Chapter
1 Where Emergency Management and Disaster Behavioral Health Meet: Through an Emergency Management Lens
An Emergency Management Perspective
National Incident Management System and the Incident Command System
Threat, Hazard, and Risk Assessments
A Disaster Behavioral Health Perspective
Foundation: Incident Command Structure
Understanding the Difference Between Typical Community Mental Health Care and DBH Services
Preparing for the DBH Effects of Disaster
DBH in the Recovery Phase
Workforce Behavioral Health Protection
Recommendations for the Future
2 Where Emergency Management and Disaster Behavioral Health Meet: Through a Disaster Behavioral Health Lens
A Disaster Behavioral Health Perspective
The Formation of the Field
Emerging Forces Driving Policy
Central Challenges to Address
The State of State Behavioral Health Systems
An Emergency Management Perspective
Meeting the Needs of Disaster Survivors
Meeting the Needs of Disaster Workers
Opportunities for Promoting Integration
3 Why Is Integrating Disaster Behavior Health Essential to Emergency Management? Challenges and Opportunities
Through an Emergency Management Lens
Who are Emergency Managers and What Do They Do?
Looking at Clouds from Both Sides: A First Person Account From an Emergency Manager
Wednesday, April 19, 1995
Through a Disaster Behavioral Health Lens
Identify Behavioral Health Resources
Explore Scope and Limits of Practice and Availability
Orientation to the World of Emergency Management
Assure BH Focus on Both Survivors and Workers
Establish and Support a Positive EM Culture
Include DBH Professionals in Exercises and Drills
Focus on Shared Needs and Challenges
Monitor, Evaluate, and Revise the Nature and Success of Integration
4 Why Is Integrating Emergency Management Essential to Disaster Behavioral Health? Challenges and Opportunities
Through a Disaster Behavioral Health Lens
The Culture of Emergency Management
The Culture of Disaster Behavioral Health
A Brief Review of Disaster Behavioral Health Literature (1977–2016)
Integration Through the Assimilation of Two Cultures
Through an Emergency Management Lens
Why Does Disaster Behavioral Health Need Emergency Management?
How Can Integration Be Facilitated?
Factors Hindering Integration
Strategies to Help DBH Gain and Sustain Integration
How Can DBH Become Indispensable to EM?
How Does All This Look at the Various Parts of the Disaster Cycle?
Empowerment at Work: An example of State System Integration
The Promise of an Integrated DBH and EM
II. Key Areas of Integration
5 Integration in Disasters of Different Types, Severity, and Location
Through a Disaster Behavioral Health Lens
Complex Systems Thinking for EM and DBH Integration in Disasters
Different Levels of Disaster Response
The Event Dictates the Level of EM Response
The Event Defines the Level of DBH Response
Local DBH Response for a Crisis or Emergency
Local DBH Response for a Disaster or Catastrophe
An Example of State-and-Regional Level DBH Response for a Disaster or Catastrophe: State of Florida, USA
National DBH Response for a Disaster or Catastrophe: United States of America
International DBH Response for a Disaster or Catastrophe Focusing on Contrasts to United States National Response
Concluding Comments and Take-Home Lessons for EM and DBH Professionals
Through an Emergency Management Lens
An Emergency Management Perspective
Integration in an Urban Evacuation: Yonkers Mudslide
Integration in a Multicultural Mass Violence Event: Binghamton New York Shootings
Integration in a Human Exploitation Case: Forced Labor of Deaf Mexicans
Integration in a Terrorist Event: The Boston Marathon
Understanding Variations in Local, State, and Federal Disaster Authorities
6 Not All Disasters Are the Same: Understanding Similarities and Differences
Through an Emergency Management Lens
Nature of Foundation Elements
Nature of Current Services
Through a Disaster Behavioral Health Lens
Develop Local and Statewide Disaster Behavioral Health Plans
Develop DBH Annexes in State All Hazard Plans
Develop Local and Statewide Disaster Behavioral Health Assets
Provide Basic Psychological Training to Emergency Personnel
Include Behavioral Health Representatives in Emergency Planning Efforts
Incorporate Disaster Behavioral Health into Exercises and Drills
Formalize the DBH Role Through Legislation
Integrate Senior Mental Health Officials into the Command Structure
Use Mental Health Experts in a Consultative Role
Link Disaster Behavioral Health Leadership and Experts to Other Decision-Makers
Require the Lead Mental Health Agency to Develop a DBH Incident Action Plan
Develop a Disaster Behavioral Health Coordinating Committee
The Future of Integration
7 What Can DBH Actually Do To Make Emergency Managers Jobs Easier?
Through a Disaster Behavioral Health Lens
Consultation to Leadership
Understanding the Body and Brain Responses to Extreme Situations: What It Means for Integration
Risk Communication/Media Information
Program Evaluation, Measurement, and Monitoring
Tracking, Documenting, and Projecting Behavioral Health Consequences
Through an Emergency Management Lens
Awareness and Understanding
Questions Versus Statements Posed as Questions
Internal Shelter Dynamics2
Transitional and Short-Term Housing Assistance
Interim Housing Solutions
Property Acquisition and Buy Outs
Benefits to Emergency Managers
8 Expanding the Tent: How Training and Education Partnerships with Other Professions Can Enhance Both EM and BH
Through and Emergency Management Lens
The Course Syllabus: Disaster Behavioral Health for Emergency Managers
Do Expectations Reflect Reality?
What Is Your Approach to the Media?
Bringing Allied Professions into the Tent
Emergency Management Training and Education and Disaster Behavioral Health
Summary and Further Thoughts
Through a Disaster Behavioral Health Lens
National Biodefense Science Board (NBSB)
Education/Training Strategies in Disaster Behavioral Health
Educating the Education Community
Educating Criminal Justice and Law Enforcement
Psychological First Aid Training
Learning about Each Other
Mental Health Professionals
Obstacles in Cross Training
Stigma About Receiving Psychological Support
9 Linking with Private Sector Business and Industry
Role of Private Sector and Nongovernmental Organizations (NGOs) in Emergency Response and Recovery
Evolution of Disaster Complexity and Private Sector Collaboration
Case Example: Missouri Floods
Case Example: Lead Contamination Flint, Michigan
Case Example: Sandy Hook School Shootings
Case Example: Omaha Metropolitan Medical Response System
Missouri’s Evolving Practice: From Floods to Ferguson
Case Example: Ferguson, Missouri
Case Example: Virginia Responds to the 9/11 Attack on the Pentagon
Integrating Volunteers into Disaster Response
Strategic Steps Toward Accomplishing Emergency Management, Disaster Behavioral Health, and Private Sector Integration
Step One: Educating Individuals and Organization
Step Two: Preparing Individuals and Organizations
Step Three: Reach Out to Key Partners
Step Four: Live Emergency Management for Life
A Nation Responds: Diana Nordboe’s Reflection on 9/11
Susan Flanigan’s Reflections: Ferguson
III. Special Opportunities to Enhance Integration
10 Integration in the Emergency Operations Center (EOC)/Emergency Communications Center (ECC)
Through an Emergency Management Lens
An Emergency Manager’s First Hand Account of Encountering Behavioral Health Effects
Emergency Operations Centers
Emergency Communications Centers
Linking the EOC, ECC, and Field Operations
Integrating Behavioral Health in the EOC and ECC
Understanding the Stresses
Addressing the Stress: What to Do?
Through a Disaster Behavioral Health Lens
Why it is Important for DBH Personnel to be Located in an EOC and What Roles Can They Play?
Assure Provision of Behavioral Health Services
Challenges in Integrating Within the EOC
Defining Terms and Mutual Education
Establishing the Partnership
11 Risk and Crisis Communications
Through a Disaster Behavioral Health Lens
Mutual Understanding of Roles and Skills
Working with Emergency Managers to Increase Understanding of Victim Priorities
Working with Emergency Managers to Develop Anticipatory Guidance
Fostering Emergency Managers’ Communication with Victims
Assisting in Crafting Messages
Assisting in Monitoring and Managing Stress of Emergency Management Personnel
Through an Emergency Management Lens
Today’s Communication Environment
A Systems Approach to Effective Communication during Disasters
12 How to Navigate External Factors: Legal, Ethical, and Political Issues
Through an Emergency Management Lens
Some Important Context: Speed and Privacy
Evolution of the Disaster Assistance Application Process
The Evolution of Disaster Behavioral Health Services
The Intent and Complications of Providing Assistance
The Current Process: What DBH Needs to Know About Information Sharing
Through a Disaster Behavioral Health Lens
What are the Relevant Current Laws, Policies, and Ethical Guidances for Disaster Behavioral Health Services?
How Does the Disaster Context Impact Ethical, Legal, and Policy Questions?
What are the Long-Term Ethical and Policy Concerns for Impacted Individuals and Communities?
13 Sustaining Integration: A Way Forward
Why Integration Breaks Down
Changing Evidence and Practice
Competing Demands and Priorities
Four Pillars of Sustained Integration
Exceptional Opportunities
Some Convincing is Still Needed
Taking the Time/Resources to Make It Happen
Understanding Changing Rules and Requirements
Integrating Emergency Management and Disaster Behavioral Health
：One Picture through Two Lenses
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