MENTAL HEALTH INVOLVEMENT IN POST DISASTER RESTORATION EFFORTS

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MENTAL HEALTH INVOLVEMENT IN POST DISASTER
RESTORATION EFFORTS THE BAHAMIAN
EXPERIENCE 2004
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AGENDA Information Will Be Presented Under The
Following Topics

• 1.0 INTRODUCTION
• 2.0 ISLANDS AFFECTED
• 3.0 PLANNING STAGE
• 4.0 TREATMENT MODALITIES
• 5.0 REACTIONS TO US
• 6.0 KEY MENTAL HEALTH CONCERNS
• 7.0 HELPING
• 8.0 MULTI AGENCY PARTNERSHIPS
• 9.0 CHALLENGES
• 10.0 LESSONS LEARNT
• 11.0 TRAINING COMPONENT
• 12.0 RECOMMENDATIONS
• 13.0 SEASONS

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• 1.0 INTRODUCTION
• Mental health was not apart of the original
  National Post Disaster Plan, however, the need
  became obvious after the country received
  widespread damage as a result of Hurricanes
  Frances and Jeanne in September 2004. It soon
  became apparent that it was necessary not only to
  assist with the restoration of building, but also
  with the restoration of lives.
• The Mental Health Post Disaster Team was able to
  respond immediately due its previous experience
  with other disasters
• Hurricane Andrew 1992
• Hurricane Floyd - 1999
• Hurricane Michelle 2001
• Collision At Sea August 2 2003

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• 2.0 ISLANDS AFFECTED
• LONG ISLAND
• GRAND BAHAMA
• ELEUTHERA
• ABACO
• SAN SALVADOR
• CAT ISLAND
• MAYAGUANA
• ACKLINS
• CROOKED ISLAND
• INAGUA
• Key Received catastrophic damage

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• 3.0 PLANNING STAGE
• Approximately 83,000 (27.4) of the Bahamian
  population had been directly affected by the
  hurricanes. 2000 persons were left homeless,
  many more suffered significant property loss.
• INFORMATION SHARING
• The data needed to assist the planning efforts
  for individual communities, was the number of
• Persons affected by the trauma
• Elderly persons living in the community
• Mentally ill
• Children adolescents
• Persons who have suffered major loses
• Person grieving
• Deaths

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• 4.0 TREATMENT MODALITIES
• HOW
• v     Town meetings
• v     Group meetings
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• HOW THEY CONTRIBUTE TO THE RECOVERY PHASE
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• Allow participants to
• Connect with each other
• Ventilate about their losses
• Share experiences
• Normalized reactions
• Accept their temporary situation
• Focus initially on survival issues rather than a
  mental health focus
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• GROUPS SEEN
•  

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• 5.0 REACTIONS TO US
• Reactions were mixed. There were persons
• That were glad to see the committee, welcomed us
  and involved us in their activities
• That felt that the teams presence suggested
  that they were crazy and this was not so
• Expected the committee to provide information on
  much expected disaster relief supplies.

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• 6.0 KEY MENTAL HEALTH CONCERNS
• v Depression
• v     Acute Traumatic Reaction
• v     Post Traumatic Stress Disorder
• v     Anxiety Syndrome
• v     Persons with a history of mental illness,
  may have a relapse
• v     Stress reaction burn out in the disaster
  workers
• Ø      Uniform branches
• Ø    Health care workers
• Ø      Post disaster workers
• First responders

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• 77.0 HELPING
• DDebriefing sessions and Post Traumatic Stress
  Disorder (PTSD) questionnaires revealed that 30
  of those surveyed reported experiencing PTSD
  symptoms. Thus indicating that there was a
  definite need for counseling and information
  sharing regarding traumatic experiences the
  phases of recovery. Information was shared with 
• v     The general population
• v     First responders
• v     Recovery workers
• v     Health care workers
• TThese services were provided for approximately
  3,096 persons

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• 8.0 MULTI-AGENCY PARTNERSHIPS
• Advantages
• v     Have specific objectives
• v     Funding available to accomplish identified
  objectives only
• v     These groups have available
• Disadvantages
• Lack of communication between agencies
• Duplication of efforts
• No information sharing
• No mental health involvement
• Concerned with a specific group
• Their Challenges
• Their mental health needs
• v     Their mental health needs
• Loses (personal)
• Demands from the public

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9.0 CHALLENGES

• Sub-population language barriers
• Geography
• Coordination of efforts
• Duplication of efforts due to a lack of central
  command
• Mental health not a part of the initial
  assessment
• Facilitating acceptance
• Funding
• Activities restricted
• Excessive time spent securing funding
• Less than 24 hours to prepare for visits
• Only 2 islands visited vs. 10 identified

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9.0 CHALLENGES CONTD

• Limited available data
• No NEMA protocols
• Limited necessary preparation on the ground
• Questionnaires not returned
• Formation of the Your Grand Bahama Mental Health
  Team

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• 10.0 LESSONS LEARNT

• REPRESENTATION
• Mental health must be represented at every
  level
• Planning, Training, Initial Assessment Ongoing
  Assessment
• COMMUNICATION
• v     Between agencies government non-
  government
• v Agencies updating the public regularly
• V Early contact with agencies
• V Build relationships Restore confidence
• 3 TEAMS RESPONSIBILITY
• V The post disaster mental health must be able
  to
• v Address the needs of persons they come in
  contact with
• Or
• v Find out where they can get information or
  assistance

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11.0 TRAINING
1.0  Whos on first? What is the order of
response for mental health personnel? 2.0 What
to do? What are the responsibilities of the
mental health post disaster response
team? 3.0 How to do it? Training for the
members of the mental health post disaster
response team.
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12.0 RECOMMENDATIONS

• Identify and secure available funding
• Identify contact persons in affected communities
• Immediate inclusion of post disaster mental
  health management in NEMA Protocols
• Define the responsibilities of various groups and
  first responders
• Provide timely relief for persons who worked
  before, during and after the disaster
• Empathy needed for persons delivering services
• The Haitian community needs to be assessed and
  communicated with during a disaster
• Each community needs its own recovery team

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12.0 RECOMMENDATIONS CONTD

• 9. The Department of Social Services
• assessments needs to be timely
• 10. Need for rapid assessment tools and timely
  response of the multi sectorial team.
• 11. Timely processing of insurance claims
• 12.  The public needs frequent and timely
  communications from disaster relief agencies,
  government and non- government agencies

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• 13. SEASONS

HURRICANE SEASON STARTS 01 JUNE 2005
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