Insight Matters
Summer, 2004

Disaster drill reveals mental health needs
by Marion Sherman, M.D., Chair, Ad Hoc Committee on Disaster Mental Health

OPA presence continues to expand in the all-hazards emergency planning arena. As we become more involved, we share experiences and encourage others to contact local emergency management coordinators, grow local relationships, and participate in exercises.

As an example, in the Central Ohio chemical disaster exercise on July 29, 2004, a simulated bomb "exploded" at a local high school political "rally," creating "injuries" in the crowd of about 90 youth and adults. Disaster exercise participating agencies/institutions included: City of Columbus Public Schools, Walnut Ridge High School, Franklin County Emergency Management Agency, City of Columbus, American Red Cross, Amateur Radio, Ohio Funerals Association, local police, bomb, and fire departments, and participating hospitals providing care in their emergency rooms.

Prior to the exercise, the pre-incident debriefing was done by a MH disaster responder team with professionals from Twin Valley Behavioral Healthcare and Ohio Hospital for Child and Adolescent Psychiatry. Their pre-incident focus discussed simulation stressors, when to get help, who to contact, what to expect during the drill.

During the full day exercise, the mental health team observed the initial incident, reported on-scene to the Incident Commander (police captain), assisted at the scene, rode on buses with volunteers to local participating hospitals, observed and assisted when requested during triage and hospital experience, and returned to the original scene on buses following the completion of the exercise. MH team members participated in pairs to attend to real needs of volunteers, and to participate in the mock disaster MH aspects.

One disaster MH team member stayed at the scene to assist with temporary morgue, potential MH issues with responders, MH consultation, and volunteers returning from the hospitals. At the exercise conclusion, volunteers were checked out and dismissed.

After the exercise, a large responder debriefing was held with representatives from participating groups and the team of evaluators. The disaster MH team thanked COTS for inclusion in the Central Ohio disaster exercise, and reported out summary findings, including observations that early intervention with responders and with victims families decreased ultimate impact and mitigated damage.

The team also reported limitations to the mental health portion of the exercise. At the scene and the hospitals there was need for increased MH interaction. Examples included:

• Mental health responders were needed in emergency rooms and scene triage;
  
• Youth on a bus with two other kids who unexpectedly "died" on bus without attention to MH impact on victims;
  
• Decontamination was in spots performed gruffly without regard to humanity of recently traumatized victims;
  
• Firefighters were left dealing with deceased human remains without calling in MH presence;
  
• PIOs/media consultation to decrease anxiety and educate regarding normal responses following a disaster.
  
• Several injured youth came unescorted to the bus from the scene triage area;

The exercise was a learning opportunity. In this way OPA disaster responders can sharpen their clinical skills, and continue involvement in disaster MH preparedness.

Back to Newsletter