Disaster season is upon us: flood season, hurricane season, the cusp of wildfire season, tornado season, and then there’s earthquake season which seems to be year-round. To help myself and the team through whatever this year may hold in disasters or disaster responses, I took a free psychological first aid course called, “Building Workforce Resilience through the Practice of Psychological First Aid – A Course for Supervisors and Leaders .” While these skills are important for everybody, they’re truly critical for leaders in any capacity. Here’s what I thought of the training:
Ease of use: Excellent. I created a profile which allowed me to leave and return easily. This was important since the training was 90 minutes long, and I didn’t have an uninterrupted 90 minutes to devote. I liked that the sessions didn’t time out when I stopped to take a phone call and that when I closed the website to leave my desk, I could log in again later and pick up exactly where I’d left. Also, the training wasn’t a series of PowerPoint slides; it was professional, high-end production training modules.
Relevance: I learned a few things I could use, how to refer an employee to an employee assistance program for example. The training also brought me back to some basics of effective leadership, reminding me that a fundamental characteristic of a leader is noticing the people around us, what they’re going through, how they’re reacting to challenging or stressful situations, and how it’s affecting the entire team’s performance.
The session points out that we have to know what people are like every day to recognize when they are at their breaking point. So the training reminded me to step out of myself on a daily basis and especially during those stressful disaster response moments and look closely at the team around me. So – bonus – the techniques taught in this course have a day-to-day use, could improve my leadership skills overall, and may help build more a cohesive team.
Engagement: The training mixed narration and reading with continual movement on the screen – new pics, video, audio, text – every second or two to stimulate the senses and prevent boredom.
The course engaged me right away and kept me engaged by challenging me throughout with quizzes that required carefully reading and actual thinking. I realized I was cheering for myself, “hurray, I got two points!” It was a simple, quick way to draw me into the topic and dare me to continue paying attention.
Just as in life, the tests didn’t come at predictable intervals, and there were no do-overs. I’m on the competitive side and getting a wrong answer galls me. Thankfully injured pride is the only negative outcome to getting a wrong answer in the training. You can go back, look at what you could have done better, and really learn.
Overall rating: I have to admit that I’m not usually a fan of online training, but this one was a great surprise. I’d give it a two-thumbs-up, 4.5 out of 5 stars; it was definitely better than other psychological first aid webinars or slide-based training I’ve taken. In my opinion, only classroom training with actual role playing beats it. Yes, I’ll recommend it to my friends, even those who aren’t in official leadership positions.
If you’ve taken it , let me know what you thought by commenting on this blog.
Whether you work for a hospital, are part of a healthcare coalition, or are a healthcare provider, emergency manager or a public health practitioner, you are probably looking for a smarter way to keep the people who rely on you healthy, safe, and informed when disaster strikes. Finding information is easy – finding the right information can be a lot harder.
That’s where ASPR TRACIE comes in.
The ASPR Technical Resources Assistance Center and Information Exchange (ASPR TRACIE) is a new information gateway that connects public health and medical professionals with the emergency preparedness, response and recovery information that they need. ASPR TRACIE can help you quickly identify resources to get your planning started, build on the experience of your colleagues, prioritize activities for the future, make smart decisions, find training, and get answers to your questions.
ASPR TRACIE is divided into three main parts:
- Technical Resources (TR): The technical resources section provides a collection of disaster, medical, healthcare and public health preparedness materials. This section includes a series of Topic Collections, which are annotated bibliographies vetted by experts in the field that highlight key resources under specific public health and medical topics. They include a short list of “Must Reads” as well as additional resources, such as studies, toolkits, lessons learned, planning guides, trainings and more. To go even more in depth on a topic, you can also search the ASPR TRACIE Resource Library, which includes the National Library of Medicine’s DisasterLitTM, a database of over 8,000 records from over 700 organizations.
- Assistance Center (AC): Sometimes, you need a person to help – a person with the expertise to provide guidance, identify gaps and answer questions. ASPR TRACIE Technical Assistance specialists can help you navigate the research materials; find resources to support training and exercises; identify upcoming training and exercises; and more.
- Information Exchange (IE): Working together, we can find better solutions than we do on our own. The Information Exchange provides discussion boards in a password protected environment. Users will be able to ask questions, discuss past experiences, and share plans and other resources.
Every disaster teaches us something new and disaster health is a complex, constantly evolving topic. Using ASPR TRACIE can help you and your organization plan for disasters more efficiently and effectively. To learn more about the resources that are available, check out the new ASPR TRACIE.
Do you have ideas on ways that we can make the site better, new topics that we could cover, or information that could help you plan, respond and recover? Please send us your ideas!
In June 2012, a derecho was on its way to Virginia. I had never heard of a derecho, but I knew enough to heed the warnings I heard on the news. I needed to beef up my emergency kit, and – as with most things I have to do on my list – I was waiting until the last minute to do this.
My kit wasn’t completely lacking at the time. I had plenty of bottled water for everyone in the house, but my brother-in-law was visiting. We weren’t prepared for the extra body. I took inventory of everything else and learned that my spare batteries had been stolen from the kit by my daughter who used them for an experiment to learn if charging the dirt in a potted plant would make it grow faster and bigger. (It didn’t, FYI.)
So I grabbed my keys and headed out to the grocery store to see what supplies I could manage to find on such short notice. News outlets were reporting shortages of everything across the region. I had no luck at the two grocery stores near my house for either water or batteries. I had what I thought was a genius idea and walked across the parking lot to the Radio Shack to see if I my luck would improve. Apparently there were a lot of geniuses in the parking lot that day.
I was starting to get frustrated, and standing in the parking lot wasn’t getting me anywhere. As I stared blindly across the street trying to figure out my next move, I realized I was staring at a store whose entire inventory ran on batteries. A store that sold batteries to go with said inventory to ensure its customers could avoid temper tantrums later. A giant toy store!
I walked into the store and was immediately rewarded for my creativity. There next to the checkout aisle stood an entire wall – floor to ceiling – of glorious black and gold batteries. I wanted to cry. I grabbed what I needed, checked out, and then immediately posted to my social networks where my local friends could find this rare commodity.
Inspired by my creativity and luck, I started thinking about how to solve my bottled water problem. I thought back to a recent snowstorm that left the stores out of milk and the good luck I had finding it at a gas station. Yes, it was priced higher than the grocery store, but I was going to have milk. So I headed over to the gas station, and EUREKA! there was water. Smaller bottles instead of gallons, and at a much higher price, but there was water.
There are two morals to this story. The first is to make sure your emergency kit is always well stocked. It’s important to check this when the skies are clear, and there is no disaster in sight. After this event, I set up a quarterly task in my productivity app to do just this. The other is that no matter how much you might try to prepare for a disaster or bad weather, sometimes what you have is just not enough. Having a houseguest made it necessary to ensure we had more supplies on hand. Our “Plus 1” rule for our emergency kit means we have enough for every member of our family – plus one.
When disaster strikes, many people find that their plans have gaps or their kits are short a few critical items. If this ever happens to you, don’t panic. Instead, focus on what you do have, be prepared to get creative, and remember that there’s probably more than one place to get the things you need.
We know that people react differently to disasters psychologically – some bounce back quickly while others report serious symptoms that are similar to post-traumatic stress disorder or major depressive disorder. The ability to bounce back from a disaster and sustain low levels of psychological symptoms over time is called psychological resilience. We also know that psychological resilience is important for individuals and communities, but we really don’t know much about the community factors that support psychological resilience, since few studies have been conducted on this topic.
To help fill this gap, ASPR awarded a research grant to Boston University that was aimed at better understanding the individual and community level factors that influence mental health after a large scale disaster. Specifically, the study looked at individual factors, such as gender, socioeconomic status and past exposure to stressful events from a representative sample of residents in the New York City neighborhoods that were most severely affected by Hurricane Sandy. The study also examined the impact that the interaction between individual factors and the resources of the community have on overall psychological resilience.
Some of the study’s findings were as anticipated, but others were definitely a surprise to the researchers. For example, the researchers expected to find that residents of communities with more people living by themselves had lower levels of psychological resilience – but that wasn’t what they found. Turns out, residents of communities with more people living by themselves actually experienced higher levels of psychological resilience. Researchers aren’t sure why this is the case, but some possible reasons include:
- Higher Social Capital: A community with more people living alone could actually have higher levels of social capital during disasters. Residents might have more connections with friends and family in other neighborhoods and could have called upon them for assistance during Sandy.
- Economic Resources: Communities with more residents living alone in New York City also may have more economic resources that, in turn, could protect against post-traumatic stress.
- Lower Exposure: Researchers noted that the neighborhoods with the lowest percentages of residents living alone were concentrated in areas that were the least exposed to Hurricane Sandy, including Midtown Manhattan. Lower exposure could foster community resilience.
The study looked at other individual and community level factors as well.
For example, the study concluded that communities with higher median household incomes did not have lower levels of depression overall. However, living in a higher-income community was associated with lower depression for study participants who had not experienced stressors, like displacement, loss of power, financial loss or property damage.
The study’s findings built on prior research and confirmed some existing findings. Levels of psychological resilience are higher among men, people with a higher socioeconomic status, and those who had been exposed to fewer stressful events.
There is still a lot we don’t know about the ways individual and community factors predict psychological resilience and we need more research in this area. Additional research could help promote mental health in communities affected by Hurricane Sandy and other disasters. But this study has helped us better understand a topic that could help public health and emergency management professionals work more effectively with their communities.
To learn more, check out the full results of this study, Psychological Resilience after Hurricane Sandy: The Influence of Individual- and Community-Level Factors on Mental Health after a Large-Scale Natural Disaster .
This research project is part of a larger series of ASPR Grants that support scientific research and related to Hurricane Sandy Recovery. ASPR’s Sandy recovery science researchers are working on projects that could shed light on how Hurricane Sandy impacted individual and community resilience, the health system response and healthcare access, and mental health outcomes. The more that we learn about the factors that impact disaster recovery, the better equipped we will be to make informed decisions when seconds count or even for years after the disaster.
When a disaster strikes, individuals and communities feel the impact – but they don’t all feel it the same way. Disasters can be particularly hard for older adults and can make existing health conditions, from diabetes to dementia, harder to manage. On the other hand, older adults may also have long-lasting friendships, experience and skills that they can use to help themselves and their communities.
Older Americans are important parts of communities across the country. In fact, there will be about 72.1 million older people living in the United States by 2030-- more than twice the number of older adults at the beginning of this century. As Older Americans Month comes to a close, it is a great time to reflect on this year’s theme and “get into the act.” As individuals, older Americans can take the critical steps needed to plan for their health needs in a disaster and stay safe. As a caregivers, public health or medical professionals, and as a community, we can focus on better planning for the needs of older Americans so that we are ready when disaster strikes.
Disasters pose special challenges to many older Americans and their caregivers. Chronic conditions that exist prior to an emergency can be exacerbated, equipment damaged or lost, and services or treatments interrupted. These challenges can result in additional harm or stress, particularly for older adults residing in long-term care facilities or nursing homes.
According to 2012 study titled The Effects of Evacuation on Nursing Home Residents with Dementia, residents faced increased risk for adverse outcomes (e.g., morbidity, mortality, and hospitalization) due to health conditions made worse by disaster-related activities such as evacuation and distribution of daily routines. The study also found that residents with severe cognitive impairment who are evacuated were at increased risk of death even at 30 and 90 days post-evacuation. This research illustrates the need to develop policies, programs, and trainings for long-term care providers, clinicians, public health officials, and emergency responders to better prepare for and respond to the specific needs of older adults in these communities.
Also published in 2012, a report from the Office of the Inspector General (OIG) reinforces the need for tailored preparedness plans for residents of nursing homes. The nationwide study found that while most nursing homes met Federal requirements for written emergency plans and preparedness training, there are still many gaps. These gaps included emergency plans lacking relevant information and the lack of collaboration between nursing homes and local emergency management.
A whole community approach to disaster and emergency preparedness, response, and recovery activities requires integrating the access and functional needs of everyone, including older adults living independently in the community and those living in supportive long-term care settings. By utilizing this approach, public health officials and emergency managers can effectively meet the needs of the older adults, wherever they might live, by engaging and coordinating with key stakeholders such as local Area Agencies on Aging, senior centers, volunteer organizations, retirement communities, home health associations, and long-term care providers.
For more information on preparedness planning for older adults, check out the following resources:
This year’s theme for Older Americans Month, “Get into the Act,” also serves as a strong reminder that many older adults can be assets in times of a disaster or emergency. Drawing from their prior experience, expertise, and mental resilience, many older adults have the capacity to survive and help others. They are important parts of our communities and many of them volunteer with organizations like the Medical Reserve Corps to help their communities become more resilient.
Successful disaster preparedness requires both building on the resilience of older adults and developing and maintaining local planning and coordination efforts to ensure the safety and well-being of older adults during times of disaster. By planning and working together as a community, we can better protect health and save lives during disasters and every day.
Older Americans give back to their communities in many ways, and one way they can assist when their communities need help most is to become a volunteer with the Medical Reserve Corps (MRC). MRC volunteers help their neighbors, and their communities, improve their health and be better prepared for, respond to and recover from disasters.
MRC volunteers include medical and public health professionals, and people without medical training. Some of the activities that these MRC volunteers have been involved in have included responding to emergencies, participating in drills and exercises, supporting medical teams at public events, conducting public health outreach, and supporting vaccination clinics. Because local MRC units train and partner with local emergency response organizations, older adult MRC volunteers can also serve a key role in sharing their perspective with emergency management officials to provide insight on the needs of older adults in disaster planning, response, and recovery to ensure they are considered.
May is Older Americans Month, and the theme for 2015 is Get into the Act, which promotes building awareness of the importance of community engagement to improve the health and wellbeing of older adults. It also highlights how older adults are actively controlling their health, being engaged in their communities, and making a positive impact in the lives of others.
Older American MRC volunteers contribute a great deal to the success of MRC units in addressing the health and response needs of their communities. In fact, about one-third of MRC volunteers are age 56 or older. The Medical Reserve Corps program includes retired medical and nonmedical professionals that are able to use their knowledge and skills to support their community’s efforts to be healthier, safer, and more resilient.
As an MRC volunteer, they are able to volunteer at their leisure as there is no required time commitment for volunteers. In fact, some older adult MRC volunteers have chosen to volunteer with units where they vacation for part of the year, in addition to where they live.
If older Americans are interested in volunteering to help their communities through their local MRC unit, they can learn more about local opportunities and the MRC by visiting www.medicalreservecorps.gov.
We are thankful for the contributions of Older Americans for their past and continuing efforts to serve the needs of our country. To find out more about Older Americans Month 2015 and how to get involved, please visit http://www.acl.gov/NewsRoom/Observances/oam/Index.aspx.
Large scale or distressing events such as the train wreck in Pennsylvania, the massive earthquake in Nepal and the protests and episodes of civil unrest occurring in many of our nations’ cities are closely monitored by many people, young and old, on television or the radio or through social media. Some follow these events to find out if they or someone they may know is directly impacted. Others are just trying to get a better understanding of things that seem far away or worrisome. People who watch or listen to too much news coverage or frequently monitor social media of traumatic events, no matter what reasons they are viewing the coverage, can experience increased stress symptoms and emotional distress. Some populations, such as children and the elderly, are even more vulnerable to these kinds of negative emotions if limits are not placed on seeing upsetting images and hearing graphic stories.
Viewing media coverage of traumatic events is especially distressing for children and young children. For very young children, repeated images of an event on the television may be interpreted as the event happening again and again. Young children may not have the cognitive or verbal skills to either understand all that is being seen and heard or to ask the questions to help them make sense of what is truly happening. Listening to the news in the background, and unsupervised, can be just as stressful for children and should be minimized.
Evidence also suggests that adults with pre-existing mental health conditions or prior trauma histories may be more vulnerable to the stressful effects of viewing coverage of emergency events or disasters.
So what can you do to minimize the potentially negative impacts of media coverage while you try and stay informed about what is happening around the world and in your neighborhood? Try and pay attention to the following:
Children and young children:
- Limit or refrain from letting children, especially young children, watch coverage of traumatic events.
- If children do watch television, listen to the radio, read the newspaper, or view social media coverage of the event, be sure to watch/listen with them and to discuss what is being seen and heard and be open to answering questions.
- Misunderstandings frequently emerge for young children and being available for them to correct information and provide support can go a long way to helping them feel safe and cared for.
- If you do not know the answer, that is ok and you should tell your child that. If you feel you can get the answer, let your child know and then make sure to follow up.
- Give children a hug and let them know they are safe and that there are people in charge who are working to resolve the situation and who are helping people who were directly impacted by the event.
- To learn more about how children react to traumatic events at different ages, see SAMHSA’s Tips for Talking with Children and Helping Children and Youth Cope after a Disaster or Traumatic Event.
- Put some limits on your own media consumption. Pay attention to your feelings and thoughts and end your viewing or reading when you recognize that you have met your limit. Try not to watch televised coverage right before going to bed, as distressing images could disrupt your sleep or dreams.
- Talk with someone about how you are feeling. If you have seen graphic images or disturbing photos and video and are upset, or if learning about an event has brought up feelings about your own trauma history, reach out to a friend, family member or a mental health professional.
- Contact the National Disaster Distress Helpline and share information with friends and family as a resource. (1-800-985-5990 or text TalkWithUs to 66746.)
- Utilize healthy coping strategies to manage the distress such as talking with someone, getting plenty of exercise and sleep and eating healthy foods.
Emergency Medical Services Week is a great time for us to step back and celebrate the EMS providers who risk their own lives and health to protect the well-being of others.
Kevin Horahan, a paramedic and Senior Policy Analyst with the HHS Office of the Assistant Secretary for Preparedness and Response, shares his thoughts on the ways that EMS professionals serve during disasters and everyday, including ways that they can better help people in chaotic situations when every second counts.
Governments, hospitals and other members of the public health community often wrestle with how to demonstrate the value of preparing for disasters. ASPR’s recent collaboration with a regional coalition in southeastern Pennsylvania provided a unique opportunity to measure the costs and benefits, and it resulted in one of the first economic evaluations applied to preparedness.
And, as it turns out, it truly does pay to be prepared.
Public and private public health organizations created the Surge Medical Assistance Response Team, or SMART, to address local disasters in southeast Pennsylvania. SMART is a multidisciplinary, collaborative effort that includes a wide variety of volunteers who augment surge capacity at hospitals and alternate care sites.
Working closely with SMART, we were able to evaluate both the cost of the resources they had available and the cost of responding to their local disasters in recent years. This regional response team produced positive returns on the region’s investment after only six years. The break-even point for each community would vary depending upon a number of factors.
We also studied innovative ways that regional emergency response teams could be funded. Some regional disaster response organizations across the country have relied on membership models to make up for decreases in public funding. We applied that model to SMART, and found that their model still worked. In their model, a 10 percent decline in public funding could be offset if each participating hospital paid $410 and each long-term care facility paid $148 in annual membership fees. Even if there was no public funding, hospitals would only pay $4,096 and long-term care facilities would pay $1,484 each year in membership fees. Through this membership structure, all of the entities that rely upon the regional response team for support would share a portion of its cost.
We concluded that not only can public health entities support regional response teams through membership fees, but also the model could attract private funding because of positive financial return on investment.
We outline several financial models that could be used and ways of measuring the value of preparedness in a paper published in Disaster Medicine and Public Health Preparedness.
We don’t know when or where disaster will strike, and that makes it difficult to precisely measure the value of preparedness before disasters. However, the unique opportunity we recently had to evaluate the economics of a specific regional response program and the costs associated with its responses to recent disasters demonstrates that its value can be ascertained. Most importantly, what we learned is that preparedness pays off pretty quickly.
With natural disasters, epidemics, severe weather and other emergencies becoming more common and costly, the importance of emergency preparedness for businesses has never been greater. And that’s where national health security comes into play. National health security creates healthy and safe conditions to live, work, and play in before, during, and after emergencies.
By considering national health security as a way of life for small business owners, businesses can become more resilient to disasters, protect workers’ health and safety, decrease the time it takes to recover, and support community infrastructure to provide resources such as food and clean water to those in need.
Nearly 40 to 60 percent of small businesses never reopen their doors following a disaster. Being prepared for a disaster can protect not only the business itself but also the health and wellbeing of its employees, their families, and its community.
National Small Business Week, May 4-8, is a great reminder for small business owners and their employees to make sure they have an emergency plan. This plan can help ensure that employers and employees know where to go and how to protect themselves from hazards that can result in occupational injury and illness – ranging from basic safety training to the use of personal protective equipment.
Small businesses can help maintain the personal health of workers with emergency plans that include establishing employee assistance programs to deal with behavioral and social health impacts of a disaster. As a whole, health protection and promotion are essential to a resilient workforce and workplace that can withstand, adapt to, and recover quickly from a disaster.
Here are some suggestions on what your emergency plan could address:
- Resource management- Resources essential to emergency response should be identified
- Emergency response- Plans to protect people and property should be developed
- Crisis communication- A plan should be created to establish communication with employees and customers
- Business continuity- A continuity plan that includes recovery strategies to overcome the disruption of business
- Information technology- A plan to recover computer hardware and electronic data
- Employee assistance- Encourage employees and their families to have personal preparedness plans and provide opportunities for medical, behavioral, and social support
- Incident management- A system is needed to define responsibilities and coordinate activities before, during and following an incident
- Training- People with defined roles in an emergency situation should be trained before a disaster strikes
With disasters on the rise, the time for small business owners to ensure their business is prepared and adequately protected is now. To learn more about building an emergency plan for businesses, visit www.sba.gov/disaster or www.ready.gov/business.