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Mental Health Services Post Hurricane Katrina: The Community Support and Resiliency Program

Operation Assist at Columbia University provides mental health services to children post-Hurricane Katrina, focusing on community support and resilience. The program offers clinical responses, disaster-oriented care, and collaborations with local officials. Learn about the adaptation model and ongoing clinical activities in affected areas.

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Mental Health Services Post Hurricane Katrina: The Community Support and Resiliency Program

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  1. Operation AssistChildren’s Health Fund and the National Center for Disaster Preparedness at Columbia University Mental Health Services Post Hurricane Katrina: The Community Support and Resiliency Program Rosalynn Carter Symposium on Mental Health Policy Nov. 8-9, 2006 Paula A. Madrid, Psy.D. Director, Operation Assist - Mental Health Services Associate Research Scientist, Department of Population and Family Health Mailman School of Public Health - Columbia University pam2109@columbia.edu

  2. Early Stages of Mental Health Services • NCDP meeting. What can we do? How can we help? • Houston Astrodome (Reliant Park and George R. Brown Center) • Rotating in mental health providers from our National Network to work on MMU • Focus groups in Lafayette and meetings in Baton Rouge, NOLA, and Gulfport/Biloxi (MS) to assess needs and areas for rapid intervention • Order Mental Health Mobile Unit “Community Support and Resilience Program”

  3. Clinical Response “Disaster-oriented primary care” on state-of-the-art mobile clinics Mental health services Advanced communications & electronic data collection Working with local officials and providers Short and long-term objectives Public Health Agenda Survey/document medical & mental health needs Environmental assessment Household re-entry guidance Evaluation of preparedness and response issues Collaborate with local, state, federal officials Partner with Tulane, LSU OPERATION ASSIST:Children’s Health Fund and the National Center for Disaster Preparedness at Columbia University

  4. Rationale for Clinical MH Services & Model • Based on successful 9/11 program • Informed by Research and Marist Data • Culturally appropriate interventions • Staff Diversity • Professional and Staff Training and Support • Case Management & Referrals • Flexible and Relevant Services

  5. ADAPT MODEL Adaptation and Development after Persecution and Trauma- (Silove, D., 1999) • Key psychosocial domains that are threatened by disasters • Security and safety • Interpersonal bonds • Networks • Protection from continued threat • Mental Health –Areas of Focus: • Key identities and roles • Institutions that confer cultural meaning • Coherence: traditions, religion, spiritual practices, political and social participation

  6. Currently…. • The Mississippi Gulf Coast Children’s Health Project in Biloxi/Gulfport, MS Health Partner: Coastal Family Health Center, Inc. • The Baton Rouge Children’s Health Project in Baton Rouge, LA Health Partner: Louisiana State University, Health Sciences Center School of Medicine • The New Orleans Children’s Health Project in New Orleans, LA Health Partner: Tulane University School of Medicine

  7. Community Support and Resiliency Program (CSRP) • To meet the widespread, long-term, post-Katrina mental health needs of children and their families. • Traumatized children are especially vulnerable to medical and mental health difficulties. • It is essential to help parents through psychoeducation, stress management and direct counseling. • Clinical- goal is to treat symptoms, help individuals process their traumatic experiences, foster resilience and empowerment. • Public Health Goal-add to mental health infrastructure by providing training, support and resources for professionals.

  8. Community Support and Resiliency Program- Clinical Activities • Intervention strategies based on mental status and comprehensive needs assessment. • Direct services • Individual, Family, and Group • Parent support • Modalities can include play therapy, art therapy and traditional psychotherapy • Case management, Testing & Psychiatric consultations • Training and support to other providers • Culturally Relevant Interventions • Services take place on Community Support Unit

  9. Coping Boxes …We all need a tool box of coping skills and resources that we can draw upon when in need • Boxes containing toys and other “transitional objects” and materials considered to have potential therapeutic value to children. • Children (ages 6-11 years old) • Offers a tangible way to self-sooth • Encourage projective play • Encourages discussion about coping • Enhance resilience… (within a therapeutic environment) • Disaster Preparedness tools • FUN

  10. SBHC Survey : Mental Health Needs of Students ~6 Months Post-Katrina • Fall, 2005-February 2006: Design of SBHC survey instrument • February-March 2006: Survey instrument distributed to 43 SBHCs • Responses from 42 SBHCs • Data coded for input to Excel and analyzed in EpiInfo • Comparisons made between schools with “more” or “fewer” displaced students

  11. Reported increase in Student Behavior Problems • Student verbal arguments, 76% • Physical fights, 64% • Truancy, 55% • Disruptive behavior, 43% • Reported parental conflict, 36% • Sexual promiscuity, 31%

  12. So… • SBHCs can be an important resource in meeting student needs following a disaster • Staff require sufficient resources and support to do their work and to manage their own losses and trauma • Training on assessment and treatment of psychological trauma is needed • Sustained efforts are required to ensure that the availability of services meets the increased level of need following a disaster

  13. LA School-Based Health Center Training ProgramAdolescent School Health Initiative/Office of Public Health- Operation Assist_________________________________________________________________________________________________ • There are 55 SBHC’s in Louisiana providing services to nearly 50,000 students. • Many children served by SBHCs – traumatized, underserved, at risk. • Enhance the capacity of SBHC’s MHP to serve children, adolescents and their families. • Opportunity for peer support and consultation among MH professionals. • Already trained over 300 providers • Recently begun a series of monthly trainings in 6 different cities in LA

  14. Special Health Considerations: Mental Health • Identify children with pre-Katrina concerns • Early screening • Determine and provide appropriate intervention • Build Resilience! • Pay attention to “trigger moments” • Understand/ minimize educational problems • Care for caregivers • Understand Culture • Study how to encourage “posttraumatic growth” • Understanding how to best care for impacted populations …these are extremely urgent issues: diagnosis, support and establish “normalcy”

  15. Lessons LEARNED? …Not Yet! • Ensure access to a robust health care system & economic security • Secure critical infrastructure • Invest in relevant preparedness measures • Learn from previous events • Establish evidence-based preparedness protocols

  16. What else? • Provide Training Incentives for ethnically diverse MH Providers • Access to training on Trauma Treatment • Mental Health Competencies for Delivery of Services post-trauma • Care for Caregivers to prevent Compassion Fatigue

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