MENTAL HEALTH INVOLVEMENT IN POST DISASTER RESTORATION EFFORTS “THE BAHAMIAN EXPERIENCE”

1. MENTAL HEALTH INVOLVEMENT IN POST DISASTER RESTORATION EFFORTS “THE BAHAMIAN EXPERIENCE” 2004

2. AGENDA Information Will Be Presented Under The Following Topics: 1.0 INTRODUCTION 2.0 ISLANDS AFFECTED 3.0 PLANNING STAGE 4.0 TREATMENT MODALITIES 5.0 REACTIONS TO US 6.0 KEY MENTAL HEALTH CONCERNS 7.0 HELPING 8.0 MULTI – AGENCY PARTNERSHIPS 9.0 CHALLENGES 10.0 LESSONS LEARNT 11.0 TRAINING COMPONENT 12.0 RECOMMENDATIONS 13.0 SEASONS

3. 1.0 INTRODUCTION • Mental health was not apart of the original National Post Disaster Plan, however, the need became obvious after the country received widespread damage as a result of Hurricanes Frances and Jeanne in September 2004. It soon became apparent that it was necessary not only to assist with the restoration of building, but also with the restoration of lives. • The Mental Health Post Disaster Team was able to respond immediately due its previous experience with other disasters: • Hurricane Andrew – 1992 • Hurricane Floyd - 1999 • Hurricane Michelle – 2001 • Collision At Sea – August 2 2003

4. 2.0 ISLANDS AFFECTED • LONG ISLAND • GRAND BAHAMA* • ELEUTHERA • ABACO* • SAN SALVADOR • CAT ISLAND • MAYAGUANA • ACKLINS • CROOKED ISLAND • INAGUA Key:* Received catastrophic damage

5. 3.0 PLANNING STAGE • Approximately 83,000 (27.4%) of the Bahamian population had been directly affected by the hurricanes. 2000 persons were left homeless, many more suffered significant property loss. INFORMATION SHARING The data needed to assist the planning efforts for individual communities, was the number of: • Persons affected by the trauma • Elderly persons living in the community • Mentally ill • Children & adolescents • Persons who have suffered major loses • Person grieving • Deaths

6. 4.0 TREATMENT MODALITIES HOW vTown meetings vGroup meetings HOW THEY CONTRIBUTE TO THE RECOVERY PHASE Allow participants to: Connect with each other Ventilate about their losses Share experiences Normalized reactions Accept their temporary situation Focus initially on survival issues rather than a mental health focus GROUPS SEEN vAdolescents vSocial Workers vPost disaster relief workers vHealth care workers vMulti-sectorial community meeting vFirst responders

7. 5.0 REACTIONS TO US • Reactions were mixed. There were persons: • That were glad to see the committee, welcomed us and involved us in their activities; • That felt that the team’s presence suggested that they were “crazy” and this was not so; • Expected the committee to provide information on much expected disaster relief supplies.

8. 6.0 KEY MENTAL HEALTH CONCERNS • v Depression • v     Acute Traumatic Reaction • v     Post Traumatic Stress Disorder • v     Anxiety Syndrome • v     Persons with a history of mental illness, may have a relapse • v     Stress reaction & burn out in the disaster workers • ØUniform branches • ØHealth care workers • ØPost disaster workers • First responders

9. 77.0 HELPING DDebriefing sessions and Post Traumatic Stress Disorder (PTSD) questionnaires revealed that 30% of those surveyed reported experiencing PTSD symptoms. Thus indicating that there was a definite need for counseling and information sharing regarding traumatic experiences & the phases of recovery. Information was shared with:  vThe general population vFirst responders vRecovery workers vHealth care workers TThese services were provided for approximately 3,096 persons

10. 8.0 MULTI-AGENCY PARTNERSHIPS • Advantages • v     Have specific objectives • v     Funding available to accomplish identified objectives only • v     These groups have available: • Disadvantages • Lack of communication between agencies • Duplication of efforts • No information sharing • No mental health involvement • Concerned with a specific group Their Challenges • Their mental health needs • vTheir mental health needs • Loses (personal) • Demands from the public

11. 9.0 CHALLENGES • Sub-population & language barriers • Geography • Coordination of efforts • Duplication of efforts due to a lack of central command • Mental health not a part of the initial assessment • Facilitating acceptance • Funding • Activities restricted • Excessive time spent securing funding • Less than 24 hours to prepare for visits • Only 2 islands visited vs. 10 identified

12. 9.0 CHALLENGES CONT’D • Limited available data • No NEMA protocols • Limited necessary preparation on the ground • Questionnaires not returned • Formation of the Your Grand Bahama Mental Health Team

13. 10.0 LESSONS LEARNT • REPRESENTATION • Mental health must be represented at every level; • Planning, Training, Initial Assessment & Ongoing Assessment • COMMUNICATION vBetween agencies government & non- government • v Agencies updating the public regularly • V Early contact with agencies: V Build relationships & Restore confidence 3TEAM’S RESPONSIBILITY V The post disaster mental health must be able to: v Address the needs of persons they come in contact with Or v Find out where they can get information or assistance

14. 11.0 TRAINING 1.0 Who’s on first? What is the order of response for mental health personnel? 2.0 What to do? What are the responsibilities of the mental health post disaster response team? 3.0 How to do it? Training for the members of the mental health post disaster response team.

15. Identify and secure available funding Identify contact persons in affected communities Immediate inclusion of post disaster mental health management in NEMA Protocols Define the responsibilities of various groups and first responders Provide timely relief for persons who worked before, during and after the disaster Empathy needed for persons delivering services The Haitian community needs to be assessed and communicated with during a disaster Each community needs its own recovery team 12.0 RECOMMENDATIONS

16. 12.0 RECOMMENDATIONS CONT’D 9. The Department of Social Services’ assessments needs to be timely 10. Need for rapid assessment tools and timely response of the multi – sectorial team. 11. Timely processing of insurance claims 12.  The public needs frequent and timely communications from disaster relief agencies, government and non- government agencies

17. 13. SEASONS HURRICANE SEASON STARTS 01 JUNE 2005