CO Division of Mental Health

by Curt H Drennen, PsyD, RN
Mental Health Disaster Response Coordinator
Colorado Behavioral Health Services

The Colorado Division of Mental Health was activated by the Colorado Division of Emergency Management to be on site at the former Lowery Air Force Base to provide behavioral health support to the evacuees and the responders providing medical, housing and individual services. As we activated our efforts, several other agencies were activating theirs as well, including the Mile High Chapter of the American Red Cross, Colorado Organization for Victim Assistance and several faith based and professional organizations.

At one point in time, we had approximately four volunteers for every evacuee. It is events like this that highlight our need to develop an over-arching structure to increase the effectiveness and efficiency of our response efforts. We have a broad range of resources and when the community is in need, there is no limit to those who come to lend a hand. Unfortunately, we have often had systems that were at odds with each other, having different philosophies, different organizational structures, different intervention technologies and different expectations of who should be doing what, when and where. These differences negatively affect our ability to achieve our goal of supporting those impacted by trauma.

The Colorado Division of Mental Health’s Disaster Response and Planning Workgroup began hosting the Mental Health Disaster Response Planning Council in order to address these issues. A group of 65 professionals from across the state had our first meeting on December 19, 2006 at Four Mile Historic Park in Denver Colorado. This group committed to come together every other month for the next 6 to 9 months to develop a working structure for behavioral health disaster response. Initial work included developing 6 sub committees (Command, Training and Credentialing, Communications, Resource Development, Response Team Development, and Deployment/Response Protocols).

We expect that there will be some difficulty with this process and yet we expect the outcomes of this process will result in stronger working relationships across response agencies and organizations, greater trust and improved effectiveness in the field. We identified our vision as “An inclusive, collaborative and cooperative model of mental health disaster response” with the following five goals:

1. Identification of missing partners with the purpose of including them in the process,
2. Adoption and adaptation of the Incident Command System for behavioral health response,
3. Development of true partnerships across agencies throughout the system for behavioral health disaster response, including formal Memorandums of Understanding and Mutual Aid Agreements,
4. Development of communication systems that are inclusive and redundant, and
5. Development of a protocol document that can be utilized by the larger system as well as a template for regional, county and city/town partnerships for behavioral health disaster response.

While we have a long way to go to achieve our goals, we expect that this effort will pay dividends for years to come. The results of this effort should be greater collaboration and cooperation, more effective deployments that utilize our human resources effectively and efficiently, and a greater sense of community between disaster events. Stay tuned. I hope to be able to report our areas of progress in a few months.

VOAD

The Southwest Center for Public Health Preparedness partners will gather in New Mexico April 18 to attend the National Voluntary Organizations Active in Disasters Annual Conference.
Click here to learn more.

ICCTC at OUHSC

The Indian Country Child Trauma Center (ICCTC), at OUHSC is part of the Child Traumatic Stress Network (NCTSN) that is funded by SAMHSA, with the specific goal of developing culturally relevant trauma intervention models and materials for use with American Indian and Alaskan Native children exposed to trauma.
Click here to find out more.

Volunteer Training in NM

In conjunction with the Albuquerque Medical Reserve Corps, our SWCPHP partners in New Mexico have completed several training events for volunteers.
Click here for more information.

New Mexico Answers the Call

Our SWCPHP partners in New Mexico have just completed the long-awaited 2007 update to the core emergency preparedness training for healthcare and public health professionals.

This four-hour course, entitled Answering the Call: Health and Medical Emergency Preparedness and Response in New Mexico, provides an awareness-level overview of the emergency response elements unique to New Mexico. The curriculum also provides basic information about the federal response system, incident management, risk communication, and threat awareness. To learn more about this course, or to schedule a course in your community or agency, please contact Leslie at 505-272-6272 or LScarborough@salud.unm.edu. Or you can visit the website for the UNM Center for Disaster Medicine at http://hsc.unm.edu/som/cdm.

Pandemic Influenza Information

Did you know? SWCPHP now has a website devoted to Pandemic Influenza.
Click here to view the Pan Flu website.

Psychological First Aid

Dr. Betty Pfefferbaum discusses the importance of psychological first aid and the compassion that is required in order to assist individuals experiencing psychological distress in times of disaster. Fortunately, the National Child Traumatic Stress Network and the National Center for PTSD have recently developed manuals to aid mental health professionals and other response workers in establishing early connections with distraught survivors.
See the full text here.

Learning from Katrina

by Brenda L. Elledge, Dr. P.H.
Spring 2006

In response to a call from the University of Texas Health Sciences Center, the SWCPHP departed for Houston on September 7th with an environmental health response team, led by Dr. Daniel Boatright, to assist with the Hurricane Katrina response. Team members included Drs. Brenda Elledge and Rod Clinkenbeard of the Department of Occupational & Environmental Health and Dr. Paul Woodson of the Southwest Center for Public Health Preparedness. Dr. Robert Vincent joined the team on September 10.

In Brief
Following the hurricane, more than 200,000 were displaced to evacuation centers in at least 18 states. Thousands of displaced citizens of New Orleans and surrounding areas were relocated to Houston, with temporary placement at the Reliant Center.

Our Part
The SWCPHP team supported our UTHSC colleagues in their efforts to deal with prevalent environmental health issues. Upon arrival, approximately 25,000 citizens were housed in three separate facilities within the Reliant Center.

Team Work
The SWCPHP joined several other teams in performing thousands of health assessments every evening using a one page rapid assessment tally form. The information gathered was used to help identify communicable disease signs and syndromes and expedite care for those in need.

Observations
The team observed volunteers engaging in numerous risky behaviors that not only contributed to the possible spread of infection, but also increased personal risk of exposure.

Discussion
At the 2006 OPHA pre-conference, the SWCPHP will discuss the educational and training curricula with public health leaders, volunteer leaders, volunteers and emergency responders. Following this, materials will be developed and made available for dissemination.

Potential Pitfalls
As a part of our effort, the SWCPHP team observed a number of public health issues that inevitably occur when evacuees are placed in this type of situation. A few to mention include over-crowding, bright environment, noise, sleep deprivation, poor diet, spread of infectious diseases, lack of hygienic practices, lack of facilities conducive to good hygiene, a reluctance to seek medical care and poor support for special populations.

Points
As an element of our response, several lessons were learned. While many are obvious--such as providing a strong ICS, extra support for special populations, better waste disposal, increased security, adequate staffing and services to provide for the needs of entire populations--one of the most important lessons recognised was the need for volunteers to have training in fundamental public health tenants, especially basic environmental sanitation.

Synthesis
The SWCPHP is in the process of describing educational and training curricula that may be presented to volunteer organizations and interested parties, along with dissemination techniques and strategies to enhance not only response effectiveness and efficiency, but to reduce the risk of exposure to volunteers.

NM Partner Sits Down with OK Vets

by Laura Banks, DVM, MPH, UNM Center for Disaster Medicine
Spring 2006

Dr. Laura Banks from the New Mexico regional partner program joined Dr. Paul Woodson in a visit to the Oklahoma Veterinary Medical Association’s annual conference in Tulsa in January. They addressed the lunch-time meeting of the OVMA Board of Directors to explain the SWCPHP mission, and to offer suggestions for veterinary training in emergency preparedness and public health.

DC NACCHO Conference

by Paul Woodson, Ph.D.
Spring 2006

The SWCPHP, in association with the Association for Schools of Public Health (ASPH), provided an exhibitor’s booth at the 2006 Local, State, and Federal Public Health Preparedness Summit in Washington, DC, February 22-24, 2006, which provided visitors with education & training materials from past and current presentations. The exhibition, located in the Concourse Level of the Washington Hilton Hotel (a.k.a the “Resource Rodeo”) yielded excellent networking opportunities for all who attended. Inquiries & interest in our website, which developed and sustained throughout the sessions, indicate that the SWCPHP has excelled on many levels. The National Association of County and City Health Officials (NACCHO), ASPH, Centers for Disease Control (CDC) and various private vendors provided support for a variety of Sharing Sessions & Learning Labs for the five SWCPHP attendees, all with public health preparedness as the focus point.

ARE YOU READY?

by Ronnie Warren, Director, Oklahoma City Office of Emergency Management
Spring 2006

This is a question that emergency managers are asking their citizens everyday. When it comes to disaster preparedness, the responsibility begins with the citizen. Don’t depend on your local first responders to get to you in record time. As first responders are responding to the most heavily damaged area, those less affected could be waiting for long periods of time. Why wait when you, a “citizen responder,” could be helping out in your neighborhood, or even volunteering on a citizen’s response team?
One of the best training programs for citizens is the United States Department of Homeland Security’s Citizen Corps Program, CERT (Community Emergency Response Team). Most emergency managers who are active in community response programs and education offer this training. This training teaches you how to conduct search and rescue, first aid, triage, and many other useful skills needed during a disaster. For more information go to http://www.citizencorps.gov/programs/cert.shtm and contact your local emergency manager.

Masters Track at OUHSC

by David L. Johnson, Ph.D.
Spring 2006

Get an MPH in Preparedness and Terrorism
The College of Public Health, with CDC sponsorship, offers a curriculum leading to the Master of Public Health (MPH) in Public Health Preparedness and Terrorism. This 44-semester hour degree program provides core knowledge and skills in public health practice as well as specialty knowledge and skills related to public health preparedness for natural disasters (e.g. floods, tornados, and earthquakes), technological disasters (e.g. accidental chemical spills and intentional acts of terrorism), and emerging infectious diseases (e.g. SARS). It also provides an opportunity for those individuals with a professional degree in health care or health service to enhance their ability to participate in coordinated responses to disasters and emerging infectious diseases as an integral part of the Incident Command System.
The curriculum consists of: (1) introductory courses in epidemiology, biostatistics, environmental health, health promotion sciences, and health administration and policy, (2) specialty courses in emerging infectious diseases and terrorism, epidemiology of infectious diseases, mental health and psychological aspects of terrorism, policy and legal aspects of terrorism, risk communication, and current topics in preparedness, and (3) elective courses that allow greater depth in desired areas. A practicum provides a structured field practice experience under the guidance of a preceptor.
For more information please visit the OUHSC College of Public Health’s website at: http://www.coph.ouhsc.edu/coph/degrees/degree-mph.asp

Oklahoma Inter-Tribal Emergency Management Coalition

by Vicki Tall Chief, Ed.D
Spring 2006

The Inter Tribal Emergency Management Coalition was developed in December 2004 to address the implications regarding the local, state and national all-hazards preparedness planning process in Oklahoma, home to 39 federally recognised Native American tribes.
The Coalition is comprised of Tribal Emergency Management agencies’ as well as other emergency response agencies, who share information and ideas on improving emergency response for member tribes. Participants include representatives from over 22 Oklahoma tribes and representatives from the Southwest Center for Public Health Preparedness, U.S. Attorney’s Office, Oklahoma State Department of Health, Oklahoma Office of Homeland Security, and Oklahoma Department of Emergency Management.
In order to address preparedness needs, the Southwest Center has developed workshops specifically for tribal employees on a variety of topics which include Preparedness for Nurses in Tribal and IHS clinics, Tribal, IHS and Public Health Emergency Preparedness Training, Emergency Risk Communication, FEMA E580 and FEMA Mitigation for Tribal Officials. The Coalition hosts a website that lists upcoming meetings, trainings and other news and events. For additional information about the coalition, contact Gary Robison, Emergency Manager, Kaw Nation, Drawer 50, Kaw City, OK 74641; phone: 580-362-1232; email: kawemgy@yahoo.com; website: http://www.itemc.org

An Introduction from Daniel Boatright, Ph.D.

The Southwest Center for Public Health Preparedness is pleased to debut our online news section, SWCPHP News / Events. We hope to provide timely and insightful information to our colleagues, partners, and all interested parties about Center activities and events. In addition, articles on timely preparedness issues will be presented by our faculty, staff and partners from across the Southwest region and from around the country.
The Southwest Center can only be as successful in performing its mission to assist in preparing the public health workforce from an all hazards perspective to respond more effectively in times of crisis through being an effective member of the larger team that includes the entire range of agencies, organizations and institutions engaged in these critical education and training activities. Our sensitivity to being a team player is exceeded only by the strong desire to contribute to the overall national goal of continual improvement in areas of preparedness and response.
We are grateful to the Centers for Disease Control and Prevention that funds the activities of the Southwest Center throughout Colorado, New Mexico and Oklahoma; we appreciate the coordination and support provided by the Association of Schools of Public Health as we execute our mission. We invite our readers to contribute abstracts for articles, areas of interest to serve as points of discussion, and to provide feedback on the usefulness of this venture.
Daniel T. Boatright, Director