Finding a new normal in the wake of disaster begins with successful incident response, a daunting task requiring strong leadership, quick decision-making, and coordination of efforts across a variety of organizations. And the work doesn’t end once an immediate crisis is allayed. Long after the event, the trauma of a disaster continues to affect individuals and communities.

Through partnerships with the Minnesota Department of Health (MDH), the University of Minnesota Medical Reserve Corps, and local counties, the University of Minnesota School of Public Health (SPH) develops essential trainings and resources to help health professionals better support communities in crisis and assist as they rebuild and recover.

Partnering with MDH for improved incident response

A collaborative project between the Minnesota Department of Health and the School of Public Health, through its Centers for Public Health Education and Outreach, came about thanks to CDC funding.

SPH is one of five schools nationwide to host both a Preparedness and Emergency Response Research Center (PERRC), which conducts investigations related to preparedness and response, and a Preparedness and Emergency Response Learning Center (PERLC), responsible for training the public health workforce. The coexistence of these two centers within one organization, under the leadership of SPH associate dean Debra Olson, has helped create an environment where research translates directly to practice.

The strength of the practice component would not have been possible without the health department. “The SPH and MDH partnership allows us to combine academic and on-the-ground expertise to…identify potential best practices in a real-world setting,” says Mickey Scullard, planner at the Minnesota Department of Health who serves as co-lead investigator on SPH grant-funded projects.

One of the challenges MDH has identified is that leadership trainings designed for fire and rescue teams don’t always meet the needs of public health officials, whose typical work environment differs vastly from the demands of a crisis scenario.

“In public health practice, you spend a lot of time building consensus and coming to an agreed upon solution…,” says Scullard. “During emergency response, you’re suddenly put into the incident command system that has a somewhat military approach to it, and you have to make fast decisions based on incomplete information.”

A training currently in development will help address this challenge. It will complement existing FEMA trainings and improve the application of the incident command system in public health responses.

Additional resources developed through the partnership include a course, now being converted for e-learning, focused on improving team functioning called Moving Beyond HSEEP*. Principles from the course have been used in other trainings, including the Disaster Behavioral Health series. Another product resulting from the joint research project is Global Outbreak, an online simulation game designed for public health professionals who fill planning, operations, and logistics chief roles during responses.

Joining forces with experts in the field

Prioritizing the mental health of individuals and communities who experience disaster is a fundamental component of psychological first aid, a post-9/11 concept that became more fully developed after Hurricane Katrina.

“Disaster footprints have an impact that is significantly more psychological than medical or physical,” says Jonathan Bundt, Metro Region Disaster Behavioral Health Coordinator and president of Masa Consulting, who illustrates the point with the example of a colleague who assisted in emergency response after Hurricane Katrina. “He came back and said, “We sort of got it wrong. We brought all these medical people down and only a couple social workers and we should have inverted that staffing ratio: mostly social workers and mental health professionals.’ That’s what people really need.”

Bundt’s years of experience in the field made him indispensable to conversations that began in 2007 after the collapse of the I-35W bridge in Minneapolis. Stakeholders at city, county, and state levels came together to achieve better coordination, to make sure training methodology was consistent, and to minimize duplication of effort. One clear goal that emerged from discussions was the need to integrate behavioral health and emergency response.

When the University of Minnesota joined the conversation, it brought a wealth of interdisciplinary expertise and a broad capacity to organize. “Probably the biggest contribution that the University offers is the scope of resources that we bring to the table,” says Tai Mendenhall, assistant professor in the Department of Family Social Science and leader of the Behavioral Health Response Strike Team for the UMN Medical Reserve Corps. “For any type of disaster, we have a buffet of people who are able to get organized and respond.”

Like Bundt, Mendenhall serves as a trainer in the Disaster Behavioral Health series co-developed by SPH, MDH, and other key partners within the University. The trainings first targeted mental health professionals and now have broadened their reach to include members of the public health workforce.

Moving beyond the burden of disaster

Response teams, comprised of professionals and volunteers who care deeply about the communities they serve, are in no way immune from the psychological impact of disaster. The School of Public Health spearheaded the development of a cell phone self-care application for psychological first aid to mitigate compassion fatigue and burn out [for responders] in the field, says Mendenhall. MDH response teams will soon start field testing the app.

“With what we’re doing as partners just can’t be underscored enough,” Scullard says. “It brings together a nice well-rounded team with the right expertise to move projects forward.”

That impetus to move forward together is perhaps best summed up by Jonathan Bundt, who based the name of his consulting organization on the Hebrew word masa, which can mean either journey or burden depending on context. “Disaster can weigh us down for short periods of time or for lifetimes. We’re trying to help, not only others, but also ourselves to see that there can be positive growth. And that’s the journey.”

* HSEEP is the Homeland Security Exercise and Evaluation Program

~ Post by Karen Carmody-McIntosh