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Researchers conduct training in disaster mental health

June 01, 2006

911, hurricanes, earthquakes and bombings drive creation of new field

Researchers from the University of Rochester Medical Center today announced that they have received the final portion of a $610,000 grant to train mental health professionals and spiritual advisors (e.g. clergy) in how to counsel victims of natural disasters and terrorist attacks. The grant, from the New York State Department of Health (DOH), is designed to address the fact that most mental health professionals have no disaster mental health training. Sept. 11, 2001, Hurricanes Katrina and Rita, the Oklahoma City Bombing and many other disasters have made it clear that current resources and infrastructure are overmatched by victims' needs.

"When disaster strikes, people experience a range of stress reactions, with most recovering quickly but up to a third experiencing serious, long-term mental health problems," said Jack Herrmann, M.S.Ed., NCC, assistant professor of Psychiatry and director of the Program in Disaster Mental Health at the University of Rochester Medical Center. "With the right training, mental health professionals can reduce suffering and stress in the short term, and also identify those who may need more professional help over time. Our effort in New York state is clearly unique, and hopefully, the beginning of a national trend."

With funding from the DOH Grant, Herrmann has already trained 168 community-based mental health professionals, who then went on to train hundreds of additional mental health workers across New York. This first group of trainees came from private practices and community mental health centers that typically are part of the frontline response to disaster. Having local resources ready to respond to disaster is the key to rapid response.

With the final portion of funding announced today, Herrmann will begin training a second group of professionals statewide that includes hospital-based mental health professionals, spiritual counselors and other hospital personnel. The training is designed to provide healthcare professionals with the skill set needed to address the emotional needs of victims, first responders and others affected by the disaster.

A New Field

As a fledgling discipline, disaster mental health is supported by a limited body of research. The evidence, however, argues urgently that it receive greater attention, Herrmann said. Past research shows that a minority of disaster victims develop significant, long-term mental health problems that can include acute stress disorder, post-traumatic stress disorder, major depression and substance abuse disorders. In general, people with these conditions struggle with hopelessness, anxiety, sleeplessness, flashbacks and a variety of other symptoms. Like many forms of mental health trauma, the impact reaches beyond affected individuals to involve families, and often, entire communities, researchers said.

Past studies suggest that disaster victims do better when immediately cared for by mental health professionals and first responders that are compassionate, trustworthy and properly trained. Now it is time, Hermann said, to confirm early data with new research on disaster victims and to prove scientifically the severity of problems faced and the effectiveness of treatments. Complicating this work, is the relative lack of "evidence-based" guidelines for care in disaster mental health. Evidence-based medicine places a premium on training healthcare providers to systematically assess and record the outcomes of their work, so that the effectiveness of treatment can be precisely measured.

Herrmann is leading the training effort because of his 13 years of experience as a disaster relief volunteer with the American Red Cross. He has been deployed as part of relief operations following earthquakes, hurricanes and floods, and had mental health leadership roles in relief efforts following the 911 attacks and Hurricane Katrina.

"This work in disaster mental health represents the emergence of a new field, one that we call public health and preventive psychiatry," said Eric Caine, M.D., chair of the Department of Psychiatry at the Medical Center. "It trains professionals from a public health perspective to respond to the problems confronting entire populations and communities, as well as individuals. It also vigorously promotes preventive interventions that anticipate emergencies, rather than waiting for them to happen before we respond to people's needs. With the next hurricane season beginning now, the need for as sense of urgency is obvious."

University of Rochester Medical Center