Hostname: page-component-8448b6f56d-m8qmq Total loading time: 0 Render date: 2024-04-23T18:14:47.326Z Has data issue: false hasContentIssue false

Building a National Model of Public Mental Health Preparedness and Community Resilience: Validation of a Dual-Intervention, Systems-Based Approach

Published online by Cambridge University Press:  08 December 2014

O. Lee McCabe*
Affiliation:
Department of Mental Health and the Center for Public Health Preparedness, Johns Hopkins Bloomberg School of Public Health, and Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
Natalie L. Semon
Affiliation:
Department of Environmental Health Sciences, Center for Public Health Preparedness, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
Carol B. Thompson
Affiliation:
Johns Hopkins Biostatistics Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
Jeffrey M. Lating
Affiliation:
Loyola University Maryland, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
George S. Everly Jr
Affiliation:
Center for Public Health Preparedness, Johns Hopkins Bloomberg School of Public Health, and Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
Charlene J. Perry
Affiliation:
Kent County Health Department, Maryland Department of Health and Mental Hygiene, Chestertown, Maryland
Suzanne Straub Moore
Affiliation:
Shrewsbury Parish, Episcopal Diocese of Easton, Maryland
Adrian M. Mosley
Affiliation:
Office of Community Health, Johns Hopkins Health System, Baltimore, Maryland.
Jonathan M. Links
Affiliation:
Department of Environmental Health Sciences, Center for Public Health Preparedness, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
*
Correspondence and reprint requests to O. Lee McCabe, PhD, Johns Hopkins Hampton House, 624 N Broadway, Ste 193, Baltimore, MD 21205 (e-mail: lmccabe@jhsph.edu).

Abstract

Objective

Working within a series of partnerships among an academic health center, local health departments (LHDs), and faith-based organizations (FBOs), we validated companion interventions to address community mental health planning and response challenges in public health emergency preparedness.

Methods

We implemented the project within the framework of an enhanced logic model and employed a multi-cohort, pre-test/post-test design to assess the outcomes of 1-day workshops in psychological first aid (PFA) and guided preparedness planning (GPP). The workshops were delivered to urban and rural communities in eastern and midwestern regions of the United States. Intervention effectiveness was based on changes in relevant knowledge, skills, and attitudes (KSAs) and on several behavioral indexes.

Results

Significant improvements were observed in self-reported and objectively measured KSAs across all cohorts. Additionally, GPP teams proved capable of producing quality drafts of basic community disaster plans in 1 day, and PFA trainees confirmed upon follow-up that their training proved useful in real-world trauma contexts. We documented examples of policy and practice changes at the levels of local and state health departments.

Conclusions

Given appropriate guidance, LHDs and FBOs can implement an effective and potentially scalable model for promoting disaster mental health preparedness and community resilience, with implications for positive translational impact.(Disaster Med Public Health Preparedness. 2014;8:511-526)

Type
Original Research
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Davidson, JR, McFarlane, AC. The extent and impact of mental health problems after disaster. J Clin Psychiatry. 2006;67(Supp 2):9-14.Google ScholarPubMed
2. Yun, K, Lurie, N, Hyde, PS. Moving mental health into the disaster-preparedness spotlight. N Engl J Med. 2010;363(13):1193-1195.Google Scholar
3. Meredith, LS, Eisenman, DP, Tanielian, T, et al. Prioritizing “psychological” consequences for disaster preparedness and response: a framework for addressing the emotional, behavioral, and cognitive effects of patient surge in large-scale disasters. Disaster Med Public Health Prep. 2011;5(1):73-80. doi: 10.1001/dmp.2010.47. Epub 2010 Nov 24.Google Scholar
4. Pfefferbaum, B, Flynn, BW, Schonfeld, D, et al. The integration of mental and behavioral health into disaster preparedness. Disaster Med Public Health Prep. 2012;6(1):60-66.CrossRefGoogle ScholarPubMed
5. North, CS, Pfefferbaum, B. Mental health response to community disasters: a systematic review. JAMA. 2013;310(5):507-518. doi: 10.10.1001/jama.2013.107799.Google Scholar
6. Chou, YJ, Huang, N, Lee, CH, et al. Suicides after the 1999 Taiwan earthquake. Int J Epidemiol. 2003;32(6):1007-1014.CrossRefGoogle ScholarPubMed
7. Wang, PS, Gruber, MJ, Powers, RE, et al. Mental health service use among hurricane Katrina survivors in the eight months after the disaster. Psychiatr Serv. 2007;58(11):1403-1411.CrossRefGoogle ScholarPubMed
8. Raviola, G, Eustache, E, Oswald, C, Belkin, GS. Mental health response in Haiti in the aftermath of the 2010 earthquake: a case study for building long-term solutions. Harv Rev Psychiatry. 2012;20(1):68-77. doi: 10.3109/10673229.2012.652877.Google Scholar
9. Bromet, EJ, Parkinson, DK, Dunn, LO. Long-term mental health consequences of the accident at Three Mile Island. Int J Ment Health. 1990;19:48-60.CrossRefGoogle Scholar
10. Palinkas, LA, Downs, MA, Petterson, JS, Russell, J. Social, cultural, and psychological impacts on the Exxon Valdez oil spill. Hum Organ. 1993;52(1):1-13.CrossRefGoogle Scholar
11. Ohbu, S, Yamashina, A, Takasu, N, et al. Sarin poisoning on Tokyo subway. South Med J. 1997;90(6):587-593.CrossRefGoogle ScholarPubMed
12. North, CS, Nixon, SJ, Shariot, S, et al. Psychiatric disorders among survivors of the Oklahoma City bombing. JAMA. 1999;288(8):755-762.CrossRefGoogle Scholar
13. Galea, S, Ahern, J, Resnick, H, et al. Psychological sequelae of the September 11 terrorist attacks in New York City. N Engl J Med. 2002;346(13):982-987.CrossRefGoogle ScholarPubMed
14. North, CS, McCutcheon, V, Spitznagel, EL, Smith, ES. Three-year follow-up of survivors of a mass shooting episode. J Urban Health. 2002;79(3):383-391.CrossRefGoogle ScholarPubMed
15. Drury, SS, Scheeringa, MS, Zeahnah, CH. The traumatic impact of Hurricane Katrina on children in New Orleans. Child Adolesc Psychiatr Clin N Am. 2008;17(3):685-702.Google Scholar
16. Kar, N. Psychological impact of disasters on children: review of assessment and interventions. World J Pediatr. 2009;5(1):5-11. doi: 10.1007/s12519-009-0001-x. Epub 2009 Jan 27.CrossRefGoogle ScholarPubMed
17. Ranasinghe, PD, Levy, BR. Prevalence of and sex disparities in posttraumatic stress disorder in an internally displaced Sri Lankan population 6 months after the 2004 tsunami. Disaster Med Public Health Prep. 2007;1(1)1:34-41.Google Scholar
18. Corrarino, JE. Disaster-related mental health needs of women and children. MCN Am J Matern Child Nurs. 2008;33(4):242-248. doi: 10.1097/01.NMC.0000326079.26870.e3.CrossRefGoogle ScholarPubMed
19. Lee, E, Shen, C, Tran, TV. Coping with Hurricane Katrina: psychological distress and resilience among African American evacuees. J Black Psychol. 2009;35(1):5-23.CrossRefGoogle Scholar
20. Pole, N, Best, SR, Metzler, T, Marmar, CR. Why are hispanics at greater risk for PTSD? Cultur Divers Ethnic Minor Psychol. 2005;11(2):144-161.Google Scholar
21. Adams, RE, Boscarino, JA. Differences in mental health outcomes among Whites, African Americans, and Hispanics following a community disaster. Psychiatry. 2005;68(3):250-265.Google Scholar
22. Lima, BR, Pai, S, Santacruz, H, Lozano, J. Psychiatric disorders among poor victims following a major disaster: Armero, Columbia. J Nerv Ment Dis. 1991;179(7):420-427.CrossRefGoogle Scholar
23. Breslau, N, Davis, GC, Andreski, P, Peterson, EL. Traumatic events and posttraumatic stress disorder in an urban population of young adults. Arch Gen Psychiatry. 1991;48(3):216-222.CrossRefGoogle Scholar
24. Weems, CF, Watts, SE, Marsee, MA, et al. The psychosocial impact Hurricane Katrina: contextual differences in psychological symptoms, social support, and discrimination. Behav Res Ther. 2007;45(10):2295-2306.CrossRefGoogle ScholarPubMed
25. Bonnano, GA, Galea, S, Bucciarelli, A, Vlahov, D. What predicts psychological resilience after disaster? The role of demographics, resources, and life stress. J Consult Clin Psychol. 2007;75(5):671-682.Google Scholar
26. Kessler, RC, Galea, S, Gruber, MJ, et al. Trends in mental illness and suicidality after Hurricane Katrina. Mol Psychiatry. 2008;13(4):374-384.CrossRefGoogle ScholarPubMed
27. Kar, N. Suicidality following a natural disaster. Am J Disaster Med. 2010;5(6):361-368.Google Scholar
28. Frechtling, JA. Logic Modeling Methods in Program Evalution. San Francisco, CA: John Wiley & Sons; 2007.Google Scholar
29. Institute of Medicine. Building Community Disaster Resilience Through Private-Public Collaboration. Washington, DC: National Academies Press; 2011.Google Scholar
30. Kaminsky, MJ, McCabe, OL, Langlieb, A, Everly, GS. An evidence-informed model of human resistance, resilience, and recovery. Brief Treat Crisis Interv. 2007;7(1):1-11. doi:10.1093/brief-treatment/mh1015.Google Scholar
31. Aldrich, DP. Building Resilience: Social Capital in Post-disaster Recovery. Chicago, IL: University of Chicago Press; 2012.Google Scholar
32. Morton, MJ, Lurie, N. Editorial: Community resilience and public health practice. Am J Public Health. 2013;103(7):1158-1159.CrossRefGoogle ScholarPubMed
33. McCabe, OL, Mosley, AM, Gwon, HS, et al. The tower of ivory meets the house of worship: psychological first aid training for the faith community. Int J Emerg Ment Health. 2008;9(3):171-180.Google Scholar
34. McCabe, OL, Lating, JM, Everly, GS, et al. Psychological first aid training for the faith community: a model curriculum. Int J Emerg Ment Health. 2008;9(3):181-192.Google Scholar
35. McCabe, OL, Perry, C, Azur, M, et al. Psychological first aid training for paraprofessionals: a systems-based model for enhancing capacity of rural emergency response. Prehosp Disaster Med. 2011;26(4):1-8.Google Scholar
36. McCabe, OL, Perry, C, Azur, M, et al. Guided preparedness planning with lay communities: a systems-based model for enhancing capacity of rural emergency response. Prehosp Disaster Med. 2013;28(1):1-8. doi:10.1017/S1049023X12001483.CrossRefGoogle ScholarPubMed
37. Everly, GE, Barnett, DB, Links, JM. The Johns Hopkins model of Psychological First Aid (RAPID PFA): curriculum development and content validation. Int J Emerg Ment Health. 2012;14(2):95-103.Google Scholar
38. Everly, GS, McCabe, OL, Semon, NL, Thompson, CB, Links, JL. The development of a model of psychological first aid for non-mental health trained public health personnel: the Johns Hopkins RAPID-PFA. J Public Health Manag Pract. In press.Google Scholar
39. Bandura, A. Self Efficacy: The Exercise of Control. New York, NY: Freeman Publishing; 1997.Google Scholar
40. Ispwoods. Sanctuaries of Hope [video online]. http://www.youtube.com/watch?v=X3vvIJ1CnQE. Published January 21, 2011. Accessed April 18, 2014.Google Scholar
41. McCabe, OL, Everly, GS, Brown, LM, et al. Psychological first aid: a consensus-derived, empirically-supported, competency-based training model. Am J Public Health. 2014;104(4):621-628.Google Scholar
42. Brown, LM, Framm, KA, Hyer, K, Gibson, M. Psychological first aid: guide for nursing homes. http://agingstudies.cbcs.usf.edu/pdf_files/PFA_for_Older_Adults_2ndEd.pdf. Published 2008. Accessed April 18, 2014.Google Scholar
43. Cullerton-Sen, C, Gerwitz, A. Psychological first aid for families experiencing homelessness: Ambit Network and the National Child Traumatic Stress Network. http://www.trauma-informed-california.org/resources/. Published 2009. Accessed April 18, 2014.Google Scholar
44. American National Red Cross. Psychological first aid: helping people in times of stress. http://www.redcrosstbc.org/pdf/psych_first_aid_fs%281%29.pdf. Published 2009. Accessed April 18, 2014.Google Scholar
45. World Health Organization. Psychological First Aid: Guide For Field Workers. Geneva, Switzerland: World Health Organization; 2011.Google Scholar
46. NCTSN, NCPTSD, MRC National Mental Health Workgroup. Psychological First Aid for Medical Reserve Corps: Field Operations Guide. http://www.nctsn.org/content/psychological-first-aid. Published 2008. Accessed April 18, 2014.Google Scholar
47. Zahner, SJ, Corrado, SM. Local health department partnerships with faith-based organizations. J Public Health Manag Pract. 2004;10(3):258-265.Google Scholar
48. Barnes, PA, Curtis, AB. A national examination of partnerships among local health departments and faith communities in the United States. J Public Health Manag Pract. 2009;15(3):253-263.Google Scholar
49. Zahner, SJ. Local public health system partnerships. Public Health Rep. 2005;120(1):76-83.Google Scholar
50. Campbell, DT, Stanley, JC. Experimental and Quasi-Experimental Designs for Research. Chicago, IL: Rand-McNally & Co; 1963.Google Scholar
51. McCabe, OL, Marum, F, Gwon, MS, et al. Community Capacity-Building in Disaster Mental Health Resilience: A Pilot Study of an Academic/Faith Partnership Model. Int J Emerg Ment Health. 2012;14(2):112-124.Google ScholarPubMed
52. McCabe, OL, Marum, F, Semon, N, et al. Participatory public health systems research: value of community involvement in a study-series in mental health emergency preparedness. Am J Disaster Med. 2012;7(4):303-312.Google Scholar
53. Mays, GP, Halverson, PK, Scuthfield, FD. Behind the curve? What we know and need to know from public health systems research. J Public Health Manag Pract. 2003;9(3):179-182.Google Scholar
54. Scutchfield, FD, Marks, JS, Perez, DJ, Mays, GP. Public health services and systems research. Am J Prev Med. 2007;33(2):169-171.Google Scholar
55. Lenaway, D, Halverson, P, Sotnikov, S, et al. Public health systems research: setting a national agenda. Am J Public Health. 2006;96(3):410-413.CrossRefGoogle ScholarPubMed
56. Acosta, J, Nelson, C, Beckjord, EB, et al. A National Agenda for Public Health Systems Research on Emergency Preparedness. Santa Monica, CA: RAND; 2009.Google Scholar
57. Knebel, A, Trabert, ES. Medical Surge Capacity and Capability: A Management System for Integrating Medical and Health Resources during Large-Scale Emergencies. Alexandria, VA: The CNA Corporation; 2004.Google Scholar
58. United States Department of Health and Human Services (USDHHS). National Health Security Strategy (NHSS). http://www.phe.gov/Preparedness/planning/authority/nhss/strategy/Documents/nhss-final.pdf. Published 2009. Accessed April 18, 2014.Google Scholar
59. United States Department of Homeland Security (USDHS). Presidential Policy Directive/ PPD-8: National Preparedness. http://www.dhs.gov/presidential-policy-directive-8-national-preparedness. Published 2011. Accessed April 18, 2014.Google Scholar
60. Institute of Medicine. Research priorities in emergency preparedness and response for public health systems: A letter report. Washington, DC: The National Academies Press; 2008.Google Scholar