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Disaster and Mental Health > Staff Mental Health Services > Flashcards

Staff Mental Health Services Flashcards

1
Q

Primary role of DMH

A

A primary role of DMH is to provide support for disaster workers—before, during and after the response.

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2
Q

DMH workers help?

A

DMH workers help other disaster workers manage their stress through education, individual or group contacts; surveillance of stressors and worker functioning within the working environment

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3
Q

Key Characteristics and Helping Behaviors of Disaster Mental Health Workers

A

Adventuresomeness, sociability, calmness, systems savvy, and therapeutic acumen

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4
Q

Adventuresomeness

A

The inclination toward curiosity and learning from experience as well as the willingness to develop creative solutions to complex problems.

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5
Q

Sociability

A

To work with people who may be experiencing extreme stress, and to maintain the stance of a sensitive and observant listener and helper. Does not mean over-involvement or pseudo-friendliness

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6
Q

Calmness

A

Working and living conditions are often chaotic: noisy settings, long hours, substandard lodging, unstructured schedules, ambiguous roles and rules – these high-stress circumstances call for emotional poise.

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7
Q

System Savvy

A

The disaster mental health professional represents a distinct interest – that of supporting and enhancing the psychosocial safety and functioning of helpers, survivors, and their community. By becoming familiar with the scope of disaster relief operations (i.e., community, state, and national political arenas), the mental health professional can better assume the role of an impartial mental health advocate.

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8
Q

Therapeutic Acumen

A

To provide therapeutic assistance without “therapizing” disaster survivors or workers, the mental health professional’s perspective must be grounded in empathy, genuineness, and respect.

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9
Q

Empathy

A

Ability to help the survivor feel that he or she is understood.

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10
Q

Genuineness

A

Ability to reduce the emotional distance or alienation between the survivor and oneself.

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11
Q

Unconditional Positive Regard

A

Ability to convey respect for the survivor.

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12
Q

Listening

A

Ability to utilize array of listening skills

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13
Q

Empathic Behaviors

A

Express desire to comprehend survivor
Discuss what is important to survivor
Refer to survivor’s feelings
Correctly interpret survivor’s implicit feelings

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14
Q

Genuine Behaviors

A

Friendly and open
Spontaneous rather than rigid or overly formal
Actions congruent with intent

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15
Q

Respectful Behaviors

A

Be on time for appointment and meetings
Make statements that express respect for the survivors
Express non-verbal attentiveness and concern
Summarize survivor’s messages accurately (e.g. appropriate eye contact and tone of voice)

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16
Q

Listening Behaviors

A

Ask clarifying questions
Paraphrase survivor’s statements accurately
Verbally reflect survivor’s feelings accurately
Ask open-ended questions
Help clarify survivor’s mixed ( incongruent) messages

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17
Q

Behaviors providing therapeutic structure

A

Recognize overt and covert problems with stress
Recognize antecedent conditions that triggers stress responses
Understand how survivor’s stress response to stress influences post- disaster behavior
Educate survivors about stress response
Syndromes and stress management strategies

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18
Q

Provide therapeutic structure

A

ability to conceptualize survivors’ stress-related problems

19
Q

Disaster mental health teams take two basic forms.

A

Standing Teams
Ad hoc Teams

20
Q

Standing Teams

A

are formed before or shortly after disaster occurs (i.e., by agencies such as community mental health centers or the Department of Veterans Affairs; or by mental health and emergency service practitioners).

21
Q

Ad hoc Teams

A

are formed at disaster sites, often joining together several standing teams to provide a coordinated response.

22
Q

Staffing Roles

A

Disaster Team Leader
Direct Service Providers ( a) Field Coordinator(s); b) First Responders; c) Back-up teams )
Ad hoc Secretarial Support.
Program Analyst / Researcher

23
Q

Direct Service Provider Selection Considerations

A
  1. Possess a mental health clinical license.
  2. Be available for service on “hours to days” notice for 10-14 day assignment.
  3. Have letters of reference indicating that the candidate has:
    a) A high tolerance for difficult working conditions which may include: - long hours - substandard lodging, primitive facilities - unstructured or ambiguous situations - intense political competition - rapid change;
    b) Ability to establish rapport with people of various ages, ethnicity, and social, economic, and educational backgrounds;
    c) Training and experience in emergency mental health debriefing methods;
    d) Organizational “savvy” and political sensitivity;
    e) Ability to give educational group presentations to survivors, helpers, community groups;
    f) Training as a disaster mental health volunteer with the American Red Cross.
24
Q

All members of the DMH Team require

A

specialized training because many of the intervention skills needed differ from those used in traditional outpatient or inpatient clinical work

25
Q

Content of training of DMH team should include the following:

A
  • impact of disaster on individuals, disaster workers, organizations, and communities;
  • factors associated with adaptation to disaster-related trauma;
  • at-risk groups and individuals in the wake of disaster;
  • specific interventions to match the needs of specific at-risk groups and individuals in each phase of disaster impact (i.e., on-scene, early post-impact, and restoration phase)
  • operational guidelines for applying disaster mental health interventions, including defusing, debriefing, death notification, and ritual and psychoeducational interventions;
  • operational guidelines for disaster mental health worker stress management;
  • pertinent issues involved in forming and operating a disaster mental health team;
  • an overview knowledge of the Federal Response Plan and the disaster mental health team’s and practitioner’s liaisons to other disaster response organizations
26
Q

Development of standard operating procedures address?

A

Each disaster mental health team will need to develop standard operating procedures to address fiscal, skills development and maintenance, mobilization, field services, return to home site, and evaluation practices

27
Q

These considerations aside, standard operating procedures should address:

A

a. Fiscal
b. Mobilization
c. Field Procedures
d. Demobilizations
e. Education
f. Program Policy and Evaluation

28
Q

a. Fiscal

A
  • Fiscal responsibility mechanisms
  • Budget for equipment (cell phones, flashlights, identification badges, etc.)
  • Budget for logistical support (transportation to and from site, on-site vehicles)
  • Budget for lodging and per diem expenses
  • Budget for miscellaneous expenses (postage, phone bills, laptops, miscellaneous stationary supplies, etc.)
29
Q

Mobilization

A
  • Equipment procurement procedures
  • Staff notification procedures
  • Staff check-in procedures
  • Logistical support (providing staff transportation, lodging, and per diem expenses)
30
Q

Field Procedures

A
  • Conduct of needs assessment
  • Coordination of staff assignments, frequency of status reports, scheduling
  • Liaison with other agencies ·
  • Mitigation and monitoring of stress levels of staff
  • Intra-operation defusing
  • Post-operation debriefing
31
Q

Demobilizations

A
  • Demobilization procedures
  • Reintegration back into regular assignment
  • After action report formats
  • Intra/inter-agency coordination
32
Q

Education

A
  • Development & distribution of educational materials for the public (e.g., common stress reactions in adults, elders, children; stress management techniques; other information)
  • Continuing education of team - Trainings - Exercises
33
Q

Program Policy and Evaluation

A
  • Development of Disaster Mental Health Team policy including membership process, administrative structure, liability, referrals, clinical and statistical reporting forms, expense records, etc.
  • Development of program evaluation mechanism
34
Q

a. Stressors Affecting Disaster Mental Health Workers Assisting Survivors

A
  • Exposure to survivor grief, terror, shame, guilt, confusion
  • Vicariously experiencing death and injury to children and adults
  • Pressure to provide answers/solutions to insoluble problems
  • Prolonged physically and emotionally demanding activity with few if any breaks
  • Separation from loved ones; inability to protect or communicate with loved ones
  • Direct threats to one’s own physical safety
  • Witnessing or experiencing grotesque destruction and its aftermath
  • Personal loss caused by the disaster (e.g., home, personal belongings)
35
Q

b. Common Stress Responses of Disaster Mental Health Workers

A
  • Compassion strain: Frustration, psychic numbing
  • Vicarious traumatization: Shock, fearfulness, horror, helplessness
  • Hyperarousal and hypervigilance
  • Confusion and disorientation
  • Urge to “anaesthetize” (e.g., substance abuse, excessive sleep)
36
Q

Acute and Chronic Stress Disorder Indicators

A
  • Compassion fatigue: Demoralization, alienation.
  • Ruminative or compulsive re-experiencing
  • Attempts to “overcontrol” relationships
  • Withdrawal and isolation
  • Addictive attempts to anaesthetize
37
Q

Stressors Associated with Disaster Mental Health Work

A

a. Stressors Affecting Disaster Mental Health Workers Assisting Survivors
b. Common Stress Responses of Disaster Mental Health Workers
c. Acute and Chronic Stress Disorder Indicators

38
Q

Before an Assignment

A

Personal Preparation
Managing personal resources
Safety of Family Members
Social and Organizational Support

39
Q

During an Assignment

A

Working With a partner
Limit length of shifts
Use stress management techniques
Keep a notebook
Defuse regularly
Call home Regularly
Closures

40
Q

After an Assignment

A

Returning home

41
Q

Certain values and beliefs often held by helpers may may actually interfere with self-care. For example:

A

“It would be selfish to take some time to rest”
“Others are working around the clock, day after day; I should too”
“I should be strong enough to work all the time”
“Needs of survivors are more important than the needs of helpers”
“I can contribute the most by working all the time”

42
Q

Obstacles to Self-care

A

Thus, barriers to self-care come from the demands of the disaster environment, but also from attitudinal barriers on the part of some disaster workers. Because an exhausted disaster worker is at risk to perform less well, become irritable, and solve problems less ably, it is important for helpers to re-examine their attitudes and, when on assignment, be alert to these obstacles to self-care

43
Q

Therapeutic Acumen

A

empathy, genuineness, and respect

Disaster and Mental Health (3 decks)

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