US Northern Command: Conference Examines Disaster Behavioral Health

[Commonground]

Conference Examines Disaster Behavioral Health

By Army Sgt. 1st Class Gail Braymen
Special to American Forces Press Service

COLORADO SPRINGS, Colo., July 14, 2008 ? The physical consequences of a pandemic influenza in the United States -- potentially millions of people either sick or dead, schools and businesses closed, store shelves empty -- are obviously apparent and top any disaster recovery to-do list. But what about the invisible, not-so-obvious results of a national catastrophe?

Air Force Maj. Gary Frunz, U.S. Northern Command?s interim joint regional medical plans and operations officer for Federal Emergency Management Agency Region 8, discusses the mental health consequences of a potential pandemic flu at the Continental Divide Disaster Behavioral Health Conference in Colorado Springs, Colo., July 10, 2008. U.S. Army photo by Sgt. 1st Class Gail Braymen, U.S. Northern Command
(Click photo for screen-resolution image);high-resolution image available.
Specifically, what about Americans? mental health?

That?s the question more than 200 mental and behavioral health specialists gathered to discuss at the Continental Divide Disaster Behavioral Health Conference here last week. U.S. Northern Command, along with the University of Colorado at Colorado Springs and the Colorado Department of Human Services, sponsored the three-day event.

?The idea of disaster mental health, or disaster behavioral health, is kind of a specialty within the area of mental health in general, and it?s gaining speed and momentum quickly,? said Air Force Lt. Col. Lisa Sayegh, NorthCom?s command mental health officer, who cited high rates of post-traumatic stress disorder, depression, suicides and substance abuse after Hurricane Katrina struck the U.S. Gulf Coast in 2005.

?There?s a great need for people to be trained and able to respond in a disaster event from a mental health or psychological standpoint,? Sayegh said.

Two other prominent issues contributing to increased incidences of mental health disorders in recent years, Sayegh said, are the terrorist attacks of Sept. 11, 2001, and the focus on a possible pandemic influenza.

NorthCom, which provides defense support of civil authorities during emergencies or disasters when ordered by the president or secretary or defense, is the first and only of the country?s 10 combatant commands to have a mental health officer, command officials said.

?NorthCom has recognized the need to have mental health as part of its package for the surgeon?s office,? Sayegh said. ?I?m just pleased, as a mental health practitioner myself, that the [Department of Defense] and other levels of medical care in our country are taking notice of the importance of mental health and what we can do to help increase our psychological resilience to either everyday stressors or a catastrophic stressor.?

In 1918 and 1919, a pandemic influenza killed 650,000 Americans, Navy Capt. (Dr.) James Terbush, NorthCom?s command surgeon, said. Experts use data from that pandemic to model what could happen in a 21st-century event.

?So many aspects of the pandemic revolve around human behaviors -- what we think people are likely to do and, in contrast, what we hope that they?ll do,? he said.

The public health measures, or behaviors, that the public would be directed to do, especially ?social distancing? -- staying home instead of going to work or school or other group functions -- all affect mental health.

?Social distancing -- staying in your house -- that?s a hard thing to do,? Sayegh said.

But because social distancing may be one of the most effective ways to help control the spread of a pandemic flu, mental and behavioral health experts are searching for methods to help people do it safely and sanely.

As a military organization, NorthCom is concerned not only about public health, but also about the health of its own personnel. The 1918 pandemic influenza hit people between the ages of 20 and 40 hardest, Terbush said, and today?s military is ?likely to be exceptionally affected by the virus unless we prepare properly.?

That preparation includes planning to help troops stay mentally healthy, Sayegh said, especially if they are required to perform traumatic duties.

The Disaster Behavioral Health Conference was the first time many, if not most, of the conference participants met military health professionals and learned about the military?s pandemic response plans.

?NorthCom brings the unique organizational capacity, but also the unique perspective, of the military and their whole interaction with the rest of the civilian population,? said Dr. Chip Benight, professor of psychology and director of the University of Colorado at Colorado Springs? CU Trauma, Health and Hazards Center. ?We discovered this, obviously, in [Hurricane] Katrina, where we have to create these partnerships and these relationships, or else we?re not going to be able to function in a way that?s most effective in terms of preventing not only physical problems in terms of deaths, obviously, and injuries, but in terms of mental health support and resilience, which we need to find ways to enhance.?

Creating and strengthening relationships among representatives of local, state and federal agencies was an important part of the conference, agreed Dr. Curt Drennan, Colorado Department of Human Services disaster behavioral health planner and coordinator and manager of the Disaster Planning and Response Team for the Division of Behavioral Health.

?The goal here is to build greater understanding of culture, of capacity, of resources, and then to really build the relationships between individuals within those areas of expertise and fields and specialty areas so that we can more effectively work together when we really need to work together,? Drennan said.

Before the conference, he added, he was not aware of the ?extreme level of expertise and capacity? within the Defense Department.

?It?s kind of relieving for myself, in my position, that?s for sure,? Drennan said. ?It?s like, OK, this is a bigger community, this is a broader set of resources.?

U.S. Northern Command was established on Oct. 1, 2002, to anticipate and conduct homeland defense and civil support operations within the assigned area of responsibility to defend, protect and secure the United States and its interests. Its geographic area includes the continental United States and Alaska.

(Army Sgt. 1st Class Gail Braymen serves in the North American Aerospace Defense Command and U.S. Northern Command Public Affairs Office.)

http://www.defenselink.mil/news/newsarticle.aspx?id=50496

 

[Oracle]

Can we be frank here?

Can we be frank here?

The Federal government has already been frank with us: Don't count on the Feds to bail you out if there is a pandemic.

The US DOD has been equally succinct, and have warned us that the military won't be available to coordinate disaster relief. They are spread thin in two wars and dozens of other military policing actions, abroad.

In fact, given the sustained military action in Iraq and Afghanistan, active troops, those awaiting re-deployment and recently returned veterans are in the worst possible shape, mental and physical, to serve in emergency response capacity at home in the event of a major epidemic.

They are the last people you want to exposed to potentially lethal virus that preys on the immunologically weakened: the chronically stressed and chemically exposed. Depressed, hyper-vigilant and malnourished.

Those were the conditions of troops in WWI in the trenches of Europe.

Bringing troops 'home', at the end of the war spread Spanish 'Flu far and wide. Never has an global epidemic hit BOTH hemispheres simultaneously and spread so fast with lethal consequences. This has been broadly recognized as the key factor behind the outbreak timing and successive wave geographical 'travelogue'.

Never has the US population been in such lousy physical shape, in terms of immune defense, or in terms of mental and social preparation, resigned to hunker down and wait out 'the wave'.

They have very little food stored. When word first hits, they will *completely* clean out the stores - grocery, pharmacy, hardware - in panic buying, setting off a wave of just in time breakdown in supply. There will be no stock for resupply of goods for weeks, maybe months, once this happens.

Your average Joe and Jane will not have the self-control to stay home for an extended period of time. They will be out 'foraging', as they have been conditioned to do all their lives by modern consumer supply policy, meant to streamline corporate production and delivery, but rendering us ill-equipped for sudden supply chain shutdown.

Meanwhile, their kids will be socializing with bored friends, defeating the purpose of social distancing. Public schools close, but haphazardly - not immediately, because there is no overall coordination. That decision is left up to each school district, with backup oversight from the State.

Many businesses have no plan that will allow their workers to stay home during a pandemic nor do they have plans that allow them to function with minimal workers present - the most likely scenario if the death toll rose quickly and public paranoia sets in.

The US population has a near-deficit of social support networking, to help us care for one another when acutely ill. We no longer live close to 'family'. We reside in communities of strangers and we have lost the sense of purpose in community living: survival by altruism, when the worst of times rolls around, as it did with astonishing frequency.

It's almost assured that area hospitals, clinics and physicians offices will be swamped with panicked patients. Their doors to most of these health care institutions will close early on - you can count on that, because many health professionals will 'opt out'. They have already made their intentions clear in a number of public surveys. Ill-prepared, under-staffed public health facilities, overrun with critically ill patients and short on supplies - that is another parallel between the reality of a present-day pandemic and conditions encountered 1918.

Moreover, most of us have no clue on how to nurse an ill family member, friend or neighbor - nor are we likely to suddenly morph into Nurse Nightingale and acquire that expertise. We don't have the medical supplies, and we are unused to dealing with ill family members or compatriots outside of clinical setting.

You do not die at home, anymore.

In 1918, you were NOT likely to go to a hospital if you were ill unless the local physician couldn't attend to you at home - it was a time when local doctors made house calls.

Families lived under more crowded conditions, sharing meals, chores and lives undistracted by electronic toyz. They knew how to 'make do' when calamity arrived, as it did with familiar regularity in our historical past - be it Europe, Asia and the South Pacific, Africa or North America. Most had personally experienced physical privation. Loss of family members from sudden acute infectious illness was common to every household, since it claimed nearly 20% of each new generation under the age of 5.

We don't have food stocked, we aren't trained in medical self-care, and we're chronically conditioned to seek help from, and rely on professionals when things go bad.

How are we to succeed at 'social distancing' for a minimum of 8 weeks?

The best thing that NorCom and USDOD can do is to get serious, admit that we are in deep sh"t with respect to public preparedness, shift the emphasis to personal preparation for every man, woman and child in the US.

Now is the time to condition human behavior and defensive planning, to prepare for *any disaster*. It's ill-advised for the Feds to pin individual self-preparedness on a pandemic, because we have a statistical probability of a major regional disaster - like the recent mid-west floods - about every 18 months.

The risk of a pandemic hasn't diminished, but you'd think it had all but evaporated completely. Your average person doesn't believe it will happen, anymore than they believe in proactive behavioral changes to offset global warming.

Convincing the general populace to prepare for the worst will be a very difficult uphill battle.

 

[tropical]

Re: US Northern Command: Conference Examines Disaster Behavioral Health

Oracle depicted it (widely) very well.

 

[AlaskaDenise]

Re: US Northern Command: Conference Examines Disaster Behavioral Health

Convincing the general populace to prepare for the worst will be a very difficult uphill battle.

Given that this has been discussed by various agencies for years, I'd say that .....what we see is what we'll get......... widespread lack of preparation and it's consequences.

I look to DOD to utilize marshall law to contain civil disorder to a minimum geographical area.

One nagging question is......... why don't we hear European countries advising their population to stockpile food and supplies? Can we assume that they plan to have a government-controlled distribution system?

It will be interesting to see the outcomes. Will underdeveloped countries with populations that are compelled to be self-sufficient fare better than industrialized countries whose populations cannot care for themselves?

.

 

[tropical]

Re: US Northern Command: Conference Examines Disaster Behavioral Health

...
I look to DOD to utilize marshall law to contain civil disorder to a minimum geographical area.

One nagging question is......... why don't we hear European countries advising their population to stockpile food and supplies? Can we assume that they plan to have a government-controlled distribution system?

It will be interesting to see the outcomes. Will underdeveloped countries with populations that are compelled to be self-sufficient fare better than industrialized countries whose populations cannot care for themselves?

.

After a year of unrealized plans, seems that now became visible why (with the actual state of the prep matter) the inclusion of the military would be necessary:
"to utilize marshall law to contain civil disorder to a minimum geographical area"

"... why don't we hear European countries advising their population to stockpile food and supplies?"
Seems that:
- their behaviour are not diferent from the wider one;
- their advisings stopped at 2006 when no further human illnesses starts after Turky, and the wild birds illness remain contained to few episodes plus chickens
- their "by web" advising are generaly much smaller than US/C/NZ/...
- their plans are detailed - but local stocks?
- obviously, looking the TV media awareness, it's now likely non-existent, after the 05/06 scare

"Can we assume that they plan to have a government-controlled distribution system?"
Probably controlled as possible, depending on the quantity of inner-state loc. aut., and local budgets.

Will underveloped countries with populations that are compelled to be self-sufficient fare better than industrialized countries whose populations cannot care for themselves?
If those "self-sufficient" population have autonomous crops, manures, ..., water, than maybe (meds/health apart), if they are only an depaupered industrial population, than it would be worst.

 

[Oracle]

Re: US Northern Command: Conference Examines Disaster Behavioral Health

Many developing nations have damaged their agricultural lands through poor soil management and overgrazing.

While it seems obvious that when your local climate patterns include periods of seasonal and extended droughts, you use raised beds to reduce erosion and maximize scant water supplies to grow food for your family. This survival strategy (that also produces food to sell locally, an income source when all other crops fail in urban and rural areas) is - astonishingly - a relatively new concept to the developing world, even though it is 'old technology'.

The larger issue is that many developing nations are embroiled in ethnic violence; food storage is impossible.

Corrupt officials in poor nations of Africa and parts of Asia have been 'trained' by decades of inappropriate foreign aid - they can always ask for MORE, while ignoring (or worse, taking direct advantage of ethnic social conflict to 'manage' their populace) pressing problems of food, water, health - because there will always be foreign money and direct supply when famine/drought/epidemics occur.

Well, that time of internal social largess is about to pass, because the world economy is headed downward.

Too many hands out, not enough resources to go around.

Hint: the collapse of international emergency food supply and rapidly rising costs of replacing it, has produced a shortage not seen in 3-4 decades.

 

[AlaskaDenise]

Re: US Northern Command: Conference Examines Disaster Behavioral Health

If we use Dr. Robert Webster's figure of 50% of the global population dying from pandemic H5N1, it may boil down to how far any nation/geographic area is in either direction from that 50%.

source: http://abcnews.go.com/WNT/AvianFlu/story?id=1724801

"Society just can't accept the idea that 50 percent of the population could die. And I think we have to face that possibility," Webster said.

.