Assessing and managing mental health after a disaster is a key focus of UC Irvine's Center for Disaster Medical Sciences. Increasing evidence suggests that one of the most enduring health effects following disasters, including terrorism events, are mental health consequences.
Under the direction of Merritt Schreiber, Ph.D., the Disaster Mental Health Program at CDMS is focused on exploring the continuum of risk and resilience and on developing programs at the population and individual level to enhance resilience and mitigate long-term risk.
Current CDMS projects and products of Disaster Mental Health include:
PsySTART, or Psychological Simple Triage and Rapid Treatment, is a strategy for rapid mental health triage and incident management during large-scale disasters and terrorism events. It is believed to be the first evidence-based, disaster mental health triage system that can help responders rapidly assess and provide for any surge in acute and longer-term mental health impacts after disasters.
A number of organizations around the nation use PsySTART, including the American Red Cross, the Los Angeles County Emergency Medical Services Agency and 83 hospitals within the Los Angeles Hospital Disaster Resource Center System, as well as the state of Minnesota.
PsySTART is a key component of the only national model for the needs of children in disasters. Known as the National Children’s Disaster Mental Health Concept of Operations and related Disaster Mental Health Concept of Operations, it was developed for Los Angeles and Seattle/King counties. Previous iterations of this model approach for children were identified by Federal Emergency Management Agency (FEMA) as a "model emergency management practice" and included in FEMA's Compendium of Exemplary Emergency Management Practices.
PsySTART has three components:
When aggregated across multiple service sites in a jurisdiction,
the system can be used to prioritize services and provide a "common operating
picture" that gives real-time situational awareness of unmet needs and
resources. This information helps to develop local mental health
incident action plans (IAPs) as well as requests for mutual aid. It also helps local
communities integrate mental health response across "disaster systems of care."
Rapid mental health triage is critical because just as in emergency medicine
where there is the "golden hour" to deliver care, in disaster mental health, there
is increasing evidence that there is a "golden month" to match individuals identified at high risk with evidence-based care.
PsySTART provides for situational awareness of "at risk" individuals and linkage to follow on care. In a surge environment of many "at risk" individuals, the PsySTART system uses a "floating triage algorithm" to prioritize those individuals who need be seen first and those who need to seen next or can be referred for assessment after the initial surge. This allows for better management of limited acute phase psychological resources and the prioritization of mutual aid needs based on a common evidence-based metric.
PsySTART feature in The California Psychologist (July/August 2013)
The National Children's Disaster Mental Health Concept of Operations (CONOPS) is a mental health strategy for states and communities to address the needs of children in disaster.
The center has developed three psychological first aid guides entitled "Listen Protect and Connect." One guide is for parents, one is for teachers and schools, and the third is an all-ages, family-to-family, neighbor-to-neighbor guide.
The guides suggest ways to support emotional well-being before, during and after emergencies. They build on ideas, strengths and practices that parents, teachers and schools already use with children, and offer more ideas and tools to call upon in times of disaster or terrorism. The other document listed is the U.S. Department of Education guidelines for school use of "Listen Protect Connect."
Other guides include: LPC Model and Teach, Helpful Hints on LPC and U.S. Dept of Education-authorized versions in Spanish, Japanese, Chinese and Haitian.
Our center also provides consultative support to requesting agencies.
To request a consultation, please email Merritt (Chip) Schreiber.
The Anticipate, Plan and Deter program is aimed at enhancing the resilience of responders, including healthcare workers and other responders during disasters.
The program currently is being used as part of Los Angeles County Emergency Medical Services Agency Disaster Program; it is also being used by U.S. Public Health Service response teams and is included in training of National Disaster Medical System responders in response to the earthquake in Haiti. The program also is part of a new report, "Community Health Resilience," from the U.S. Department of Homeland Security, Office of Health Affairs.