International Journal Of Emergency Mental Health[JOURNAL]
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200 papers
Lay mental health in the aftermath of disaster: preliminary evaluation of an intervention for Haiti earthquake survivors.
James LE, Noel JR
Int J Emerg Ment Health · 2013 · PMID 24558745
In the year following the 2010 Haiti earthquake, local earthquake survivors trained as lay mental health workers implemented a culturally-adapted, psychosocial and trauma-focused group intervention for residents of camps...
In the year following the 2010 Haiti earthquake, local earthquake survivors trained as lay mental health workers implemented a culturally-adapted, psychosocial and trauma-focused group intervention for residents of camps for internally displaced peoples (IDPs). Analysis of evaluation data collected at three Port-au-Prince IDP camps revealed decreased self-reported posttraumatic distress (measured using the Harvard Trauma Questionnaire) associated with participation in this intervention. Improvement occurred across all three PTSD symptom clusters (re-experiencing, avoidance, and hyperarousal). Female participants reported higher baseline distress, were more likely to participate in the intervention, and benefitted more than did men. Results provide initial support for the effectiveness of train-the-trainer interventions utilizing local lay disaster survivors.
A pilot investigation in constructing crisis communications: what leads to best practice?
Firestone RM, Everly GS
Int J Emerg Ment Health · 2013 · PMID 24558744
Crisis communications can play an important role in mitigating, or exacerbating, the psychological and behavioral reactions to critical incidents and disasters. Effective crisis communications can serve to mitigate anxio...
Crisis communications can play an important role in mitigating, or exacerbating, the psychological and behavioral reactions to critical incidents and disasters. Effective crisis communications can serve to mitigate anxiogenesis and direct rapid and focused rescue, recovery, and rehabilitative operations. Ambiguous and/or deceptive communications can serve to worsen mental health reactions and delay operational response and recovery (Everly, Strouse, & Everly, 2010). It seems, therefore, that inquiry into the content of acute crisis communications would be warranted Said more simply, given limited time, cryptic messaging in social media, and the "sound bite" mentality that seems to govern news dissemination, it is important to identify the most important content to convey in the wake of critical incidents and disasters. This paper reports on a pilot investigation into "best practices" for the construction of acute crisis communications.
Mental health outcomes at the Jersey Shore after Hurricane Sandy.
Boscarino JA, Hoffman SN, Kirchner HL … +4 more , Erlich PM, Adams RE, Figley CR, Solhkhah R
Int J Emerg Ment Health · 2013 · PMID 24558743
On October 29, 2012, Hurricane Sandy made landfall in the most densely populated region in the US. In New Jersey, thousands of families were made homeless and entire communities were destroyed in the worst disaster in th...
On October 29, 2012, Hurricane Sandy made landfall in the most densely populated region in the US. In New Jersey, thousands of families were made homeless and entire communities were destroyed in the worst disaster in the history of the state. The economic impact of Sandy was huge, comparable to Hurricane Katrina. The areas that sustained the most damage were the small- to medium-sized beach communities along New Jersey's Atlantic coastline. Six months following the hurricane, we conducted a random telephone survey of 200 adults residing in 18 beach communities located in Monmouth County. We found that 14.5% (95% CI = 9.9-20.2) of these residents screened positive for PTSD and 6.0% (95% CI = 3.1-10.2) met criteria for major depression. Altogether 13.5% (95% CI = 9.1-19.0) received mental health counseling and 20.5% (95% CI = 15.1-26.8) sought some type of mental health support in person or online, rates similar to those reported in New York after the World Trade Center disaster In multivariate analyses, the best predictors of mental health status and service use were having high hurricane exposure levels, having physical health limitations, and having environmental health concerns. Research is needed to assess the mental health status and service use of Jersey Shore residents over time, to evaluate environmental health concerns, and to better understand the storm's impact among those with physical health limitations.
Children of National Guard troops: a pilot study of deployment, patriotism, and media coverage.
Pfefferbaum B, Jeon-Slaughter H, Jacobs AK … +1 more , Houston JB
Int J Emerg Ment Health · 2013 · PMID 24558700
This exploratory pilot study examined the psychosocial effects of the war in Iraq, patriotism, and attention to war-related media coverage in the children of National Guard troops across phases of parental deployment--pr...
This exploratory pilot study examined the psychosocial effects of the war in Iraq, patriotism, and attention to war-related media coverage in the children of National Guard troops across phases of parental deployment--pre deployment, during deployment, and post deployment. Participants included 11 children, ages 8 to 18 years. Data collected in each deployment phase included demographics, the Behavior Assessment System for Children, (Second Edition, BASC-2), patriotism (national identity, uncritical patriotism, and constructive patriotism), and attention to war-related media coverage. School problems and emotional symptoms were significantly higher during deployment than post deployment. National identity and constructive patriotism increased and uncritical patriotism decreased post deployment from levels during deployment. Uncritical patriotism correlated positively with emotional symptoms and correlated negatively with personal adjustment. Constructive patriotism correlated positively with emotional symptoms and with internalizing problems. Greater attention to war-related media coverage correlated with uncritical patriotism, and attention to internet coverage correlated with constructive patriotism. Attention to media coverage was linked to greater emotional and behavioral problems and was negatively correlated with personal adjustment. The results of this pilot study identified relationships of both patriotism and attention to media coverage with children's emotional and behavioral status and personal adjustment suggesting areas for future investigation.
Resilient leadership and the organizational culture of resilience: construct validation.
Everly GS, Smith KJ, Lobo R
Int J Emerg Ment Health · 2013 · PMID 24558699
Political, economic, and social unrest and uncertainty seem replete throughout the world. Within the United States, political vitriol and economic volatility have led to severe economic restrictions. Both government and...
Political, economic, and social unrest and uncertainty seem replete throughout the world. Within the United States, political vitriol and economic volatility have led to severe economic restrictions. Both government and private sector organizations are being asked to do more with less. The specter of dramatic changes in healthcare creates a condition of uncertainty affecting budget allocations and hiring practices. If ever there was a time when a "resilient culture" was needed, it is now. In this paper we shall discuss the application of "tipping point" theory (Gladwell, 2000) operationalized through a special form of leadership: "resilient leadership" (Everly, Strouse, Everly, 2010). Resilient leadership is consistent with Gladwells "Law of the Few" and strives to create an organizational culture of resilience by implementing an initial change within no more than 20% of an organization's workforce. It is expected that such a minority, if chosen correctly, will "tip" the rest of the organization toward enhanced resilience, ideally creating a self-sustaining culture of resilience. This paper reports on the empirical foundations and construct validation of "resilient leadership".
EAP-based critical incident stress management: utilization of a practice-based assessment of incident severity level in responding to workplace trauma.
DeFraia GS
Int J Emerg Ment Health · 2013 · PMID 24558698
Central to the field of trauma psychology is assessment of the impact of critical incidents on individuals, as measured by individual symptoms of stress. Accordingly, the trauma literature reflects a proliferation of cli...
Central to the field of trauma psychology is assessment of the impact of critical incidents on individuals, as measured by individual symptoms of stress. Accordingly, the trauma literature reflects a proliferation of clinical impact of event scales. Workplace incidents however, affect not only individual employees, but also work organizations, requiring a multi-level response. Critical incident stress management (CISM) is the most prevalent multi-level incident response strategy utilized by organizations, often through specialized CISM units operating within their employee assistance programs (EAPs). While EAP-based CISM units seeks to support both individuals and organizations, studies focused on individual stress dominate the literature, mirroring assessment scales that tend to emphasize clinical as opposed to organizational practice. This research contributes to less-prevalent studies exploring incident characteristics as disruptive to organizations, rather than clinical symptoms as disruptive to individuals. To measure incident disruption, an EAP-based CISM unit developed a critical incident severity scale. By analyzing this unit's extensive practice database, this exploratory study examines how critical incident severity level varies among various types of incidents. Employing the methodology of clinical data mining, this practice-based research generates evidence-informed practice recommendations in the areas of EAP-based CISM intake assessment, organizational consultation and incident response planning.
Relationship between posttraumatic stress disorder, resilience, and religious orientation and practices among university student earthquake survivors in Haiti.
Burnett HJ, Helm HW
Int J Emerg Ment Health · 2013 · PMID 24558697
This study examined the prevalence of PTSD symptoms; the relationship between PTSD and resilience, religious orientation and religious practices; and how gender is associated with these variables among a volunteer sample...
This study examined the prevalence of PTSD symptoms; the relationship between PTSD and resilience, religious orientation and religious practices; and how gender is associated with these variables among a volunteer sample of 140 students attending a Christian university in Haiti approximately four months after the January 2010 earthquake. Using the PTSD Checklist-Civilian (PCL-C), the Resilience Scale (RS), and the Religious Orientation Scale (ROS) found no significant relationship between PTSD, resilience, religious orientation and religious practices. Results did indicate that 34% of the sample had PCL-C scores indicative of PTSD; female participants had higher PTSD symptoms than males; higher levels of intrinsic religious orientation were associated with more religious practices than extrinsic religious orientation; and males with higher PTSD symptoms were associated with lower levels of attending church-sponsored social events, while females with higher levels of resilience were more associated with church attendance and attending church social events. Mental health providers should develop more comprehensive disaster mental health services that build trust and are culturally sensitive to the post-trauma needs of the Haitian people.
Differences in mental health outcomes by acculturation status following a major urban disaster.
Adams RE, Boscarino JA
Int J Emerg Ment Health · 2013 · PMID 24558696
A number of studies have assessed the association between acculturation and psychological outcomes following a traumatic event. Some suggest that low acculturation is associated with poorer health outcomes, while others...
A number of studies have assessed the association between acculturation and psychological outcomes following a traumatic event. Some suggest that low acculturation is associated with poorer health outcomes, while others show no differences or that low acculturation is associated with better outcomes. One year after the terrorist attacks on the World Trade Center, we surveyed a multi-ethnic population of New York City adults (N= 2,368). We assessed posttraumatic stress disorder (PTSD), major depression, panic attack, anxiety symptoms, and general physical and mental health status. We classified study respondents into "low," "moderate," or "high" acculturation, based on survey responses. Bivariate results indicated that low acculturation individuals were more likely to experience negative life events, have low social support, and less likely to have pre-disaster mental health disorders. Those in the low acculturation group were also more likely to experience post-disaster perievent panic attacks, have higher anxiety, and have poorer mental health status. However, using logistic regression to control for confounding, and adjusting for multiple comparisons, we found that none of these outcomes were associated with acculturation status. Thus, our study suggests that acculturation was not associated with mental health outcomes following a major traumatic event.
Professional support requirements and grief interventions for parents bereaved by an unexplained death at different time periods in the grief process.
Rudd RA, D'Andrea LM
Int J Emerg Ment Health · 2013 · PMID 24187887
The purpose of this qualitative phenomenological study examines the support needs and grief interventions professional and bereaved parents believed were helpful during different time periods in the grief process: the fi...
The purpose of this qualitative phenomenological study examines the support needs and grief interventions professional and bereaved parents believed were helpful during different time periods in the grief process: the first 72 hours, first three to 14 days, and two weeks and beyond. Ten professionals from the following disciplines were interviewed: emergency communications, emergency medical technician, police, fireman, detective, social worker funeral director chaplain, peer support leader, and bereavement organization. Five parents and one grandparent bereaved by Sudden Infant Death Syndrome (SIDS) or Sudden Unexplained Death in Childhood (SUDC) were interviewed. This study identified 13 support need and grief interventions: contact support people, emotional and cognitive regulation, preliminary information on cause of death, time with deceased child, accommodate and advocate, human compassion and support, describe timeline and process, referrals and resources, affordable and easy access to services, communication and follow-up, community experience, professional mental health support, and memorialize. Recommendations are provided on ways to improve services to newly bereaved parents.
An exploration and analysis on the timeliness of critical incident stress management interventions in healthcare.
Priebe R, Thomas-Olson LL
Int J Emerg Ment Health · 2013 · PMID 24187886
There is debate in the literature regarding the definition and effectiveness of "early" critical incident stress management (CISM) interventions. Definitions range from interventions that take place within twelve hours (...
There is debate in the literature regarding the definition and effectiveness of "early" critical incident stress management (CISM) interventions. Definitions range from interventions that take place within twelve hours (Everly and Mitchell, 1999; Stallard, Velleman, Salter & Howse, 2005) and up to a three month window (Bisson & Cohen, 2006). Others define early support as an intervention directly after an incident, before the individual leaves work and definitely before having their first sleep (Talbot, 1990; Snelgrove, 2000). Most CISM research is carried out in industries that do not have the same characteristics as healthcare namely, 24/7 operation and a strong female demographic. Therefore, given the lack of research evidence around the timeliness of CISM interventions in healthcare, this study examined the effect of early (< 24 hours post-incident) vs. late (> 24 hours post-incident) CISM interventions on stress reaction and employees perceptions of service. Although the subject population in each group was too small to show statistical significance, the quantitative data showed an overall trend that the early intervention group had lower mean scores for avoidance, intrusion and hyperarousal at all three time periods. Thematic analysis demonstrated both groups found the CISM intervention was beneficial and the timing appropriate.
National police suicide estimates: web surveillance study III.
O'Hara AF, Violanti JM, Levenson RL … +1 more , Clark RG
Int J Emerg Ment Health · 2013 · PMID 24187885
The present study is the third in a series of web surveillance of police suicides (prior analyses conducted in 2008 and 2009). In this age of world web communications, a police suicide in even the smallest and most remot...
The present study is the third in a series of web surveillance of police suicides (prior analyses conducted in 2008 and 2009). In this age of world web communications, a police suicide in even the smallest and most remote community is generally transmitted nationally and through police websites, forums, and blogs. 55,000 police suicide specific web articles were reviewed over the entire year 2012 data was then compared with 2008 and 2009 police suicide data. There were 141 police suicides in 2008. Suicides declined from 143 in 2009 to 126 in 2012 (an 11.9% decrease). Across the three time periods, male and female suicides appeared to occur at a similar rate, averaging 92% and 6% respectively. In 2012, (1) suicides appeared to cluster more in the 40-44 year age group more than in previous years among officers of lower rank; (2) an increase in suicide was seen among officers with 15-19 years of service; (3) gunshots remained the most prevalent means of suicide across all three years (91.5%), and (4) personal problems appeared to be prevalent (83%) with work associated legal problems ranking second (13%). Approximately 11% of suicides were military veterans. California (n = 10) and New York (n = 12) had the highest police suicide rates. Four murder-suicides were noted over the entire year. Suggestions for suicide preventive policies, improving police mental health, and future research are discussed.
The Communities Advancing Resilience Toolkit (CART): development of a survey instrument to assess community resilience.
Pfefferbaum RL, Neas BR, Pfefferbaum B … +2 more , Norris FH, Van Horn RL
Int J Emerg Ment Health · 2013 · PMID 24187884
While building community resilience to disasters is becoming an important strategy in emergency management, this is a new field of research with few available instruments for assessing community resilience. This article...
While building community resilience to disasters is becoming an important strategy in emergency management, this is a new field of research with few available instruments for assessing community resilience. This article describes the development of the Communities Advancing Resilience Toolkit (CART) survey instrument. CART is a community intervention designed to enhance community resilience to disasters, in part, by engaging communities in measuring it. The survey instrument, originally based on community capacity and related literature and on key informant input, was refined through a series of four field tests. Community organizations worked with researchers in a participatory action process that provided access to samples and helped to guide the research. Exploratory factor analysis performed after each field test led to the identification of four interrelated constructs (also called domains) which represent the foundation for CART Connection and Caring, Resources, Transformative Potential, and Disaster Management. This model was confirmed using confirmatory factor analysis on two community samples. The CART survey can provide data for organizations and communities interested in assessing a community's resilience to disasters. Baseline data, preferably collected pre disaster can be compared to data collected post disaster and/or post intervention.
Does a one-day educational training session influence primary care pediatricians' mental health practice procedures in response to a community disaster? Results from the reaching children initiative (RCI).
Adams RE, Laraque D, Chemtob CM … +2 more , Jensen PS, Boscarino JA
Int J Emerg Ment Health · 2013 · PMID 24187883
Although many children and adolescents need assessment and treatment for psychological problems, few get such treatment from mental health specialists after a community disaster Research suggests that a very large propor...
Although many children and adolescents need assessment and treatment for psychological problems, few get such treatment from mental health specialists after a community disaster Research suggests that a very large proportion of children are seen in pediatric primary care settings and that pediatricians can provide appropriate care for many social and emotional problems in children. However few pediatricians have received training in providing this help. The focus of this study was to assess whether brief training to increase the capacity of primary care pediatricians (PCPs) to respond to the social or emotional problems of children after the World Trade Center terrorist attacks improved the quality of services to disaster-affected children. Pediatricians (N = 137) attended a one-day training workshop covering best practice treatments for mental health problems with an emphasis on trauma, bereavement, and medication use. We surveyed attendees prior to training, immediately post-intervention, and 1- and 6-months later. At 6-months post-intervention, 64% of the primary care clinicians reported instituting practice changes recommended during training. Reported use of formal mental health screening instruments increased, but greater use of medications was more limited. Although participants in the immediate post-intervention survey indicated strong agreement with the desirability to implement specific practice changes, the perceived desirability of such changes declined substantially at the 6-month follow-up. Changes in PCPs 'mental health related practice procedures can be facilitated by brief educational interventions, but continued training and support may be needed. We discuss these results relative to preparedness for community disasters.
What's really in a name?
Int J Emerg Ment Health · 2013 · PMID 24187882
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The role of law in addressing mental health-related aspects of disasters and promoting resilience.
Rutkow L
Int J Emerg Ment Health · 2012 · PMID 23350229
Law plays a critical role in emergency preparedness and disaster response by establishing an infrastructure for the response and facilitating coordination among the federal, state, and local governments. Once a disaster...
Law plays a critical role in emergency preparedness and disaster response by establishing an infrastructure for the response and facilitating coordination among the federal, state, and local governments. Once a disaster occurs, certain legal mechanisms are activated to ensure that individuals' needs for mental health care are met, both for pre-existing and emergent conditions. This includes the rapid deployment of mental health care personnel and the implementation of crisis counseling programs in affected regions. By facilitating an influx of resources, including personnel, supplies, and financial assistance, the law can help communities quickly rebound and return to a sense of normal. Drawing on examples from the United States, this article illustrates the diverse ways in which the law simultaneously addresses mental health-related aspects of disasters and promotes resilience within affected communities.
Assessment of psychological preparedness and emergency response willingness of local public health department and hospital workers.
Errett NA, Barnett DJ, Thompson CB … +6 more , Semon NL, Catlett C, Hsu E, Gwon H, Balice RD, Links JM
Int J Emerg Ment Health · 2012 · PMID 23350228
This study sought to investigate the relationship between psychologically-related attitudes/beliefs toward public health emergency response among local health department (LHD) and hospital workers and their willingness t...
This study sought to investigate the relationship between psychologically-related attitudes/beliefs toward public health emergency response among local health department (LHD) and hospital workers and their willingness to respond to a pandemic influenza emergency scenario and a radiological 'dirty' bomb scenario, to inform workforce resilience-building interventions. LHD and hospital workers participated in a survey based on an established threat- and efficacy-oriented behavioral model (the extended parallel process model) that focused on collection of the aforementioned attitudes, beliefs, and self-reported response willingness. Odds ratios associating psychologically-related attitudes and beliefs with self-reported response willingness were computed Perceived levels of psychological preparedness and support were shown to impact response willingness, with more pronounced effects in the radiological 'dirty' bomb scenario. Compared to those who did not perceive themselves to be psychologically prepared, those who did perceive themselves as prepared had higher odds of self-reported response willingness. The relationship of these perceptions and self-reported willingness to respond in all contexts, both scenarios, and both cohorts was influenced by perceived self-efficacy andperceived family preparedness.
Community capacity-building in disaster mental health resilience: a pilot study of an academic/faith partnership model.
McCabe OL, Marum F, Mosley A … +5 more , Gwon HS, Langlieb A, Everly GS, Kaminsky MJ, Links JM
Int J Emerg Ment Health · 2012 · PMID 23350227
We describe an academic/faith partnership approach for enhancing the capacity of communities to resist or rebound from the impact of terrorism and other mass casualty events. Representatives of several academic health ce...
We describe an academic/faith partnership approach for enhancing the capacity of communities to resist or rebound from the impact of terrorism and other mass casualty events. Representatives of several academic health centers (AHCs) collaborated with leaders of urban Christian-, Jewish-, and Muslim faith-based organizations (FBOs) to design, deliver, and preliminarily evaluate a train-the-trainer approach to enhancing individual competencies in the provision of psychological first aid and in disaster planning for their respective communities. Evidence of partner commitment to, and full participation in, project implementation responsibilities confirmed the feasibility of the overall AHC/FBO collaborative model, and individual post-training, self-report data on perceived effectiveness of the program indicated that the majority of community trainees evaluated the interventions as having significantly increased their: (a) knowledge of disaster mental health concepts; (b) skills (self-efficacy) as providers of psychological first aid and bereavement support services, and (c) (with somewhat less confidence because of module brevity) capabilities of leading disaster preparedness planning efforts within their communities. Notwithstanding the limitations of such early-phase research in ensuring internal and external validity of the interventions, the findings, particularly when combined with those of earlier and subsequent work, support the rationale for continuing to refine this participatory approach to fostering community disaster mental health resilience, and to promoting the translational impact of the model. An especially important (recent) example of the latter is the formal recognition by local and state health departments of program-trained lay volunteers as a vital resource in the continuum of government assets for public health emergency preparedness planning and response.
Reciprocal peer support (RPS): a decade of not so random acts of kindness.
Castellano C
Int J Emerg Ment Health · 2012 · PMID 23350226
A model entitled "reciprocal peer support" (RPS) is introduced in this article to describe the peer support activity provided at University Behavioral HealthCare-University of Medicine and Dentistry of New Jersey (UMDNJ)...
A model entitled "reciprocal peer support" (RPS) is introduced in this article to describe the peer support activity provided at University Behavioral HealthCare-University of Medicine and Dentistry of New Jersey (UMDNJ) in a variety of peer programs. More than 10 years of peer support have been developed, reviewed, and assessed by this writer in an attempt to clarify the "lessons learned" and encourage RPS as an effective approach to peer support service in the future. The Cop 2 Cop, NJ Vet 2 Vet, and several other UBHC peer support programs, which conform to "best practices" criteria, have been sustained and expanded based on the RSP principles discussed in this article.
The Johns Hopkins model of psychological first aid (RAPID-PFA): curriculum development and content validation.
Everly GS, Barnett DJ, Links JM
Int J Emerg Ment Health · 2012 · PMID 23350225
There appears to be virtual universal endorsement of the need for and value of acute "psychological first aid" (PFA) in the wake of trauma and disasters. In this paper, we describe the development of the curriculum for T...
There appears to be virtual universal endorsement of the need for and value of acute "psychological first aid" (PFA) in the wake of trauma and disasters. In this paper, we describe the development of the curriculum for The Johns Hopkins RAPID-PFA model of psychological first aid. We employed an adaptation of the basic framework for the development of a clinical science as recommended by Millon which entailed: historical review, theoretical development, and content validation. The process of content validation of the RAPID-PFA curriculum entailed the assessment of attitudes (confidence in the application of PFA interventions, preparedness in the application of PFA); knowledge related to the application of immediate mental health interventions; and behavior (the ability to recognize clinical markers in the field as assessed via a videotape recognition exercise). Results of the content validation phase suggest the six-hour RAPID-PFA curriculum, initially based upon structural modeling analysis, can improve confidence in the application of PFA interventions, preparedness in the application of PFA, knowledge related to the application of immediate mental health interventions, and the ability to recognize clinical markers in the field as assessed via a videotape recognition exercise.
Seven characteristics of highly resilient people: insights from Navy SEALs to the "greatest generation".
Everly GS, McCormack DK, Strouse DA
Int J Emerg Ment Health · 2012 · PMID 23350224
Having reviewed investigative methods such as structural equation modeling, seminal manuals of war (von Clausewitz, 1976, rev. 1984; Clavell, 1983), as well as individual interviews and focus groups with highly resilient...
Having reviewed investigative methods such as structural equation modeling, seminal manuals of war (von Clausewitz, 1976, rev. 1984; Clavell, 1983), as well as individual interviews and focus groups with highly resilient people such as Navy SEALs, law enforcement professionals, and the "children of the Great Depression" now commonly referred to as the "greatest generation," we sought to discover the common themes, or characteristics, of highly resilient people. In this paper, we present our initial impressions that there exist seven important characteristics that seem to be associated with enhanced human resilience.
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