Daily Kos

Psychological Resilience and Disaster Management

Sun May 11, 2008 at 03:49:46 PM PDT

In facing future scenarios that involve:

•an increase in possibility of extreme weather and storms,
•a critically transforming climate,
•a money economy disrupted and threatening collapse,
•an energy economy based on declining supplies of oil and other non-renewable fuels,
•an observable diminishment of water and food resources,
•a threat of pandemic disease occurring in an ever destabilizing social environment,
•where the medical emergency establishment is understaffed--undercapitalized, unprepared, (see)
•the possibilities of mass migrations in the first world countries mirror the horror in Darfur...  

It is important that we increase individual and community resilience so that we may better function when they become a reality (whether gradual or sudden). Many governmental and community organizations and agencies are recognizing the need to establish preparation and training following the devastation of Hurricane Katrina on the Gulf Coast and in New Orleans where they were caught completely unprepared.  The near miss of Hurricane Rita at the heels of Katrina threw the city of Houston and its surroundings into such panic and disorder that lives were unnecessarily lost.

Much has been written and spoken about need for preparing adequately for such future disasters.  But of course there is much more to be prepared for in community crisis management than increasingly severe and more frequent storms.  When we acknowledge the climate change, peak oil, and economic collapse scenarios, we are working with a much more complex system of interacting variables.  Richard Heinberg, author of "Peak Everything, Waking up to the Century of Declines" has written a call to arms in which he enumerates ways and means of building resilience in his Museletter article, "Resilient Communities: A Guide to Disaster Management".  Also see Transition Culture for additional community resilience ideas.

As a mental health professional, I must add that there is a need to increase individual and community resilience on the psychological-emotional level as well as on the organizational.  Critical Incident Stress Management (CISM) is an established methodology for relieving symptoms of traumatic stress encountered during critical incidents and catastrophic situations.  Stress management and debriefing are designed to increase individual and group resilience to trauma for those responding to emergency situations.  The training is given to both mental health professionals and volunteer responders so that they may form a team which provides debriefing to those workers on duty at the scene.  The interventions performed by the CISM team allow the responders to continue functioning both during the event and throughout its recovery period.  The training naturally increases personal resilience for the CISM team members in such a way that their performance is enhanced when they are on active crisis response duty.

Psychological resilience training for the public in general as a preparation for dealing with disaster (both natural and other) would be greatly beneficial in decreasing the amount of traumatic stress people feel when facing critical future scenarios.  Being prepared mentally and emotionally and having an emergency plan for different types of possible critical situations makes all the difference in the ability to control irrational panic responses that would further endanger them and their communities when clear thinking and quick action are necessary for survival.

I believe in considering these possible future scenarios it would serve us well to establish centers in our communities where the populace could be educated about these potential dangers and provided with reasonable and accurate information for preparation and planning.  In these centers they could receive some training in CISM so that they are prepared to facilitate crisis management in their homes and neighborhoods.  Educating people about life-changing possibilities occurring in the near future without giving them information and skills for dealing with them creates a critical level of stress and only serves to activate and crystallize the natural coping mechanism of psychological denial.  Offering scenarios that are overwhelmingly outside their ability to control or manage tends to shut down their natural ability to seek solutions and act on them.  Providing stress management tools and skills enhances their sense of personal safety and resilience.

Other survival skills could be taught in these centers.  Embracing home and farm economics as well as nursing skills and practices our grandparents (great-grandparents for some of you) knew well but which have been lost in the fast pace of modern (post-modern and beyond) life, would be both beneficial and stress relieving.   Having this kind of knowledge and ability is, in itself, a way of increasing resilience to critical future scenarios, be they energy depletion, pandemic, storm, or "doomer" dystopia.

I have written diaries here and here with my thoughts and suggestions as a mental health professional.  The city of Houston actually has a mental health team for responding to disasters, but I would like to see them begin a program for public preparation.  

Tags: psychological resilience, community resilience, community building, disaster management, community resource center, CISM, traumatic stress management, Critical Incident Stress Debriefing, International Critical Incident Stress Foundation; Peak Everything Future Scenarios, health, peak oil, environment (all tags) :: Previous Tag Versions

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  •  great topic (5+ / 0-)

    We need to balance money spent toward infrastructure with money for mental health as related to disasters.

    However, look at dollars spent for mental health in terms of veterans and you will see that it is still not a legislative priority.

    My wife is a mental health professional so I understand what we are dealing with in terms of public perception of allocation of resources.

    Thanks for all you do.

  •  I agree (3+ / 0-)

    If we wait for government to take the lead on this, however, we'll be waiting a long time, as it still considers psychologists useful only for abusing terrorism suspects and whistleblowers, which it views much the same.

    •  Houston mayor supports sustainable community (2+ / 0-)

      Recommended by:
      SarahLee, kurious

      lol, government use of psychologists...eerrgh!

      Yes, I believe we will have to build this ourselves on a volunteer basis (Build it and they will come!). Although Houston's mayor is very supportive of sustainable community.

      Finding your own Voice -- The personal is political!

      by In her own Voice on Sun May 11, 2008 at 04:28:22 PM PDT

      [ Parent ]

  •  Thanks for this diary (4+ / 0-)

    Many communities, including mine, have a long way to go in preparing for and responding to disasters.  Last summer my city was struck by a tornado.  Fortunately the damage was mainly property damage.  It was an eye opening experience though, to see that post-disaster recovery took a lot longer than expected and there were issues to be dealt with that most people don't expect or plan for:  Blocked roads, longer than expected power outages, lack of communications from the city government to the general population--so people whose homes within a 10 minute period were no longer inhabitable, didn't know when help would come, how widespread the damage was, or where or how they could find shelter or food.  Phones, both cell and landlines didn't work for hours after the event.  Then, the news media descended with helicopters flying buzzing all night long for several nights, and "gawkers" bringing the already blocked roadways to standstills.  

    Thank you for your diary and I will read the links.  I hope more city governments will take the time to plan and prepare, and communicate and educate residents about plans, shelters, resouces, etc.  

  •  Excellent post, Voice. (3+ / 0-)

    Recommended by:
    SarahLee, kurious, In her own Voice

    Thank you very much.

  •  Glad to see this topic (2+ / 0-)

    Recommended by:
    kurious, In her own Voice

    One of the first things that struck me when I was watching the news video after Katrina was that these stranded people seemed to be reacting like 'city folks' who had been dumped in the woods.  

    Is that just my impression?

    Granted, the folks who had to ride out the storm didn't have the economic resources to prepare well, if at all.  But I kept feeling that some camping skills would have helped out, at least psychologically.  Here these folks are stuck, not knowing when (or if) help will arrive, not knowing if the water is safe or if it will rise or fall, not having access to food or drinking water, or adequate shelter.  Plus they may be in trauma because the family/friends have been separated, or worse.  Very frightening.  Very disorienting.

    I speak as the daughter of my mother, who lived thru the Battle of the Bulge, right smack in the middle of it.

    •  War, resources, and N.O. (2+ / 0-)

      Recommended by:
      SarahLee, Nature Maven

      Battle of the Bulge--wow, madmommy, that was a heavy-duty critical incident!  War is one of those scenarios we hope to avoid if and when our resources are limited by the Big 3--Energy (depletion), Environment (critical climate change), and Economy (disruption and devaluation).

      Yes, the people of New Orleans were trapped in conditions through which the most prepared and most resilient couldn't have maintained themselves without traumatic stress taking them over.  More like the conditions in a third world country--though certainly not as much loss of life as in Burma/Myanmar.

      In the case of New Orleans, there should've been a community emergency plan that would have brought buses in to get the people without transportation out.  (Along with money spent on the levees--a city below sea level with a great river like the Mississippi on one side and the lake and gulf on the other has to have strong levees or abandon this ground and move the city inland.)  New Orleans has such a long history in Louisiana and American culture that it is hard to give it up--home and history to so many people--hard to give up the past and its colorful heritage.  

      Its tourist industry is also income producing for both the people of N.O. and the state -- perhaps one of the very few remaining industries for LA.  Unfortunately, a part of that history is government corruption--embezzlement and misuse of public funds.  Much to consider.  

      My daughter and son-in-law were there, but got out--they had a car...

      Finding your own Voice -- The personal is political!

      by In her own Voice on Sun May 11, 2008 at 07:48:27 PM PDT

      [ Parent ]

  •  Good diary (3+ / 0-)

    and thanks for posting to the Daily Kos Health Care Google Group.  You didn't use any standard tags, so I wouldn't have seen it otherwise.

  •  EMDR is an excellent modality (2+ / 0-)

    Recommended by:
    kurious, In her own Voice

    for critical incident response. Fellow mental health profesionals can check this reference: "Utilization of EMDR in crisis intervention." Solomon, Roger M. Crisis Intervention & Time-Limited Treatment. 1998 Vol 4(2-3) 239-246.  My only links require membership.

    Having worked in local disaster response after 9/11 in NYC, it became evident to me that CISD, at least as it was promoted by the Red Cross, assumed you could undo trauma if you ran in and attacked it fast enough after the critical incident.  Sadly, it takes time to process an initial response and more time still to resolve it. EMDR does seem to help with initial consolidation of memory, affect, behavior and cognition.

    Thanks for this diary and getting us to think, and I'm very glad your son and daughter-in-law made it out of N.O. alive.  What a compound disaster for that city and this nation that the corrupt Bush administration responded so poorly.

    The greatness of a nation can be judged by the way its animals are treated - Mahatma Gandhi

    by Nature Maven on Mon May 12, 2008 at 09:14:44 AM PDT

    •  Ooops! Dtr and Son-in-law. n/t (1+ / 0-)

      Recommended by:
      In her own Voice

      The greatness of a nation can be judged by the way its animals are treated - Mahatma Gandhi

      by Nature Maven on Mon May 12, 2008 at 09:15:55 AM PDT

      [ Parent ]

    •  EMDR vs CISM (1+ / 0-)

      Recommended by:
      Nature Maven

      Maven, I use EMDR in my practice and have worked with trauma, PTSD for a long time now.  I very much value EMDR and will "preach" with you on its efficacy.  It is the best method I know for trauma mitigation!

      The value I am giving to CISM as outlined by the International Critical Incident Stress Foundation (different from the Red Cross variety in practice and in principle) is that learning good stress management skills and being able to practice them on an ongoing basis (continuing education for CISM "peers") might prevent PTSD and other less healthy coping mechanisms from becoming entrenched.  

      Let's face it, there are many people we will never see in our offices--people who will never have the benefit of EMDR.  And yet we depend on these people (police, fire, FEMA, Coast Guard) to manage stressful, high risk situations on a daily basis.  My suggestion is to empower people to help themselves.

      Empowering people (in general--not just clients/patients) to help themselves in facing these future scenarios is the thrust of what I am suggesting here.  Feeling empowered to manage stress and the uncertainty of the future (given all the disturbing probabilities) is an essential ingredient to psychological resilience.  

      Finding your own Voice -- The personal is political!

      by In her own Voice on Mon May 12, 2008 at 11:20:28 AM PDT

      [ Parent ]

      •  Good points (1+ / 0-)

        Recommended by:
        In her own Voice

        and sounds as if we're on the same page here. Sorry if my comment sounded "preachy".

        The greatness of a nation can be judged by the way its animals are treated - Mahatma Gandhi

        by Nature Maven on Mon May 12, 2008 at 12:01:22 PM PDT

        [ Parent ]

        •  Respecting the responders (1+ / 0-)

          Recommended by:
          Nature Maven

          oops--sorry if I sounded short in my reply.  I appreciate your comments and "preachy" wasn't meant to refer to your presentation.  I can be rather "preachy" about EMDR as can my EMDR study group members. I just wanted to make sure I gave due credit to those uncredentialed "peer" responders I met in training--a great bunch of people from the Coast Guard, EPA, U.S. Marshals, police, fire-fighters, EMT's  I met during my training with the Foundation.  Many of these people had responded to both 9/11 and Katrina (still working with Katrina clean-up)  and were managing quite well, considering...  

          They are a proud group and like to think of themselves as the rescuers who don't need rescuing. But they have been trained to know when they need the additional help of a therapist. Some had good experiences with therapy while others felt they'd been made worse by therapists who had treated their "situational" symptoms as Complex PTSD.  They came out feeling depressed and disempowered--diminished in some ways.

          Their CISM training is clearly distinguished from therapy.  Trainers make them aware of the help they can receive from professionals--from EMDR and other therapies such as mayofascial release in massage therapy. They are advised to ask the right questions of therapists to make sure they get the professionals that understand and meet their needs.

          Again, the focus is on self-empowerment, hardiness, and resilience.  Similar to 12-step recovery groups...  We who are credentialed have to play down our knowledge and skill or meet with resistence.  

          Hey, maybe we don't know everything?

          Finding your own Voice -- The personal is political!

          by In her own Voice on Mon May 12, 2008 at 12:55:43 PM PDT

          [ Parent ]

          •  So true (1+ / 0-)

            Recommended by:
            In her own Voice

            I volunteered with ARC at Ground Zero and had heard a horrible tale along the way with no where to take the feelings that came up for me.  A wonderful woman from Ohio volunteering there with ARC let me unburden myself then and there so I could process the horror I'd just been handed.  Worked well.  I thank you for the reminders. I stumbled on your diary after signing up with the environmental Google DKos group, and through you found the health care one, too.  How cool!  You guys are cool peeps.

            The greatness of a nation can be judged by the way its animals are treated - Mahatma Gandhi

            by Nature Maven on Mon May 12, 2008 at 02:06:45 PM PDT

            [ Parent ]

        •  oh, and thanks for (1+ / 0-)

          Recommended by:
          Nature Maven

          your acknowledgement of my daughter and son-in-law getting out of N.O.

          My mom, sister and her family, brother and his did not fare so well on the coast of Mississippi!

          Finding your own Voice -- The personal is political!

          by In her own Voice on Mon May 12, 2008 at 12:58:24 PM PDT

          [ Parent ]

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