K Ayers, D Hilty, P Yellowlees
disaster mental health, just-in-time training, web-based disaster mental health training
K Ayers, D Hilty, P Yellowlees. Web-based Multimedia Disaster Mental Health Training—An Accessible, Accredited Program. The Internet Journal of Rescue and Disaster Medicine. 2008 Volume 9 Number 1.
Literature and website reviews of “disaster mental health training” offer varied listings for various responders. There are few low-cost, easily accessible, accredited disaster mental health training programs available for individuals who may need to be quickly trained for assisting at disaster sites or shelters. Under a grant from the State of California Department of Mental Health we have developed a set of web based, multimedia, accredited, accessible Just-In-Time-Training (JITT) modules to meet these needs. The modules are available online at no charge. Anyone can access the modules, and health professionals can receive CME/CE credits. Portions of each module may be viewed or each module may be viewed in its entirety. Individuals may view as few or as many of the modules as they wish. There is also an instructor’s manual that may be used with the modules to work with groups. The modules are described in this article, with information listed on how to access them online and on how to request an instructor’s manual. Just-in-time training for disaster mental health is a field with few inexpensive, easily accessible, web-based resources. This curriculum provides readily available training for professionals and paraprofessionals and others involved with disasters.
There is much literature available on training in treatment for PTSD, both short-term and long-term, (1, 2, 3) but less literature is available on the topic of early intervention shortly after a disaster. Given the scale of recent disasters, health care professionals may benefit from quick training (just-in-time) while traveling to, or preparing to travel to, a disaster site.
Most “disaster mental health training” programs deal with specific groups of workers such as emergency first responders (4) and school psychologists (5). There is also extensive training available through the American Red Cross (ARC) (6). The American Psychiatric Association (7) offers online courses to its members and easily accessible fact sheets to any practitioners. The American Psychological Association (8), along with the ARC, has offered disaster response training at past annual conventions and has a network of volunteer responders. Psychological First Aid (PFA) training is also available (9). Private groups also provide training (at cost). Despite these programs there is still little available for a health professional who may be called on to suddenly assist in a disaster situation, and who need urgent “just in time” training that can be literally undertaken in the hours before arrival at the disaster site.
Just-in-time training, similar to psychological first aid (PFA), could also be used for training paraprofessionals, professionals, community volunteers, and emergency responders (9). Web-based training offers convenience and accessibility. However, there are few formal, readily accessible, low or no cost curricula that cover the practice and principles of disaster mental health shortly after a disaster.
In California, the Department of Mental Health commissioned the development of such a curriculum, to be available on-line and for face-to-face training. Anyone may view the training modules, at no charge. The curriculum we have developed is fully accredited for CME and CE credits for physicians, nurses, psychologists, social workers, and marriage and family therapists. Anyone may view the modules, but only professionals in these fields may receive CME and CE credits for viewing.
The seven modules (described below) can be viewed separately or together and each takes about an hour to complete. Each module can stand alone; responders can view all the modules, only those that are needed, or view portions of a module. Studying can be done rapidly on-line, before an individual is assigned to a disaster site or while traveling to a disaster site. The modules discuss different disaster phases and are designed to be consulted at those various phases as needed. There is no charge for reviewing these modules.
Instructors’ manuals are available (at no charge) with learning objectives, discussion questions, and CME-type questions for group instruction, which may be useful for county mental health agencies. Instructors can add in additional resources for the types of disasters most likely to occur in their community, and can add in additional training to match community needs, special population needs in their community, and specific services available to their community.
The modules can be viewed at www.ucdmc.ucdavis.edu/cme then by selecting “Online CME” on the left side of the screen, then scrolling down the list to the modules to be viewed. An online overview of the modules is also available, and module content, along with learning objectives, is listed below.
The educational objectives for Module One are:
Acquire a general understanding of the California disaster response system and the way mental health services are provided within that system.
Describe the characteristics of natural and human-caused disasters.
Become familiar with funding that may be available for disaster mental health services and programmatic features of the Federal Emergency Management Agency Crisis Counseling Program.
Module Two’s Learning Objectives are:
Understand basic disaster mental health principles and the methods, strategies, and best practices for delivering disaster mental health services.
Recognize typical reactions to disasters and their time scope.
Understand differences between disasters.
The Learning Objectives for Module Three are:
Learn nomenclature for human-caused disasters that may result in mass casualties.
Understand the psychological impact of human-caused mass casualty disasters.
Understand the appropriate disaster mental health response following a human-caused mass casualty event.
The Learning Objectives for Module Four are:
Understand how anxiety presents in various ways for the short-term and long-term after a disaster.
Understand how to screen quickly for PTSD.
Module Five’s Learning Objectives are:
Distinguish among various coping styles and how they can help or harm an individual.
Help patients cope with and understand medically unexplained physical symptoms (MUPS) and understand the role anxiety plays in their causation.
Understand long-term psychosocial implications of different types of disasters and how these will affect patients in different ways.
The Learning Objectives for Module Six are:
Learn how to present bad news to families of victims and survivors.
Learn how to support families of victims and survivors.
Learn how to provide support in cases of mass casualties.
Learn how to support yourself and volunteers.
Module Seven’s Learning Objectives are:
Learn the behavioral health issues related to quarantine, isolation, and evacuation.
Understand risk communication in the context of public health education and in conjunction with state health and law enforcement authorities.
The just-in-time concept for disaster mental health training is a field with few inexpensive, easily accessible, web-based resources. Both immediate and long-term mental health responses are needed to provide support for those affected by disasters so they can begin the healing process. These services need to match the community affected by the disaster, and organizations need to work together to meet both individual and community needs. Responders also will need short-term and long-term mental health services after a disaster for their own healing. The curriculum described here provides quick, readily available training for health professionals, paraprofessionals, and others who are called upon to provide support, on short notice, for a disaster.
Competing Interests: This work was funded in part by a grant from the California Department of Mental Health to Dr. Yellowlees, Dr. Hilty and Dr. Ayers to develop a curriculum and training program for primary practitioners in disaster mental health. Contact Dr. Yellowlees for a copy of the instructor’s manual.
Additional disclosures for Dr. Hilty: Wyeth, Eli Lilly, Abbott Labs, Sepracor, AstraZeneca and GSK speaker’s bureaus.