CHILD & FAMILY DISASTER MENTAL HEALTH RESEARCH TRAINING & EDUCATION

1. CHILD & FAMILY DISASTER MENTAL HEALTH RESEARCH TRAINING & EDUCATION

3. Child & Family Disaster Mental Health Research Training & Education • Federal Sponsors • National Institute of Mental Health (NIMH) • National Institute of Nursing Research (NINR) • Substance Abuse and Mental Health Services Administration (SAMHSA)

4. Investigators Betty Pfefferbaum, MD, JDUniversity of Oklahoma Health Sciences Center Alan M. Steinberg, PhD University of California, Los Angeles Robert S. Pynoos, MD, MPHUniversity of California, Los Angeles John Fairbank, PhDDuke University

5. Objectives • To describe the National Child Traumatic Stress Network • To present an overview of the Child & Family Disaster Mental Health Research Training & Education program • To define and describe disasters and terrorism • To provide a rationale for a focus on children in disaster mental health research

6. National Child Traumatic Stress Network

7. National Child Traumatic Stress Network (NCTSN) • Funded by the Center for Mental Health Services of SAMHSA through Congressional initiative • Network includes 70 member centers • 45 current grantees • 25 previous grantees

8. NCTSN Mission • Raise the standard of care and improve access to services for traumatized children, their families and communities throughout the United States

9. NCTSN Components National Center for Child Traumatic Stress Treatment and Services Adaptation Centers Community Treatment and Services Centers

10. NCTSN Category I Center • Develop and maintain the Network structure • Provide technical assistance to the Network grantees • Oversee resource development and dissemination • Coordinate national education and training efforts

11. Treatment and Services Adaptation Centers - Category II • Provide national expertise on specific types of • Traumatic events • Population groups • Service systems • Support the adaptation of effective treatment and service approaches for communities across the country

12. Community Treatment and Services Centers - Category III • Implement and evaluate effective treatment and services in • Community settings • Youth-serving systems • Collaborate with other Network centers on • Clinical issues • Service approaches • Policy • Financing • Training issues

13. Terrorism and Disaster Center TDC

14. Mission • Improve the standard of care and access to culturally proficient mental health services for children and families affected by terrorism and disasters

15. Through Children’s Eyes, WHO

16. Disaster Research Training DRT

17. Disaster Research Training Program • Funded by the • National Institute of Mental Health, • National Institute of Nursing Research • Substance Abuse and Mental Health Services Administration

18. Mission • Enhance the nation’s capacity for conducting rapid post-event disaster mental health studies for children and families

19. Local Multidisciplinary Research TeamLMRT • Ten Local Multidisciplinary Research Teams • are being established in sites across the United • States based on their • Previous disaster history • Geographical location • Metropolitan makeup • Unique issues for disaster research

20. LMRT: Members and Focus • Each LMRT consists of professionals who will benefit from training in disaster mental health research related to children and families • Each LMRT has a unique focus • Geographic distribution is designed to address regional differences in hazards and potential natural disasters and to facilitate relationships in post-event response • Diversity in focus is intended to ensure attention to a variety of research issues while at the same time reinforcing team building around areas of like interest

21. Local Multidisciplinary Research Teams Miller Children’s Hospital Fuller Theological Seminary University of Washington Oklahoma State Agencies Melissa Institute Vanderbilt University – School of Nursing University of Virginia School of Medicine Boston College Graduate - School of Social Work Massachusetts Coalition for Disaster Education North Shore-Long Island Jewish Health System

22. LMRT Teams - 1 Miller Children’s Hospital Long Beach, California Model for Children’s Hospital System Research University of Washington Seattle Washington Model for Research in Academic Public Health Fuller Theological Seminary Pasadena, California Model for Faith-based Research Oklahoma State Agencies Mental Health, Health, Human Services, Education Oklahoma City, Oklahoma Model for State Agency Research Melissa Institute Miami, Florida Model for Early Childhood and Child Care Organizations

23. LMRT Teams - 2 Vanderbilt University School of Nursing Nashville, Tennessee Model for Nursing Research Massachusetts Coalition for Family and Child Disaster Education Boston, Massachusetts Model for Multi-Agency Disaster Response Research Boston College School of Social Work Boston, Massachusetts Model for Social Work Research University of Virginia School of Medicine Charlottesville, Virginia Model for Medical and Psychiatric Response Research North Shore-Long Island Jewish Health System Long Island, New York Model for Hospital System Research

24. Disaster Research Training Curriculum

25. Clinical modules Research modules Clinical and research modules Public health modules Team building modules Supplemental modules Curriculum Modules - 1

26. Curriculum Modules - 2 • Clinical Modules • The Psychosocial Impact of Disasters and Terrorism • Coping and Resilience • Early Childhood and Child Care Organizations • Research Modules • Research Design and Methodology • Child Disaster Mental Health Research • Program Evaluation

27. Curriculum Modules - 3 • Clinical and Research Modules • Gaps and Challenges • Cultural Competence • Assessment • Ethics • Public Health Modules • National Response and Incident Command • Risk Communication

28. Curriculum Modules - 4 • Team Building Modules • Team Building and Action Planning • Funding and Grant Writing • Supplemental Modules • Psychological First Aid • K-FLASH-II • Community Resilience Assessment

29. Disaster

30. www.drgeorgepc.com NOAA

31. Disaster • Definition • A severe disruption, ecological and psychosocial, which greatly exceeds the coping capacity of the altered community World Health Organization 1992

32. Disaster Typology • Natural • Non-Intentional/Technological • Intentional Violence

33. Natural Disasters • Earthquakes • Volcanoes • Tsunamis • Pestilence • Disease • Epidemics • Pandemics • Hurricanes • Tornadoes • Floods • Droughts • Extreme Heat • Fires • Blizzards

34. Oklahoma City Tornado May 3, 1999 • Photo: http://www.fema.gov/kids/p_tor03.htm

35. Indian Ocean Tsunami December 26, 2004 • Photo: http://usinfo.state.gov/usinfo/USINFO/Products/Photo_Gallery/tsunami.html

36. Hurricane Katrina August 28, 2005 Photo: http://www.nnvl.noaa.gov/cgi-bin/index.cgi?page=items&ser=109663&large=1

37. Pakistan Earthquake October 8, 2005 Photo: United states department of defense Photo credits: Gregory Takats,http://www.defenselink.mil/home/feathures/2005/Pakistan?index/alt.html

38. Human-Generated Disasters • Non-intentional/technological • Industrial accidents • Transportation accidents • Ecological/environmental destruction • Intentional Violence • War • Civil strife • Ethnic conflict • Terrorism

39. Terrorism

40. Terrorism • The unlawful use or threatened use of force or violence by a person or an organized group against people or property with the intention of intimidating or coercing societies or governments, often for ideological or political reasons American Heritage Dictionary, Fourth Edition 2000

41. Other Definitions • FBI The unlawful use of force and violence against persons or property to intimidate or coerce a government, the civilian population, or any segment thereof, in furtherance of political or social objectives • State Department & CIA Premeditated, politically motivated violence perpetrated against non-combatant targets by sub-national groups or clandestine agents, usually intended to influence an audience • DOD The calculated use of unlawful violence or threat of unlawful violence to inculcate fear; intended to coerce or to intimidate governments or societies in the pursuit of goals that are generally political, religious, or ideological

42. http://dart2.arc.nasa.gov/Deployments/OklahomaCityBombing1995/Oklahoma.html#poemhttp://dart2.arc.nasa.gov/Deployments/OklahomaCityBombing1995/Oklahoma.html#poem

43. Elements of Terrorism • The use or threat of violence • To create fear and intimidation • To coerce a civilian population or government • For political, social, or ideological goals

44. Alfred P. Murrah Federal Building Oklahoma City April 19, 1995 Photos: http://dart2.arc.nasa.gov/Deployments/OklahomaCityBombing1995/Oklahoma.html#poem; www.oklahomacitybombing.com

45. September 11, 2001 Photos: Don,LC Art #2, The September 11 Digital Archive, December 16, 2003 http://911digitalarchive.org

46. Weapons of Mass Destruction Chemical “CBRNE” Radiological Biological The United States Army Medical Research & Materiel Command (USAMRMC ) Nuclear High Yield Explosive

47. Are Disasters Increasing? Chart: Swiss Re, Sigma No 2/2006, page 4

48. Reasons for Increase in Disasters • Poverty and Vulnerability • Climate Change • Urbanization • Poor Building and Land Use • Environmental Destruction Briefing on World Conference on Disaster Reduction, January 18-22, 2005, Kobe, Japan

49. Why Focus on Children? Photo: Centers for Disease Control and Prevention

50. Children are not immune to the effects of disaster Reactions may be enduring and may influence later development Children’s reactions may parallel those of their parents Why Focus on Children - 1