UBC Mental Health Responders for Crisis Trauma and Disaster Events Discussion Mental Health Responders for Crisis, Trauma, and Disaster Events Critical in

UBC Mental Health Responders for Crisis Trauma and Disaster Events Discussion Mental Health Responders for Crisis, Trauma, and Disaster Events

Critical incident responders come from a variety of fields. Rescue workers (e.g., police, firefighters, emergency medical professionals) are often the first-line responders. However, the helping professionals and volunteers from emergency response organizations are often just behind the first-line responders, allocating resources, assessing situations, and addressing mental health needs of survivors.

Practitioners respond to a variety of critical incidents, such as natural disasters (e.g., hurricanes, earthquakes, and tornadoes); human-made disasters (e.g., oil spills and chemical accidents); acts of terrorism (e.g., the Oklahoma City bombing and 9/11); crises (e.g., job loss or surviving an airplane crash); as well as other trauma-causing events (e.g., childhood abuse, war, and hostage situations). The roles and responsibilities of responders vary, depending on the specifics of each situation. A helping professional responds differently when working with a natural disaster survivor than he or she would when working with a sexual abuse survivor. In this Discussion, you compare the different roles and responsibilities of responders when responding to various critical incidents.

For this Discussion, select two critical incidents to which helping professionals respond. Think about the similarities and differences in the roles and responsibilities of responders, depending on the critical incident to which they are responding.

Post a brief description of each of the two critical incidents you selected to which helping professionals respond. Then, explain the similarities and differences between the roles and responsibilities of those responders. Finally, share the insights you gained or conclusions you drew based on the comparison.

Attached I have included articles for your reference. Only need 2-3 references. Community Disasters, Psychological Trauma,
and Crisis Intervention
Joseph A. Boscarino, PhD, MPH1,2,3
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See other articles in PMC that cite the published article.
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Abstract
The current issue of International Journal of Emergency Mental Health and Human Resilience is
focused on community disasters, the impact of trauma exposure, and crisis intervention. The
articles incorporated include studies ranging from the World Trade Center disaster to Hurricane
Sandy. These studies are related to public attitudes and beliefs about disease outbreaks, the
impact of volunteerism following the World Trade Center attacks, alcohol misuse among police
officers after Hurricane Katrina, posttraumatic stress disorder after Hurricane Sandy among those
exposed to the Trade Center disaster, compassion fatigue and burnout among trauma workers,
crisis interventions in Eastern Europe, and police officers’ use of stress intervention services.
While this scope is broad, it reflects the knowledge that has emerged since the Buffalo Creek and
Chernobyl catastrophes, to the more recent Hurricane Katrina and Sandy disasters. Given the
current threat environment, psychologists, social workers, and other providers need to be aware
of these developments and be prepared to mitigate the impact of psychological trauma following
community disasters, whether natural or man-made.
Keywords: Disasters, psychological trauma, crisis intervention, public health
Disasters are typically classified into several distinct categories, including: natural disasters and
major disease outbreaks; mass violence and human-made disasters; and technological disasters
(Neria, Galea, & Norris, 2009). All three of these disaster types have both unique and common
elements that affect the impact of exposure to these events. The most common adverse outcomes
observed among people following these exposures include the onset of mental health and
physical health problems, substance misuse, and increased mental health service utilization
(Neria et al., 2009). Nevertheless, the most common health outcome observed is positive:
following disasters most persons are generally resilient and manifest few or no long-term adverse
health outcomes, a finding consistently documented in numerous studies (Bonanno, 2004;
Boscarino & Adams, 2009; Pietrzak et al., 2014). What predicts this psychological resistance?
One of the major factors is the availability of psychosocial resources (Adams & Boscarino, 2006;
Adams, Boscarino, & Galea, 2006). Another is the absence of preexisting vulnerabilities,
including preexisting mental health disorders and genetic risk factors (Boscarino & Adams,
2009; Boscarino, Erlich, Hoffman, & Zhang, 2012). Of course, the level of trauma exposure is a
major risk factor in the onset of psychopathology and the absence or low level of the latter is
protective (Boscarino, Adams, & Figley, 2004; Boscarino & Adams, 2008). In addition, and
perhaps most importantly, early brief psychosocial interventions appear to be effective in the
reduction and/ or mitigation of adverse health consequences (Boscarino, Adams, & Figley,
2011). It is noted that while our World Trade Center Disaster (WTCD) research, funded by the
National Institute of Mental Health (Grant # R01-MH-066403 and R21-MH-086317), was a
source of many findings (Boscarino & Adams, 2008), the modern disaster research literature
goes back at least several decades (Bromet & Dew, 1995; Freedy, Kilpatrick, & Resnick, 1993;
Gleser, Green, & Winget, 1981; Rubonis & Bickman, 1991). Our recent WTCD report related to
police officers and Hurricane Sandy research was built upon this preexisting body of research
(Adams & Boscarino, 2011; Boscarino, Hoffman, Adams, Figley, & Solhkhah, 2014).
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Scope of Disaster Research
The current issue of the International Journal of Emergency Mental Health and Human
Resilience includes an overview of research approaches to assess the impact of different disasters
and the importance of developing crisis interventions (Boscarino and Adams, Assessing
Community Reactions to Ebola Virus Disease and Other Disasters, pp. 234-238). This is
followed by a study of alcohol misuse among law enforcement officers following Hurricane
Katrina (Heavey et al., Law Enforcement Offcers’ Involvement Level in Hurricane Katrina and
Alcohol Use, pp. 267-273). Next is a study related to the impact of volunteerism following the
World Trade Center disaster in New York City (Adams and Boscarino, Volunteerism and WellBeing in the Context of the World Trade Center Terrorist Attacks, pp. 274-282). This study is
followed by a report related to police officers’ use of stress intervention services in Pennsylvania
(Tucker, Police Officer Willingness to Use Stress Intervention Services, pp. 304-314). Next is a
study on the subject of “compassion fatigue” (Burnett and Wahl, The Compassion Fatigue and
Resilience Connection, pp. 318-326), an increasingly important area of research related to
adverse health outcomes among disaster responders (Adams, Figley, & Boscarino, 2008). Next,
is research related to the impact of Hurricane Sandy among those exposed to the World Trade
Center disaster (Caramanica et al., Posttraumatic Stress Disorder after Hurricane Sandy among
Persons Exposed to the 9/11 Disaster, pp. 356-362), a case report related to developing a
foundation for crisis intervention in eastern Europe (Parks, Building a Foundation for Crisis
Intervention in Eastern Europe, pp. 352-355), and an editorial on disaster mental health
(Mazumder, Disaster Mental Health and Crisis Interventions, pp. 368). Thus, the scope of studies
covered in this issue includes a wide range of disasters and psychological trauma exposures and
a number of different health outcomes.
Over the past decade, to examine the social and psychological aspects of the terrorist attacks in
New York, we studied more than several thousand adult residents and mental health
professionals (Adams, Boscarino, & Figley, 2006; Adams, Laraque, Chemtob, Jensen, &
Boscarino, 2013; Boscarino, Figley, & Adams, 2003; Boscarino et al., 2004; Boscarino, Adams,
Stuber, & Galea, 2005; Boscarino, Adams, Figley, Galea, & Foa, 2006). This body of research
has revealed key risk and protective factors associated with poorer health outcomes. As
suggested in our community reaction paper in this issue (Boscarino and Adams, pp. 234-238),
our disaster research findings are generally consistent with terror management theory, which
suggests that a key to understanding peoples’ reactions to serious environmental threats is
understanding the fear of death (Pyszczynski, Greenberg, & Solomon, 1999; Strachan et al.,
2007). Similar to stress-process theory (Adams & Boscarino, 2005; Boscarino et al., 2014), this
human fear response is affected by social factors, self-esteem, and social support — factors
responsible for buffering individuals against traumatic episodes and the subsequent adverse
cognitive processes associated with these event exposures (Pyszczynski et al., 1999; Strachan et
al., 2007).
Given the threat to public health, community interventions should be a post-disaster priority,
including community surveys, workplace education programs, and public service announcements
(Engel Jr & Katon, 1999; Foa et al., 2005), as well as provider-focused interventions (Adams et
al., 2013; Gershon et al., 2004). Post-event health surveillance also should be planned in the
aftermath of a major disaster or disease outbreak (Engel Jr & Katon, 1999; Foa et al., 2005). It
has been suggested that public education and communication can reduce or limit adverse
population reactions (Covello et al., 2001; Foa et al., 2005). It has been noted that “risk
communication” can have the effect of both reducing fear and also promoting self-protecting
behaviors, thus preventing misinformation (Covello et al., 2001; Foa et al., 2005). Without these
efforts, vulnerable persons and groups may increase the level of social disruption in the
community (Boscarino et al., 2003; Boscarino et al., 2006). As we discuss below, the nature of
major disasters make media coverage and communications critical, warranting special planning
considerations (Foa et al., 2005; North & Pfefferbaum, 2002). As we have suggested elsewhere,
our WTC disaster study indicated that simple, worksite crisis interventions offered by local
employers immediately after the WTC attacks were effective in reducing a number of mental
health problems post-disaster, including a significant reduction in anxiety symptoms (Boscarino
et al., 2011).
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Research Approach
Much of the recent disaster research has been based on surveys of adults in the affected disaster
areas (Adams & Boscarino, 2006; Boscarino et al., 2004; Boscarino et al., 2006; Galea et al.,
2002). Another major category of research includes studies of trauma workers, healthcare
personnel, and first responders (Adams et al., 2008; Adams et al., 2013; Gershon et al., 2004).
One of the limitations of these surveys is the cost, however, since these studies are expensive to
conduct (Groves et al., 2009). Consequently, other methods for data collection are used, such as
focus groups and on-line internet surveys (Groves et al., 2009). The other chief methodology
used in public health disaster research is the post-disaster research registry (Jordan, MillerArchie, Cone, Morabia, & Stellman, 2011). One of the more well known of these, is the World
Trade Center Disaster Registry (Institute of Medicine and US Department of Health and Human
Services, 2014; Jordan et al., 2011). An example of disaster research using this approach is
included in this current issue (Caramanica et al., Posttraumatic Stress Disorder after Hurricane
Sandy among Persons Exposed to the 9/11 Disaster, pp. 356-362). Regardless of the
methodology used, it is extremely important for researchers to include reliable and validated
research instruments (Boscarino et al., 2004; Boscarino et al., 2006; Boscarino et al., 2012;
Boscarino et al., 2014; Galea et al., 2002). If not, study results may be problematic (Dohrenwend
et al., 2006).
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Summary
Given current knowledge related to environmental and human-made disasters, crisis
interventions should be considered post-disaster, including community and workplace programs,
based on new and existing research (Boscarino et al., 2006; Boscarino et al., 2014; Engel Jr &
Katon, 1999; Foa et al., 2005). Post-event health surveillance also should be contemplated in the
aftermath of major incidents and the World Trade Center Disaster Registry is one of the more
well known of these approaches (Institute of Medicine and US Department of Health and Human
Services, 2014; Jordan et al., 2011). Drawing on past experiences, it has been suggested that
public education and risk communications can reduce adverse outcomes(Covello et al., 2001;
Foa et al., 2005). These communication strategies can have the effect of not only reducing fear,
but also promoting self-protecting behaviors (Boscarino et al., 2006; Covello et al., 2001; Foa et
al., 2005). The very nature of community disasters make media coverage, communications, and
social media critical, warranting special planning considerations (Boscarino et al., 2006;
Boscarino et al., 2014; Foa et al., 2005). In summary, the tools needed to mitigate the impact of
post-disaster trauma are available (Boscarino et al., 2006; Boscarino et al., 2014; Engel Jr &
Katon, 1999; Foa et al., 2005). Health professionals need to be aware of these developments. In
this current issue of the International Journal of Emergency Mental Health and Human
Resilience, we have included research and case studies related to a range of disaster and
traumatic events that have relevance for the public, as well as for first responders and healthcare
providers.
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Acknowledgments
Source of Funding: Supported in part by grants from the National Institute of Mental Health
(Grant # R01-MH-066403 and R21-MH-086317) and Pennsylvania Department of Health
(Contract # 4100042573), Boscarino PI.
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