A Framework for Planning Community Response to Overwhelming Patient Surge
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Psychosocial Network (PN)

AICA

Strategic Function: To provide behavioral health services, crisis response, and psychological first aid to individuals, families and emergency responders in a disaster incident.

The subject matter expert for this function is:

New Mexico Department of Health,
Division of Epidemiology and Response
Bureau of Health Emergency Management
Deb Boehme, Staff Manager
Risk Communications and NM Serves Volunteer Registry
(505) 476-8209
deb.boehme@state.nm.us

Why: During a disaster communities will need to have in place, a plan that addresses the psychosocial needs that will arise.

Who: Emergency planners, traditional behavioral health providers, non-profit organizations  and civic organizations that have been trained in crisis intervention and psychological first aid, can provide support.  The NM Crisis Support Team (CST) is available 24/7/365 through Santa Fe Dispatch – 505-827-9384.

When: Each community will decide through ongoing assessment, plan development, pre-incident education and exercises, the trigger(s) or threshold(s)  for the activation of the PN. 

Where: The psychosocial network plan is part of a local jurisdiction’s emergency operations plan. The available resources have been identified in the plan

How: Each community is unique. The planning and establishment of is determined by services offered in the local community.  A baseline assessment of the community’s existing resources is essential and emergency planners will integrate the existing behavioral services into the community’s psychosocial network plan.

Planning assumptions for PN include:
  • Psychological support is considered to be an extension of the personal health care of every individual and will be shared by all affected by the incident.
  • The need for psychosocial support may be required for several months to a year following an incident and will largely depend upon individuals, communities, family members, and co-workers to support each other.
  • The success of NM MEMS and the State’s response to the psychosocial needs of the community will rely, in part, on the public’s awareness of the incident, as well as  the public’s  level of individual emotional and physical preparedness.
  • As part of ongoing emergency preparedness planning, is the responsibility of lead agencies of the State to provide to public and private available information regarding potential problems, as well as instruction related to emergency awareness and preparedness (i.e. personal and family coping strategies and the basic principles of psychological first aid). 
  • The NM Human Services Department (HSD) is the State Mental Health Authority.  As such, they have the responsibility to negotiate with the federal government the state’s   eligibility  for FEMA’s crisis counseling funding.  HSD is also the lead agency for the Behavioral Health Collaborative which oversees mental health and substance abuse services throughout the state.  Local Collaboratives identify needs, help develop a range of resources and ensure the responsiveness and relevance of behavioral health services. 
  • The full range of psychosocial needs during a disaster will be addressed by the Local Collaboratives. These needs could include psychological first-aid from neighbors and to the needs of those with behavioral health disorders.
  • The specialized behavioral health training of health care workers will comprehensively address the concepts of disaster mental health and include the unique aspects of a prolonged public health emergencies as well as the appropriate clinical interventions to address both acute and long-term traumatic stress disorders related to catastrophic incidents that are prolonged and/or have high levels of mortality.
  • Consideration must be given to the disruption in treatment for chronic behavioral health disorders among patients presenting during medical or patient surge, particularly the need to ensure availability of psychotropic medication and treatment for displaced community members (e.g. shelter residents, AOCA, and CON).
Questions for consideration during assessment and planning include:
  • What psychosocial services (behavioral health, crisis response, psychological first aid) are currently provided by your community?*
  • What triage criteria are in place to process behavioral health emergencies?
  • Does your community have a system for ensuring proper credentialing of mental health professionals and adjuncts to care for increased psychosocial demands during a widespread public health emergency?
  • How would your community absorb local emergency volunteer groups, faith based organizations, community service organization and the well-intentioned public to meet the psychosocial needs of family, friends, neighbors and those at-risk individuals?
  • What "just in time" training would be available for those individuals an organization named in question #4?  What are the triggers that would initiate this training?
  • What type of community education is available to personal and family coping strategies and basic principles of psychological first aid?
  • What are the Community triggers for receiving NM State eligibility in relation for FEMA Crisis Counseling Funds?
  • What alternative plan is in place to address the disruption of treatment services and prescription dispensing of psychotropic medicines for the displaced long-term behavioral health patient?

Tool

 

 

A sample tool to identify existing psychosocial services:

 

 

 

 

 

Types of Services Offered

Agency

Individual
Support

Group
Support

Number Crisis Counselor

Hot Line

Just In Time Training

Special Populations
Served

Team Builders

 

 

 

 

 

 

Youth Shelters Family Services

 

 

 

 

 

 

Zia Behavioral Health

 

 

 

 

 

 

Catholic Charities

 

 

 

 

 

 

Pastoral Counseling Center

 

 

 

 

 

 

Crisis Response

 

 

 

 

 

 

Esperanza Shelter

 

 

 

 

 

 

Rape  Crisis

 

 

 

 

 

 

 

Resources

Summary
This function is a network of psychosocial services, including traditional behavioral health services, crises response, and psychological first aid, to support individuals, families, communities and emergency responders (including health care workers) during a widespread public health emergency (i.e. an infectious disease pandemic) or other catastrophic event (i.e. a natural disaster), where systems delivering such services will be inadequate or unavailable.

Psychosocial Protocols
Protocols for delivering psychological first aid.
University of MInnesota: Center for Infectious Disease Research & Policy - Disaster Mental Health Intervention Field Guide (IN) Web Link

Indiana: Disaster Mental Health Field Guide PDF Download

Preparing Hospitals and Clinics for the Psychosocial Consequences of a Terrorist Incident or Other Public Health Emergency: From Los Angeles County Health Services Web Link

Behavioral Health Guidance
Guidance and procedures to provide mental health interventions.
Ontario Health Plan for an Influenza Pandemic July 2007: Community Health Services Tools PDF Download

Disaster-Related Physical and Mental Health: A Role for the Family Physician Web Link

Standing Admission Orders
Description of how the state-funded behavioral health services will provide support.
Hyperlinks placed here

Patient Tracking
Ontario Health Plan for an Influenza Pandemic July 2007: Long Term Care Home Tools PDF Download

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