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ROCKY MOUNTAIN REGION DISASTER MENTAL HEALTH NEWSLETTER

ROCKY MOUNTAIN REGION DISASTER MENTAL HEALTH NEWSLETTER

Learning From The Past and Planning For The Future

MENTAL HEALTH MOMENT September 25, 2003

"Man has responsiblity, not power." - Native American Proverb (Tuscarora)


Short Subjects
LINKS

Rocky Mountain Region
Disaster Mental Health Institute

Mental Health Moment Online

CISM/CISD Annotated Links

Gulf War Syndrome

WILDLAND FIRE INFORMATION

FIRE CAREER ASSISTANCE

CONFERENCES AND WORKSHOPS:

NIMH Meeting Announcements

Extension Disaster Education Network (EDEN)
September 30 - October 4, 2003
Denver, Colorado

THIRD ANNUAL
CRITICAL INCIDENT STRESS MANAGEMENT
WORKSHOP SERIES

Rocky Mountain Region
Disaster Mental Health Institute

Dates & Locations:
Laramie, WY: November 12-15, 2003
Casper, WY: November 19-22, 2003
Contact: George W. Doherty
Box 786
Laramie, WY 82073
Email: rockymountain@mail2emergency.com
Download Flier

The Australasian
Critical Incident
Stress Association Conference

The Right Response in the
21st Century

Location: Carlton Crest Hotel
Melbourne Australia
Friday October 3, 2003 thru
Sunday October 5, 2003
For further information
please contact the conference organisers:
ammp@optushome.com.au
Conference Website:
http://www.acisa.org.au/ conference2003/

IV Mexican Congress of Social Psychology
November 5 - 7, 2003
Location: Tlaxcala, MEXICO
Contact: Manuel Gonzalez, President of SOMEPSO
(Mexican Society of Social Psychology)
Phonr: +52 55 5804 4790, Fax: 5804 4789
Email: gona56@hotmail.com,
gona@xanum.uam.mx, somepso@yahoo.com

International Conference on Creativity and
Imagination in Education and Methods of Mastery

November 17-20 2003

Location: Moscow, RUSSIA
Contact: Vladimir Spiridonov
Vygotsky Institute of Psychology
The Russian State University for the Humanities
Miousskaya Square 6, 125267
Moscow , Russia
Phone: +7-095-250-61-47, 7-095-250-66-32
Fax: +7-095-250-44-33
Email: mdyadyunova@mail.ru

Middle East/North Africa Regional
Conference of Psychology

December 13 - 16, 2003
Location: Dubai, United Arab Emirates
Contact: Dr. Raymond H. Hamden
MENA RCP, PO Box 11806
Dubai, United Arab Emirates
Phone: +971-4- 331-4777
Fax: +971-4-331-4001
E-mail: menarcp@hotmail.com

Society for Judgment and
Decision Making Annual Meeting

November 10 - 11 2003
Location: Vancouver, CANADA

Society of Australasian
Social Psychologists 33rd Annual Meeting

April 15 - 18, 2004
Location: Auckland, NEW ZEALAND

27th National AACBT Conference
(Australian Association for
Cognitive and Behavior Therapy)

May 15 - 19, 2004
Location: Perth, Western Australia
AUSTRALIA

MASSIVE HOMELAND SECURITY RESPONSE READY TO MEET HURRICANE VICTIM NEEDS AS SECRETARY RIDGE VISITS IMPACTED AREAS

The U.S. Department of Homeland Security, through its Federal Emergency Management Agency, U.S. Coast Guard and other emergency response elements, is coordinating the massive Federal response to millions of citizens throughout the mid-Atlantic region impacted by Hurricane Isabel. Homeland Security Secretary Tom Ridge said that a full range of response and recovery assets have been deployed to the disaster areas. Several thousand emergency responders are providing life-saving missions as recovery begins. For more information, go to: http://www.dhs.gov/dhspublic/display?content=1675

DISASTER STRESS A REAL PROBLEM FOR VICTIMS OF ISABEL: FEMA Offers Tips For Feeling Better

It almost goes without saying: Those North Carolina, Virginia, Maryland and District of Columbia residents hit by Hurricane Isabel are feeling stressed. The Department of Homeland Security's Federal Emergency Management Agency (FEMA) advises disaster victims to be aware that while stressful feelings are normal there are steps they can take to feel better. The most common symptoms of stress include irritability, anger, fatigue, loss of appetite, sleeplessness, nightmares, sadness, depression, headaches, nausea, hyperactivity, lack of concentration, and increased alcohol and drug abuse. For the full article, go to: http://www.fema.gov/news/newsrelease.fema?id=5048

UN ASSEMBLY OPENS ANNUAL HIGH-LEVEL DEBATE: Bush urges help to rebuild Iraq

As more than 80 Heads of State and Government convened at United Nations Headquarters in New York for the start of the General Assembly's annual high-level debate, United States President George W. Bush urged the international community to put aside its differences and help Iraq rebuild itself into a democracy with the "great power to inspire the Middle East." For the full story, go to: http://www.un.org/apps/news/story.asp?NewsID=8329&Cr=iraq&Cr1=

SECURITY COUNCIL CALLS ON ALL UN MEMBERS TO HELP BUILD JUSTICE IN WAR-TORN STATES

The Security Council appealed to all 191 United Nations Member States for input into further enhancing the world body's efforts to establish justice and the rule of law as an essential element of its peacekeeping operations in countries recovering from the crimes and brutalities of civil war and violence. For the Full Story, go to: http://www.un.org/apps/news/story.asp?NewsID=8345&Cr=justice&Cr1=

UN LAUNCHES INTERNET-BASED INITIATIVE FOR SCHOOLS AROUND THE WORLD

The top United Nations communications official today launched an initiative that will link thousands of students from around the world in one of the largest educational events ever attempted on the Internet and said the programme fits well with the world body’s desire to see the benefits of information technology spread as widely as possible. For the Full Story, go to: http://www.un.org/apps/news/story.asp?NewsID=8287&Cr=technology&Cr1=

SKYROCKETING NATURAL GAS PRICES MAKE WINTERIZATION CRUCIAL

With headlines warning of natural gas price hikes as high as 50 percent later this year, a Penn State energy expert urges agricultural producers to start winterizing their properties right away. "Many signs are pointing toward a dramatic increase in the price of natural gas this autumn," warns Dennis Buffington, professor of agricultural and biological engineering. "The reason for the price increase is a simple case of supply versus demand. The good news is that you easily can save 20 to 30 percent or more of your total energy expenses by implementing energy conservation practices around the home and farm. Don't wait until you see frost on your pumpkins -- begin winterizing today." Read the full story at http://live.psu.edu/index.php?cmd=vs&story=4108

YOUNGEST IN CLASS FACE STRESS CHALLENGES - Study

The youngest children in any school year face more stress than their older peers and are at greater risk of developing mental illness, scientists have found. For the story, go to: http://www.medscape.com/viewarticle/460718?mpid=17890

THE MEDICAL MINUTE: CONNECTIONS BETWEEN EXERCISE AND CANCER

Everyone knows that exercise has many benefits, but the latest edition of the Medical Minute, a service of Penn State Milton S. Hershey Medical Center, points out the under-appreciated fact that exercise can reduce the risk of cancer. Researchers have found that regular exercise reduces the risk of breast, ovarian and uterine cancer in women, and the risk of lung and colon cancer for men and women. To achieve these risk reductions, the exercise must be regular (four or five days a week) and last at least a half hour. The benefit of exercise seems to be due to more than just weight loss. Part of the reason may be that the immune system cells that fight cancer work better in people who exercise. Read the full story at http://live.psu.edu/index.php?cmd=vs&story=4069

SPECIAL RISK GROUPS IN DISASTERS

There are many feelings and reactions people share in common response to the direct and indirect effects of disasters. However, certain groups are more at risk for some reactions than others.

Common Needs And Reactions

1. Concern for basic survival

2. Grief over loss of loved ones or loss of prized possessions

3. Separation anxiety centered on self and also expressed as fear for safety of significant others

4. Regressive behaviors, e.g. reappearance of thumbsucking among children

5. Relocation and isolation anxieties

6. Need to express feelings about experiences during the disaster

7. Need to feel one is a part of the community and its rehabilitation efforts

8. Altruism and desire to help others

MIDDLE AGE

On the face of it, middle-aged persons seem to be an unlikely special group with specific problems. However, they are, and it is helpful to be alert to these, especially for the possibility of emotional problems arising in later, rather than immediate, post-disaster periods. Consider the family which loses its home and most possessions in a flood. Forced to rebuild, they must do so with far more cost and highly inflated financial expenses. Retirement with the mortgage paid off is now out of the question, and prospects of an old age with adequate pension and comfortable living may have vanished. It takes a while for these conditions and the realizations of a reappraised future to sink in. They may and do, however, have any number of effects such as psychosomatic problems, relationship difficulties, and occupational dissatisfactions.

Feeling and Behavior Symptoms

  • Psychosomatic problems, ulcers, diabetes, heart trouble

  • Withdrawal, anger, suspicion, irritability, apathy

  • Loss of appetite, sleep problems, loss of interest in everyday activities

    Treatment Options

  • Arrange for medical care for physical symptoms

  • Persuade victims to talk with family physician, clergyman, friends, or to accept professional help

  • Help find medical and financial assistance

  • Keep channels of communication open with members of the family

  • Help family to recognize physical signs of depression and need for professional counseling
  • OLDER ADULTS

    Senior citizens of concern here are non-institutionalized persons whose life sphere has become circumscribed due to aging, primarily, rather than to specific multiple disabilities. These older persons typically do not have highly active schedules during the day. They spend their time mostly with others of similar age and circumstances in daily routines which have become comfortable. Others are confined to house or apartment, frequently alone. When these familiar routines are disrupted by the disaster, and particularly when residential loss and relocation occur, it would be expected that the senior citizen might exhibit some symptoms.

    Feeling and Behavior Symptoms

  • Depression, Withdrawal

  • Apathy

  • Agitation, anger

  • Irritability, suspicion

  • Disorientation

  • Confusion

  • Memory loss

  • Accelerated physical decline

  • Increase in number of somatic complaints

    Treatment Options

  • Provide strong and persistent verbal reassurance

  • Assist with recovery of physical possessions; make frequent home visist, arrange for companions

  • Give special attention to suitable residential relocation, e.g., familiar surroundings and acquaintances

  • Help in re-establishing familial and social contacts

  • Assist in obtaining medical and financial assistance

  • Help re-establish medication regime

  • Provide escort and transportation services
  • An important issue is the despair accompanying loss of property and objects, which is a loss of ties with the past. Often, because loss of life has occurred among neighbors or friends, mourning the loss of sentimental objects and loss of property seems "inappropriate". However, these can and do constitute significant psychological loss.

    SOCIOECONOMIC CLASSES

    Socioeconomic circumstances are important influences on attitudes and reactions of people in stress situations. More importantly, these factors have a strong effect on the readiness with which individuals will seek or accept help voluntarily for emotional distress. For example, persons in lower economic circumstances are generally more inclined to seek medical rather than psychological treatment. This re-emphasizes the importance of "outreach" efforts in disaster relief work. Otherwise, these people will not be reached and may not get the help they need.

    By contrast, people in intermediate and upper income economic circumstances are more aware of and less likely to resist accepting all kinds of help when needed. These social groups would also be expected to be more likely to understand the possibilities of long-range benefits from early use of the services offered, i.e., heading off future problems by dealing with them now. Upper income people might be less inclined, however, to welcome outreach and "free" services as compared with lower and middle income groups.

    CULTURAL AND RACIAL DIFFERENCES

    Reports from disaster relief workers in recent years have emphasized the importance of social and cultural differences, especially of races, language, economic levels, class, and ethnicity. There are also reports of socially isolated groups who display what amounts to subcultural differences of attitudes and daily life patterns as a result of geographical isolation and dependence on a single occupational source, for example, small mining towns.

    For these groups it is essential that outreach efforts be channeled through representatives or facilities within the subculture area. Differences of language and custom, if ignored, will lead to frustration and failure by those attempting to render services.

    Feelings and Behavior Symptoms

  • Depression

  • Apathy

  • Feelings of helplessness and hopelessness

  • Resignation (to God's will)

  • Suspicious of help offered by "outsiders"

  • Ignoring or rejecting available sources of "outside" help

  • Tendency to close ranks and accept assistance only from family and close friends

    Treatment Options

  • Channel all assistance through local religious and community sources

  • Place emphasis on informational and educational assistance

  • Outreach all services with the exception of those requiring special facilities such as hospitals and clinics
  • INSTITUTIONALIZED PERSONS

    Individuals who are in institutions during a disaster are susceptible to frustration, anxiety, and panic as a consequence of their limited mobility and helpless dependence on their caretakers. The circumstances will vary widely depending on the type of institution. However, there are some common reactions which might be expected to occur in general medical hospitals, mental hospitals, adult and juvenile correctional agencies, and convalescent facilities.

    Feelings and Behavior Symptoms

  • Fear

  • Frustration

  • Anxiety

  • Helplessness

  • Anger

  • Panic

  • "Escape"

    Treatment Options

  • Assist in relocation to safe housing

  • Provide reassurance and information regarding disaster status

  • Assist in making contact with loved ones and friends

  • Encourage involvement in housekeeping and rehabilitation duties

  • Provide opportunities for group discussions of fears and anxiety
  • PEOPLE IN EMOTIONAL CRISES

    When a person is experiencing an emotional crisis, it is usually apparent even to the casual observer. In a disaster it might be expected that the direct and indirect effects of the catastrophe might produce severe emotional crises for some people. Precipitating causes could be death or separation from loved ones, sudden loss of contact with friends and familiar routines and settings, or simply the physical force of the disaster itself. The last mentioned can in some cases bring about overwhelming feelings of inadequacy in some who are suddenly confronted with their own feelings of helplessness and mortality.

    Feelings and Behavior Symptoms

  • Emotional shock

  • Apathy

  • Numbness

  • Agitated depression

  • Disorientation and confusion

  • Perseverative behavior

  • Hyperactivity

  • Minimal emotional control, e.g. explosive anger, uncontrollable crying

  • Physical symptoms, e.g., dizziness, nausea, fainting spells, headaches, hyperventilation, rapid heartbeat

    Treatment Options

  • Give verbal and physical reassurance

  • Assist in coping with some specific and tangible problem

  • Help in relocating loved ones

  • Help in getting care for loved ones who are injured

  • Help in locating and making arrangements for loved ones who did not survive

  • Give assistance and encouragement in assessing extent of damage to personal property and beginning to repair or rebuild damaged home or business

  • Assist in getting medical attention if needed
  • PEOPLE REQUIRING EMERGENCY MEDICAL CARE

    Those who are in need of immediate and surgical treatment, in addition to suffering from physical shock, may also experience anxiety caused by separation from loved ones or a lack of information about the extent of damage to home, place of business, or the community itself. The degree of anxiety experienced by the injured person may aggravate his/her physical state and affect response to medical treatment. Having mental health services available at medical treatment facilities during and following the disaster has been found useful. The worker may provide invaluable relief and reassurance to the injured person by obtaining information about loved ones or about the status of property and possessions.

    HUMAN SERVICE AND DISASTER RELIEF WORKERS

    Workers in all phases of disaster relief - whether protective services, nongovernmental shelters, clothing and food services, governmental rehabilitation and reclamation services, or human service workers - expose themselves to unprecedented personal demands in their desire to help meet the needs of the victims. For many the disaster takes precedence over all other responsibilities and activities, and the workers devote all their time to the disaster-created tasks, at least in the immediate post-impact period. As some order returns, many of the workers, especially volunteers, return to their regular jobs, but at the same time attempt to continue with their disaster work. The result of the overwork is the "burn- out" syndrome, a state of exhaustion, irritability, and fatigue which creeps up unrecognized and undetected upon the individual and markedly decreases his/her effectiveness and capability.

    The best way to forestall the "burn-out" syndrome is to expect it, to be alert to its early signs, and to act authoritatively in relieving the stress. Four primary areas of symptomatology have been identified:

    Symptoms

    Thinking: Mental confusion, slowness of thought, inability to make judgments and decisions, loss of ability to conceptualize alternatives or to prioritize tasks, loss of objectivity in evaluating own functioning, etc.

    Psychological: Depression, irritability, anxiety, hyperexcitability, excessive rage reactions, etc.

    Somatic: Physical exhaustion, loss of energy, gastrointestinal distress, appetite disturbances, hypochondria, sleep disorders, tremors, etc.

    Behavioral: Hyperactivity, excessive fatigue, inability to express self verbally or in writing, etc.

    Management

    The first step is to be aware of, to be alert for, and to recognize the symptoms of "burn-out" syndrome when they first appear. The earlier they are recognized the better. All personnel need to be indtructed about the early symptoms so that they may recognize it not only in themselves but also in their fellow workers. Any such observations, either about themselves or about others, should be reported to their supervisors. The latter also need to be alert to any early symptoms in their staff so that they can intervene.

    The supervisor should talk to the individual and try to get him/her to recognize the symptoms in him/herself. The supervisor can then make sure the person is relieved from his/her duties for a short period of time. Guilt over leaving the activity is relieved by giving official permission to stop and by pointing out how the worker is no longer helping because of the loss of his/her effectiveness. The worker can be reassured that he/she can return and that he/she will have improved greatly as a result of the short recuperation. The supervisor should at first attempt to persuade the helper to take the time off, but, if necessary, should order it. The syndrome may appear early or well into the post-disaster period, from 2 weeks to a year. On the average, it seems to take about 4 to 6 weeks for most of the symptoms to appear.

    *******************************************************************************

    REFERENCES

    To search for books on disasters and disaster mental
    health topics, leaders, leadership, orgainizations,
    crisis intervention, leaders and crises, and related
    topics and purchase them online, go to the following url:

    http://www.angelfire.com/biz/odochartaigh/searchbooks.html

    RECOMMENDED READING

    The Angry Earth: Disaster in Anthropological Perspective

    by Anthony Oliver-Smith (Editor), Susannah M. Hoffman (Editor), Susanna M. Hoffman (Editor)


     

    Editorial Review

    Elizabeth Colson, author of The Social Consequences of Resettlement "The Angry Earth breaks new ground as anthropologists take a close look at disasters and the response of victims in the immediate aftermath and over the long-run. The book demonstrates how disasters arise from the human propensity to take risks that make people vulnerable to cataclysms, whether natural or technologically related and demonstrates how far anthropology has moved from models that assumed stasis and equilibrium. The Angry Earth should be read by all who deal with disaster situations."

    Additional Readings at: Disasters and Culture in the search engine. Also try looking here for September 11, 2001: A Simple Account for Children.

    **********************************************************************

    **********************************************************************
    Contact your local Mental Health Center or
    check the yellow pages for counselors, psychologists,
    therapists, and other Mental health Professionals in
    your area for further information.
    **********************************************************************

    George W. Doherty
    Rocky Mountain Region
    Disaster Mental Health Institute
    Box 786
    Laramie, WY 82073-0786

    MENTAL HEALTH MOMENT Online: http://www.angelfire.com/biz3/news



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