© 2014 the litaker group llc all rights reserved draft document not for release or distribution...

© 2014 • The Litaker Group LLC • All Rights ReservedDraft Document • Not for Release or Distribution

Texas Department of State Health ServicesDisaster Behavioral Health Regional Planning Meetings

Facilitated Discussion ScenarioMay and June 2014

For Information • Contact Dr. John R. Litaker at [email protected] Litaker Group, LLC

mailto:[email protected]


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1. This is not a tabletop exercise; it is a facilitated discussion using a scenario-based question and answer format

2. The information presented in the scenario has been carefully chosen to represent real actions or activities that could occur

3. Today’s discussion should focus on the disaster behavioral health aspects of the actions and activities discussed

4. The scenario is based on a local, regional, and state response

5. An incident command has been established and the Disaster District Committee, State Operations Center, RHMOC, and State Medical Operations Center have been activated

6. For purposes of this facilitated discussion each PHEP capability is discussed separately, but in reality they would occur concurrently, and likely intertwine

7. Keep in mind your roles, responsibilities, and authority throughout the discussion

Assumptions for Today’s Meeting


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Capability 5Fatality

Management

Capability 7MassCare

Capability 14Responder

Safety and Health

Definition: The ability to coordinate with other organizations (e.g., law enforcement, healthcare, emergency management, and coroner) to ensure the proper recovery, handing, identification, transportation, tracking, storage, and disposal of human remains and personal effects; certify cause of death; and facilitate access to mental health / behavioral health services to family members, responders, and survivors of an incident.

Disaster Behavioral Health Issues Associated with this Capability:• Coordination with multiple agencies• Flow of information/communication to provide accurate

and timely information to families/friends• Privacy for families/friends• Counselors with the appropriate experience and training

for this type of incident • Cultural competency

Public Health Emergency Preparedness (PHEP) CapabilitiesFatality Management (Capability #5)


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Management



Safety and Health

Definition: The ability to coordinate with partner agencies to address the public health, medical, and mental health / behavioral needs of those impacted by an incident at a congregate location

Disaster Behavioral Health Issues Associated with this Capability:• Differences between Red Cross shelter and other

shelters for DBH services• Conditions in shelter that lead to behavioral health

problems (e.g., frustration, anxiety, depression) such as crowding, lack of privacy, substance abuse/sobriety, etc.

• Self-deployed helpers

Public Health Emergency Preparedness (PHEP) CapabilitiesMass Care (Capability #7)


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Management



Safety and Health

Definition: The ability to protect public health agency staff responding to an incident and the ability to support the health and safety needs of hospital and medical facility personnel if requested.

Disaster Behavioral Health Issues Associated with this Capability:• Secondary trauma• Concerns for family while responder is in the field• Pre/Post evaluations• Follow up for responders post event

Public Health Emergency Preparedness (PHEP) CapabilitiesResponder Safety and Health (Capability #14)


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Modules

Module 1Mass Care

Capability #7

Module 2Responder Safety

and HealthCapability # 14

Module 3Fatality

ManagementCapability #5


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Module 1Mass Care (Capability #7) – Scenario

Module Focus: In a mass care environment, what is your role in supporting the behavioral health needs of the shelter population?

Scenario

1. Two shelters are open. One is operated by the American Red Cross and the other by municipal government

2. The American Red Cross shelter has 110 persons and the municipal shelter has 90

3. People are showing up to both shelters with their pets, but neither shelter is equipped to accommodate pets

4. Some individuals are running low on psychotropic medications and are beginning to decompensate

5. The local methadone clinic was flooded and some people in the shelter use methadone

6. There are people in the shelter who are exhibiting signs of sadness, anger, and frustration because of the flood

7. The manager of the municipal shelter has requested help


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Module 1Mass Care (Capability #7) – Questions

Module Focus: In a mass care environment, what is your role in supporting the behavioral health needs of the shelter population

Questions

1. Is there a need for DBH response? Why or why not?2. What is the process for how this decision is made?3. What do you need from DBH responders?4. Who would DBH responders report to at the shelter?5. Who are the DBH responders in your community? Who would provide DBH

resources during a disaster in your community?


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Modules

Module 1Mass CareCapacity #7


and HealthCapacity #14

Module 3Fatality

ManagementCapacity #5


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Module 2Responder Safety and Health (Capability #14) – Scenario

Module Focus: In an ongoing disaster, how would you meet the behavioral health needs of first responders?

Scenario

1. First responders have been conducting swift water rescues2. Some first responders and their families have been personally impacted by

the flood3. Operations are beginning to transition from rescue activities to recovery

activities (i.e., retrieving the deceased)4. Families of the missing are gathering where recovery efforts are taking place5. First responders are beginning to show signs of stress and fatigue6. First responders are housed together at a base camp and have requested a

formal group debriefing


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Module Focus: In an ongoing disaster, how would you meet the behavioral health needs of first responders?

Questions

1. What first responder populations could potentially benefit from DBH services?2. What services would be provided to these first responders and their families?

Would the services differ by population? 3. What are the likely needs of first responders and their families?4. Who in your community could provide the DBH services you identified in (2)

and (3) to first responders?5. Based on this scenario, what is an action that may need to be taken to

support the community?

Module 2Responder Safety and Health (Capability #14) – Questions


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Modules

Module 1Mass Care

Capability #7


and HealthCapability #14

Module 3Fatality

ManagementCapability #5


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Module 3Fatality Management (Capability #5) – Scenario

Module Focus: What types of disaster behavioral health services would be provided to the families of victims and those missing due to the flood?

Scenario1. A family assistance center is defined as a secure facility established to serve

as a centralized location to provide information and assistance about missing or unaccounted for persons and the deceased. It is also established to support the reunification of the missing or deceased with their family members.

2. The family assistance center is located at a central location3. The flood event resulted in 10 fatalities; 12 persons are not yet accounted for

as a result of the flood4. Based on national standards, a family assistance center can be expected to

assist up to six persons per victim or missing person, in this case, the family assistance center would be expected to serve approximately 132 persons

5. The family assistance center is operational 24 hours per day for the first four or five days, depending on the needs of community


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Questions

1. What factors should be considered, based on your community, when thinking about the potential behavioral health needs to be addressed for family members at the family assistance center? You may wish to consider cultural issues, language, ethnicity, etc.

2. How will the spiritual needs of family members be met?3. Who in your community could provide DBH services to family members?4. Are there enough resources to meet the needs of family members, considering

24/7 operation for four or five days and up to 132 family members who might need assistance? If yes, how? If not, then how would you meet those needs?

5. Several groups have self-deployed to provide DBH services at the family assistance center. How should this be handled?

Module 3Fatality Management (Capability #5) – Questions

Module Focus: What types of disaster behavioral health services would be provided to the families of victims and those missing due to the flood?


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1. Moving forward, are there any planning activities that need to occur based on today’s discussion?

2. Are there stakeholders not here today that need to be engaged? Who are these stakeholders.

3. What types of technical assistance would be helpful as you consider the DBH needs of your community?

Closing Questions

© 2014 the litaker group llc all rights reserved draft document not for release or distribution...

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