for a lot of these
states, which allowed the federal resources to be utilized
before landfall actually happened.
That again, is scalability and planning in a proactive method.
Standards of operating procedures.
These are some of the standard operating procedures or some of
the basic tools within your planning process and I know that
in our state we used to disregard the need for them
because we had such a stable workforce that it didn't seem
like anyone ever retired or left so everyone knew what to do.
What we have experienced over the last few years is
mainly people who were here have gone on to other jobs or have
retired and all of the sudden you have a workforce where all
of your institutional memory is gone.
That to me is a really important reason to have your standard
operating procedures in place.
They ought to work a disaster response plan; it is ultimate
test is it can work independent of the personalities or the
history of the people involved.
If you can articulate clearly enough what your guidelines and
instructions for response are and practice them well
enough and do a cascading effect of responsibility and authority
what happen is the plan supersedes any one
individual and that is one of the goals you really want to
emphasize for yourself.
Some of the basics, when you are building a standard operating
procedure think both about the operational functions and
then the technical components.
Not only what it is that you are trying to do but what do you
need to do it and what is the best technology to use.
Anywhere from personal protection devices,
communication devices, redundancy planning, basic tools
that you need in terms of personal survival.
All of those features if taken into account, reduce the stress
on the individual responder and therefore enables them to
be able to respond to the needs that are being expressed
in that particular incident.
The other thing that you do through your practicing, through
simulations is that you hone your skills on coordination
across agencies so that what you have is that while you have
multiple jurisdictions that may be working together if they
all are sharing a standard operating procedure they can
work in a clear and effective fashion that allows for the
deployment and development of your response
to be smooth and not chaotic.
When you actually write an SOP it is almost like writing any
kind of formal procedural paper where you would want to
first identify what capability does this apply to.
Is it a capability to provide counseling?
Is it a capability to move emergency resources, food
supplies or electrical supplies into place for people?
When you are implementing it what need are you addressing?
You are able to say to yourself and your planning team
what is the recognized need.
What triggers that need and then what capability it is
necessary to address the need?
You need to think through are there pre-established agreements
already in place from the different agencies.
Are they up to date or have they aged?
If they are not in place what do they need to be replaced by.
Then, is your standard operating procedure going to be used by a
few people who know each other well?
Is it going to be used by a bunch of strangers and
volunteers who are solely reliant
on the operating procedures?
What is your rationale for bringing all of those people in
and how are they going to implement and
address the recognized need?
When you are writing the SOP it is good to be redundant.
After you have described your capability and capabilities of
the resources involved you need to speak to the authority,
use and responsibility.
Lots of times at the height of an incident people start to
question the authority as they become fatigued and they wonder
"why should I be doing this and why do you have
a right to tell me what to do?"
If you have all of that clearly stated and it is
articulated in the operating procedure what happens is you
can diffuse many of those questions
in a very businesslike manner.
That way you put to rest a lot of issues that become side
issues that are really stress related and have nothing to do
with the actual SOP you are trying to put in place.
The scope of the SOP, you need to practice this out clearly
indicating the level of authority that is involved.
Does it have to go all the way up through the command structure
at the statewide level or is this an SOP that is
implementable and governed by a local facility level need.
It can be that simple and isolated or it can be
as global as a state level SOP.
Your communication structure about when you have activated
SOP's is very important.
You do need to let the other levels of the hierarchy know
that you have activated a particular strategic standard
operating procedures because once you have activated them
often it will trigger activation of other broad spectrum SOP's
associated with both state level or innercounty relationships.
Once you have everything activated you need
at some point to discontinue it.
You usually have to run it through multiple shifts.
You have to take fatigue as an issue and you have to pull
people offline, replace them with other people where the SOP
would work for a new group of people or you have
to have a phase down feature.
That should also be a separate module
within your operating procedure.
How you phase out and this would include debriefing of the staff
involved, both your administrative and
your frontline staff.
You also need to think about your great planning and if it is
no longer applicable and you don't have a standard operating
procedure that works within the context of the particular
incident you are involved in what
are you alternative strategies?
You can be thinking of the critical questions you should be
asking yourself and your team that would provoke the kind of
thinking that is necessary to build an ad hoc strategy that
you can implement in an appropriate way given the
context of that particular disaster.
Having the skill, procedural knowledge to implement an SOP
does require either table top and then simulation exercises
where you carry things out.
We have done standard operating procedures on evacuations where
we will actually load people up on the bus and load all of the
equipment and time how long it takes us to do that so we know
what we are looking at in terms of a real time scenario.
You can get very literal in your training on these items and
testing it is what I am referring to.
Then you have to think about who is a responsibility.
Who is responsible for activating the standard
operating procedure and carrying out the various components of
that operating procedure and being able to have the authority
to adjust it as needed as the situation demands it.
In Louisiana-- I have mentioned other states and how
other states may take advantage of an SOP, one of the things we
have done in our state is we have adjusted our emergency
support functions to include a 16th function
which is our National Guard.
Across the U.S. the National Guard was activated for all of
the potential needs, which fortunately did not become
a reality with hurricane Irene.
You need to always remember the primary response of the
facilities that you are working with is the health and safety
of the people that you are charged to protect.
In the mass care function, the ESF-6 function, oftentimes
the ESF-8 function is called in to provide additional
assistance and crisis counseling.
You have an interlacing here of the different support functions
working together and that is not a constant, that will come and
go so your scalability within in your standard operating
procedures allows you to maximize the intensity of that
interaction between the different support functions and
agencies and then withdraw it as necessary.
A local context, I have mentioned how we have
used the evacuation of hospital.
We also saw a lot of this across the whole southern coast,
across the Gulf Coast of how the different operational units
both in land and on the coast had to interact with a
displacement and sheltering functions.
Your sheltering functions on the east coast you saw lots of local
sheltering goes into place and you have to activate different
response groups to support those shelters.
Not all of them will be Red Cross shelters.
Thinking about special needs populations; one of the things
that is really essential in your planning and scaling your
response is understanding who the special populations are and
whose responsibility they are, what are their particular needs.
When people are taken away from their normal support areas, how
will those needs be addressed?
You need to be aware of needs before during and after an
incident and very basic functional areas.
The important thing is to keep people as independent as they
possibly can be; therefore maintaining the kinds of support
necessary to assure independence is something that needs to be
thought through, both in general shelters and
in special needs shelters.
These are areas-- thinking about communication with loved
ones and with medical professionals.
What are the special transportation needs and
what medical supplies would be necessary.
In your planning you probably wouldn't identify everything
you would need in a shelter but what you do need to identify is
the communication and logistic method of securing the medical
equipment and supplies that you would need in various locations.
One of the biggest challenges is people who live in
institutions and you would have to evacuate an institution.
You saw in New York where they were evacuating institutions
that had never been evacuated.
It would be interesting to know if they had practiced any kind
of institutional evacuation and did they have a plan, a standard
operating procedure, they could use for the sheltering at other
hospitals or non-hospital locations of those individuals.
When you are in multicultural areas you need to take
particular time to understand the
various languages people speak.
What are their dominant languages and have your
materials and translation teams available to assist persons so
that people aren't struggling with communication on something
as basic as their primary language.
I think I may have mentioned this to you before, in an
evacuation such as we have done bus triage evacuations here
which is how we get people out of New Orleans and into safety
in other parts of the state, you need to understand and have in
place the command structure and the operations group structure
so when there are issues there is a clear chain of command.
This is an example on a very micro level of having a group
supervisor, transportation group,
evacuee group, volunteer group.
You are talking about maybe 15 people involved in each of these
groups and maybe three to four people per team, then you can
ramp that up as necessary based on the intensity and number of
people you are evacuating or having to triage.
What we have shown you today is basics of scalability, its
importance and relevance to your overall disaster plan and once
you start using that concept you find that you
really can't do it in isolation.
You have to do it within the context of the larger statewide
emergency response plan and preparedness activity and that
you have to do it in relationship to each level of
the plan, the county level, multi-county response or
regional response, local municipal response and
facility level response.
When you can test the components of your plan through a local
incident at a single facility and also statewide and assure
yourself the same principles are at work and the only dynamic is
the scalability of it, then you have a pretty good planning
process that will move with the flexibility and grace and speed
that you need in a particular event.
That concludes the basic presentation.
We are now open to any questions people may have.
Moderator: Thank you so much for your presentation Dr. Spire.
We have four questions for you.
When developing the disaster behavioral health plan, can you
offer specific examples of planning for general population
prevention and early intervention?
Dr. Spire: When you talk about general population planning and
early intervention what you want to do is have a planning goal of
increasing the very specific information people need in the
here and now to protect themselves and the safety of
their loved ones and property if possible and giving
them very direct guidance and advice.
You don't want to give partial messaging which then can create
an opportunity for miscommunication and for
people to panic in their response strategies.
Thinking through who your population is, is it a
multicultural population where you need to send out your public
service announcements in multiple language and starting
your messaging through your communication plan a good bit
earlier than an actual incident.
When you are in a season where you may be more vulnerable to
tornados or hurricanes or ice storms, part of your routine
messaging to the population should be strategies that
sensitize them that these events can occur and the importance of
having their own emergency response plan for themselves and
their family members.
You can often do this by emphasizing the importance to
children and people who are dependent upon you.
A lot of times people say they are strong and tough and they
don't need any help but they will do anything
to help their loved ones.
Moderator: How effective are these principles for some of the
most vulnerable communities in a tornadic type
event with little or no warning?
Dr. Spire: That is a very good question.
A tornado could come up in a moment and people have very
little time to prepare and can't spend days thinking about it,
it is on top of them and they have a very rapid response they
have to put together to bring themselves to safety.
If you know you live in an area like that and even if you don't
know you live in area like that, as a family member, practicing
with your family your emergency strategy that you would have if
a tornado or if a fire happened would work very well.
Think about it at the family level and then you think about
it as family members who are related to each other; you are
talking about scalability where there are multiple levels of
response in a family system.
In your planning if you get all of the way down to the
individual response and then work your way back up through
agency and community level responses it becomes
more realistic for people.
This will allow people to have very rapid response strategies
that they don't have to think about because they have
practiced them both at an agency level and an individual
level and that will assure a greater likelihood that the
planning process is successful.
Moderator: Dr. Spire, during a manmade event how is the
disaster behavioral health plan integrated into the overall
response to the event utilizing the NIMS structure?
Dr. Spire: In a manmade event you will have an event that has
many of the characteristics of a natural disaster, meaning that
it has disrupted a community.
It has created a threat to community members
or community infrastructure.
In the case of say you had a large oil spill or fire due to a
refinery explosion or you had-- which would create a smoke cloud
that would be of danger or hazard to the breathing of
individuals or you had a massive oil spill like we had across the
three states in the Gulf where you have an impact on the
community but also on the environment.
You have to add into your regular planning on mobilization
and response the fact that there is an anger component and
your communication plan and your use of psychological
first aid techniques of doing counseling have to take into
account respecting the shock and awe the people may feel and also
the anger that comes after that.
In your training what you would want to do is make sure that you
were training people to respect the fact that people are angry.
Do not minimize anger but allow people the opportunity to work
through that because it will become a major feature and the
desire to demonize whoever is the responsible party
for causing the manmade event.
Moderator: How do you plan for access to behavioral health
supports to the general population not already served if
the event is not eligible for CCP funding?
Dr. Spire: CCP funding and the crisis counseling program
funding from SAMHSA and FEMA is often what people rely on.
If you have done your planning well where if you refer back to
earlier slides in this training we talk about other stakeholder
groups, other community partners; you will find that
your agencies that are voluntary agencies
that are active in disasters.
A number of your local ministries and foundations will
have procedures already in place to where they can activate
dedicated funds to assist communities in disasters.
That is one important thing to have in your plan, how to access
non-traditional funding in local communities.
That wouldn't flow through the state but would be available and
administered through some ad hoc structure established that one
may have standardized operating procedure
to put in place at the time.
The other is in your agency planning budgets many agencies
will plan a contingency fund to help with ongoing
operations and the financing of your concept of operations.
It is something that one should consider in a
non-federally supported disaster response.
Moderator: Thank you for your presentation Dr. Spire.
Ms. Terri Spear has some closing remarks for us.
Ms. Spear: Thank you very much Dr. Spire for your
very thoughtful presentation.
It was very helpful I hope to those who participated.
This activity concludes the plan scalability webinar as well as
the Promising Practices in Disaster Behavioral
Health Planning series.
SAMHSA DTAC hopes you have found this series to both
informative and useful to your disaster behavioral
health planning needs.
We do hope that very soon each webinar in this series will be
archived on SAMHSA DTAC website and the address is given there.
Thank you very much for your participation.
Moderator: Thank you so much Ms. Spear.
Before we conclude today's webinar we wanted to give you
the contact information for SAMHSA DTAC again.
Please feel free to contact the SAMHSA DTAC team at any time.
Thank you all for participating in the Promising Practices in
Disaster Behavioral Health, Plan Scalability webinar.