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Welcome
“Bridging Behavioral Health and
Spiritual Care For Disaster Victims”
“Bridging Behavioral Health and Spiritual Care
For Disaster Victims”
Focus on:
Spiritual Bridge Connection Applications
Edward Smith
Deputy Executive Director
Victim Relief Ministries
Chance Freeman
Branch Manager
DSHS Disaster Behavioral
Health Services
What do you expect to
gain from this training?
Mission Statement
The mission of the Disaster Behavioral Health
Services (DBHS) is to lessen the adverse
behavioral health effects of trauma for victims,
survivors and responders of traumatic events,
whether those events be natural or man-made.
Mission Statement
Mission is accomplished through proactive
behavioral health responses to catastrophic
events by providing defusing, debriefings,
crisis interventions, crisis counseling services,
and referrals to additional resources.
DBHS has 6 basic program
functions
1. Serve as the liaison to the Texas Division of
Emergency Management and other federal
resources on disaster mental health issues
2. Coordinate all DBH, CISM and Crisis
Counseling services during a state or federally
declared disaster
3. Provide brief crisis counseling services during
state or federal critical incidents or disasters
Program Functions continued
4. Develop and submit all State and FEMA grant
applications on behalf of DSHS & the impacted
communities. This includes Crisis Counseling and
Public Assistance grants
5. Provide Educational, Advocacy & Stress
Management Services
6. Assist in the development of internal emergency
response abilities and resources and assist in the
coordination of internal response and recovery
activities from traumatic events.
CISM: Primary Components
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Pre-event Planning / Education / Preparation
Surveillance and Assessment
Strategic Planning
Individual Crisis Intervention
Large Group Crisis Intervention:
• Demobilizations (large groups of rescue /
recovery)
• Respite / Rehab Sectors
• Crisis Management Briefings (CMB)
CISM: Primary Components
• Small Group Crisis Intervention:
• Defusings
• CMB
• Critical Incident Stress Debriefing (CISD)
• Family CISM
• Organizational / Community intervention,
consultation
• Pastoral crisis intervention
• Follow-up and referral for continued care
Cooperation is the Key
How Texas Administers the
Program
Disaster response and recovery efforts include
partnerships between DSHS and the following:
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• 37 Local Community Mental
Texas Division of
Health Centers
Emergency Management
• 140 Contracted Substance
Federal Emergency
abuse providers
Management Agency
• 24 Critical Incident Stress
Center for Mental Health
Management Network Teams
Services
Substance Abuse and Mental • Voluntary Organizations
Health Services
Active in Disaster
Administration
• Community stakeholders and
gatekeepers
Disaster Behavioral Health
Assistance Team (BHAT)
• Specialized team that provides coordination
and delivery of DBH services during a large
disaster
• Works closely with DSHS, State Medical
Operations Center (SMOC), Local Mental
Health Authority (LMHAs), Substance
Abuse (SA) providers, TDEM, Mass Care,
and Department of Public Safety (DPS)
Liaison Officers
BHAT Responders
• Trained and certified across a broad spectrum
• licensed mental health professionals
• qualified mental health professionals
• trained para-professionals
• public health workers
• substance abuse treatment professionals
• Texas CISM Network Teams
• Spiritual Care Providers
BHAT Expectations
• Deployment within impacted region for up to
6 days
• 2 travel days
• 4 direct service days
• Provide early psychological intervention
• Gather and report encounter and financial
data to DBHS each day
Preferred Training &
Experience for BHAT
Responders
• ICS (100, 200, 700) (Free on-line)
• Psychological First Aid, Mental Health First Aid,
CISM, or some other Early Psychological Intervention
• Ability to travel and work under adverse conditions
• Experience working with survivors of disasters and/or
critical incidents
• Specialized training: children and adolescents, cultural
diversity, geriatric populations, victims of crime, grief
and loss, special needs populations, death notifications,
bilingual skills, etc.
Key Concepts of
Disaster
• No one who sees a disaster is untouched by
it
• Primary, secondary and tertiary victims
• Two types of trauma
• Individual (stress and grief reactions)
• Collective (Damages the bonds and social
fabric of the community. Increases fatigue,
irritability and family conflict.)
Dates Ingrained in our
Memories
• November 22, 1963
• April 19, 1995
• September 11, 2001
• February 1, 2003
• August 28, 2005
Dates Ingrained in our
Memories
• November 22, 1963
• Assassination of President John F. Kennedy
• April 19, 1995
• Oklahoma City Bombing
• September 11, 2001
• 911 – Attack on the World Trade Center
• February 1, 2003
• Space Shuttle Columbia Explosion
• August 28, 2005
• Hurricane Katrina impacts State of Louisiana
Crisis Counseling vs.
Traditional Mental Health
Traditional
• Primarily office-based
• Focuses on diagnosis and
treatment of mental illness
• Attempts to impact
personality and functioning
• Examines content
• Encourages insight into past
experiences and influence on
current problems
• Psychotherapeutic focus
Crisis Counseling
• Primarily home and
community-based
• Assessment of strengths,
adaptation and coping skills
• Seeks to restore pre-disaster
functioning
• Accepts content at face
value
• Validates appropriateness of
reactions and normalizes
experience
• Psychoeducational focus
Disaster Behavioral Health
Do the Programs Work?
Mural projects used as part of the
Crisis Counseling Program during
Hurricane Ike in 2008
Disaster Behavioral Health
Do the Programs Work?
The purpose and scope of the program is to provide
preventative services to survivors of disasters that are
designed to help reduce the adverse effects of trauma &
prolonged stress and reduce the development of more
long-term mental illness.
What we ARE NOT, or at least
SHOULD NOT be...
We ARE NOT there to provide traditional
therapy
• We are there to provide CRISIS counseling
and BRIEF interventions and REFERRALS as
appropriate and necessary.
• There ARE NO leather sofas, hand holding
and/or praying to the disaster gods for relief.
What we ARE NOT, or at least
SHOULD NOT be...
We ARE NOT there to “look” for customers or
consumers
• Our State and Community Center staff is there
working under the same authority and
conditions as are other state staff.
• Our services are free and NO ONE should be
charged for services. NO ONE should be
“hanging out their shingle”
What we ARE NOT, or at least
SHOULD NOT be
We ARE NOT there to make a diagnosis
• We ARE NOT there to determine that you, your staff
and/or the disaster survivors are “CRAZY”, or “IN
NEED OF THERAPY”.
• We are there to lend a listening ear, provide practical
stress management education, and provide referrals and
interventions only when necessary.
• We are there to help everyone, including “normal”
people, experiencing normal trauma, recover from an
abnormal event.
Special Populations
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Disaster Workers
First Responders
Children and Youth
Older Adults
People with Disabilities
People with Serious Mental Illness
Veterans
People with Low Socioeconomic Status
Cultural and Ethnic Groups
Crisis Intervention
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Promote safety and security
Gently explore disaster experience
Identify priority needs and solutions
Assess functioning and coping
Provide
• Reassurance
• Psychoeducation
• Practical assistance
The haunting question…
Who’s There
When the Police and Emergency Management
Leaves?
Who’s There …
•From the faith community?
•From the mental health
community?
•Who is there for the victim?
The Bible Mandate
The Great Commandment
Luke 10:27
“Love the Lord Your God
with all Your Heart and with all Your Soul and
with all Your Strength and with all Your Mind;”
and “Love Your Neighbor as Yourself.”
and “Love Your Neighbor as Yourself.”
The Commitment
to Love
Victim
Relief
• Committed To Pay
Whatever More Needed
Bible Mandate
• Promised to Return
Good Samaritan
• Paid for Lodging
Luke 10:30-35
• Spent Time with Victim
• Cared for Victim
• Obtained Shelter
• Provided Transportation
• Provided First Aid
• Responded to Victim
• Felt Compassion
How does this apply in the
“Definition” of Emotional and Spiritual Care?
EMOTIONAL CARE- Addresses the need for those in crisis to express their
fears, doubts and questions without judgment or interruption.
It is about “telling their story” to someone trained to listen.
IT IS THROUGH LISTENING- that VRM responders can tell if a person is better
served by mental, physical or spiritual services and then serve as a
facilitator to give them access to those needed services.
SPIRITUAL CARE- is the vital connection that people need in coping with the
events from their faith perspectives and how to draw from that strength,
healing and hope- all vital components of going from victim to survivor as
their recovery unfolds.
Emotional and Spiritual Care Providers serve initially as a calming presence
At the place of impact and begin the process of
“Building a Stabilizing Bridge”
From all responding and supporting groups, elements and resources
To the victim who is suffering from trauma, grief and shock!
And
On to the process of being a survivor who is regaining
Their ability to cope and deal with
The tragedy and begin to move forward
On the journey
Of the reality of the
“New Normal”
Connect to Emotional Care
• Mental Health Services/Partnership DHHS
• Crisis Intervention
• Debriefings
Work in Coordination with DSHS- Disaster Behavioral Health Services
Connect to Spiritual Care (Qualifications)
• Chaplains are ordained ministers/Crisis Responders trained
• Trained and Certified thru minimum of 16 hour VRM Basic 2-Day course
• Advanced Trauma and Grief training under Dr. Norm Wright
• CISM Trained
• Psychological First Aid
• Grief and Trauma training
• Incident Command Training and Structure
• Licensed Professional Counselors
• “Ministry of Presence”
SEARCH AND RECOVERY
EVACUATIONS
SHELTERING
PODS- POINTS OF DISTRIBUTION
CRISIS INTERVENTION
FATALITIES MEMORIALS
CISM- DEBRIEFINGS
SPIRITUAL AND EMOTIONAL STATIONS
EMERGENCY ROOMS- UTMB
RE-ENTRY OF FAMILIES
FAC’s-FAMILY ASSISTANCE CENTERS
“Bridging Mental
Health and
Spiritual Care
for
Disaster Victims”
“Spiritual Care is
Faith in Action”
Stress is:
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Normal
Necessary
Productive and destructive
Acute and delayed
Cumulative
Identifiable
Preventable and manageable
Stress
Management/Self-Care
Staff:
• Incorporate coping skills into disaster
recovery work and provide stress
management training
• Talk to friends
• Take a walk
• Exercise
Resistance & Resilience
Students identified a personal strength and created a symbol of
their strength with modeling clay. The trophies were awarded
during the final group session.
Resilience
“From the children, I learned the true meaning of
resiliency and the fact that resiliency can be
cultivated.”
Contact Information
Disaster Behavioral Health Services
909 West 45th Street
Austin, TX 78751-2008
(512) 206-5555
[email protected]
http://www.dshs.state.tx.us/MHSA-Disaster/