OVC Provider Forum Transcript

Mass Violence
Angela McCown  -  2005/11/30
I serve a rural county as the victim advocate. In the event of a disaster we would be on our own. What have you found would be the best response immediantly after a disaster? What is the first concerns to address? I am very interested in your program for rural counties.
1.  Arlene Cameron
 Thanks for the offer and I will email you to discuss it further. I love a new resource.
2.  AMcCown
 It can be difficult responding from a rural area. I would first suggest that attempt to partner with agencies in surrounding counties to create a coordinated response agreement to help out each other. Next determine which law enforcement agency would be responsible for responding to a disaster and make sure they are aware of your services. Immediately following a disaster the community will need to be able to interact with caring individuals such as yourself to address basic needs - safety, food and water, support, contacting family. Once these needs have been addressed, you would have the opportunity to provide some basic crisis intervention. I would be happy to discuss this further with you in the future at angela.mccown@txdps.state.tx.us
Please discuss your experience and observations working with the faith-based (multi-faith) community. What would you like them "to hear" from you regarding their response to mass disasters, violence and trauma (for the victims as well as the responders)? Thank you.
1.  Sandi Macvane
 I am reminded of the importance to ensure that First Responder(s) identify those who will help prior to the disaster. Having a pre-plan in place helps link critical resources, and connection to all support and safety in a more timely way. I agree Faith based support and connections are key components in providing first aid to survivors of mass disaster.
2.  AMcCown
 I have found the faith based community and their leaders to be an excellent resource during disasters. I encourage communities to identify those faith based providers who are interested in providing services during a disaster and to offer them disaster response and victim services training so that they may be better prepared to work within the response system. I have worked with Police and Fire Chaplains who are members of their International Associations because as members they have a set of guidelines to follow when working with victims that places the focus on spirituality instead of a particular religion. I also think it is important to include faith based providers who come from a variety of religious backgrounds so that your community make-up is reflected in the group.
During my twenty-eight years career,I worked with 20 small police department in Massachusetts whose members have faced much trauma. What financial and management resources are available to regionally initiate and sustain training for these first responders?
1.  AMcCown
 What a great question - it is so important to educate and care for our first reponders so that in the event they encounter a mass violence incident that will be prepared to respond and to be able to deal with the trauma. Several years ago we incorporated a critical incident response training into our basic peace officers curriculum that we offer at our law enforcement training academy. By offering this training to new officers and responders we are able to insure that they all have some basic understanding of the impact that traumatic events may have on them. Also by providing at this training at the academy we are able to absorb the cost. I am also familiar with agencies that have written criminal justice grants to fund this type of training and would be happy to put you in touch with those agencies if you contact me at angela.mccown@txdps.state.tx.us
Angie, Could you compare the PTSD experienced by police, fire, and EMS personnel? How are they the same and how are they different?
1.  AMcCown
 My experience does not qualify me to make this comparison, however I can share some general information regarding this subject. We do know, based on research, that in the general population less than 25 of individuals exposed to a significant traumatic event will develop PTSD. My experience in working primarilily with law enforcement, is that although their rate of exposure may be higher than the general public, they have received training that hopefully prepares them for this work that may increase their resilience. I would expect this to be true for Fire and Ems as well. I think this would make a very interesting research paper if someone were willing to look into the comparison.
Please discuss the availability of mental health services for Victim Service Providers. Include, e.g., any data reporting what services are provided, utilization of such services, where they may be located, how they may be accessed and any known outcome (suggesting that Victim Service Providers are being helped by mental health services intended to address the stress resulting from helping mass violence victims).
1.  AMcCown
 As I am sure you are aware there has not been a great deal of research in this area. I know that this is something that we emphasize in our training in Texas, however victim services providers do not always practice what they preach. In other words if services are made available and are not mandatory, some providers may not take advantage of them following a mass violence incident. It may be more helpful to focus on pre-incident education around stress management, so that when there is an incident, the victim services providers will have a stress management plan in place to utilize. As a Supervisor at a disaster or mass violence incident, I require my staff and volunteers to attend a group intervention following their assignment - they do not have to participate if they choose not to however I want them to be there for each other. I have found that they will all utilize the session and that they find it to be helpful. To read more on this topic and to reveiw some studies, I would recommend Charles Figley's books on Compassion Fatigue.
I am a county prosecutor's office based victim advocate. How does responding to mass violence differ from the day to day victim services? What things are you trying to accomplish in a short amount of time and how do you go about accomplishing those thing?
1.  AMcCown
 Although there are some similarities such as helping to normalize the victim's response and nurturing their resilience and ability to recover, there are some differences as well. A mass violence incident involves a much larger system response that can be even more difficult for the victim to understand and to obtain resources. In a mass violence incident the victim's personal losses and experience can become lost in the community loss and experience. A lack of resources may not allow for individual services to the victim, but more group interventions and services. I believe that your work with victims in the prosecutor's office offers a nice foundation from which to build as you learn more about the dynamics of responding to a mass violence incident. I would encourage you to read the new OVC publication on Mental Health Response to Mass Violence and Terrorism.
How are Mass Victims Incidents Teams able to handle victims that have language barriers such a sign language and other languages (Spanish or other languages)?
1.  AMcCown
 Great question - it is extremely important that when communities are in the planning stages of creating local crisis response teams that these teams be a reflection of the community they intend to serve. This means insuring that language and deaf specialists be included on these teams. This does not mean simply having them on a referral list to call if needed. It means asking them to join the crisis teams and to receive the training so that they will be better prepared to repond to victims of mass violence.
Ms. McCown, given your numerous experiences with natural disasters in Texas, what kind of planning or programs are needed to effectively assist persons with disabilities during these events? Can you point to existing programs that 'work'?
1.  AMcCown
 In Texas we have learned a great deal from those agencies (victim services as well as other social services) that serve individuals with disabilities. One of our state emergency management initiatives in 2005 was to enhance our response plan to serve persons with disabilities, and from what I could tell from our response to Hurricanes Katrina and Rita, it was very effective. I would be happy to share our plan with you if you email me at angela.mccown@txdps.state.tx.us. I would also encourage you to go to the Center for Mental Health Services website, www.mentalhealth.org, and download or order their publication on working with persons with disabilities during a disaster.
Please describe good practice in the coordination of the process by which the next of kin must formally identify the bodies of victims' killed in events of mass violence. Describe techniques for providing support which could help reduce the traumatic impact of this process on the next of kin. What agency(s)are responsible for coordinating the identification process, and what are their roles? Any information you can provide to guide collaboration and pre-planning within communities regarding the victim identification process would be appreciated.
1.  AMcCown
 This can be a very complicated task. The only disasters I have responded to where I was asked to assist with death notifications were the Jarrel tornado and the Texas A&M bonfire accident. In both cases emergency management officials and local law enforcemnet made the decision about how to go about providing death notifications, and asked us to participate. For the tornado we notified families in a church with a victim services provider and a pastor present. Notifications were made as soon as positive identification of deceased loved one's were confirmed. At the Texas A&M bonfire, an air conditioned bus was brought to the site and as loved ones were positively identified, families were taken to the bus and notified by victim services counselors, and then transported to the hospital to be with their loved one. In both cases, family members of those who were missing and presumed deceased had to wait anywhere from hours to days for a positive identification so that a death notification could be done. Therefore it is important to not only plan for how to conduct the death notifications, but also what services families may need while waiting to be notified. I would recommend that you contact your local and state emergency management to review their plans for dealing with death notifications. There is also a recent publication through the Department of Justice or OVC on planning for death notifications following a disaster or mass casuality incident. If you email me I will send you the information - angela.mccown@txdps.state.tx.us
When you speak of dealing with victims of "mass violence" is it only in the perspective of violence inflicted by person(s) or do you include the violence of nature? Do you find differences in the impact on the victim(s)?
1.  AMcCown
 I typically refer to disasters as natural, accidental, mass violence and terrorism. Although there are some similarities in how victims respond to any type of disaster, there are also differences. Natural disasters have a beginning and an end, and they are not caused by the actions of another human being. Mass violence and terrorism are characterized by the uncertainity of an on-going threat that may create pervasive feelings of anxiety. And as with victims of a single crime, victims of mass violence or terrorism may struggle with trying to understand why someone or a group of individuals would commit such an act against innocent people. Unlike victims of natural disasters, they may also be thrust into the criminal justice system.
Ms. McCown, have you done work with hurricane victims? If so, have you worked with elderly traumatized from hurricanes like what we have had in Florida this past year? Please provide information relevant to housing elder victims who've already been subjected to abuse, neglect or exploitation by a family member, friend or stranger -- and -- and is then subjected to moving into temporary housing because of a catastropic event. Thank you.
1.  AMcCown
 I have worked with hurricane victims but have limited experience in working with the elderly population. I know that in Texas during the last two hurricanes we have attempted to provide mental health services at all shelters, and this would include having individuals available that have experience in working with the elderly. The population you are describing may be particularly fragile given their previous victimization, therefore it would be important to have victim services providers or trauma counselors available to deal with not only their reaction to the hurricane, but to what it may have triggered in reference to their past victimizations. These experiences could also help focus on strengths by talking with them about how they were able to cope with these past victimizations, and suggesting that they might use these same coping skills to deal with their reaction to the hurricane. Both the FEMA and SAMHSA websites have helpful material for responding to specific populations during disasters. I would welcome the opportunity to continue this discussion with you and to hear what services and techniques you have found to be successful with this population. You can reach me at angela.mccown@txdps.state.tx.us. You can also contact Daniel Thompson at daniel.thompson@dshs.state.tx.us for more information on how Texas addressed the elderly population in Texas shelters following hurricanes Katrina and Rita.
Do you include Amateur radio operators in your planning for emergency communications? Mike P
1.  AMcCown
 Yes, many of our emergency management plans have some provision for inclusion of amateur radio operators. Disasters often overwhelm a community's response system's ability to respond, so there are many types of volunteer systems, such as amateur radio operators, that can enhance the response effort.
Have you developed an effective interview protocol to assess victim needs in mass disasters? Are there planning grants available for developing such protocols?
1.  AMcCown
 I have not developed an interview protocol to assess victim needs following mass disasters. There are interview tools that exist through the Red Cross, SAMHSA and FEMA to address needs, however I am not sure that they are specific the needs of victims of mass violence or terrorism. The new Mental Health Response to Mass Violence and Terrorism manual available from OVC provides a screening and assessment checklist, but not a specific assessment tool. I may have some samples of assessment tools in my office, and if you will forward your mailing address to me I will send them to you. I can be reached at angela.mccown@txdps.state.tx.us.Finally I would encourage you to check with the Department of Justice and the Department of Health and Human Services to see if there may be discretionary grant funds to develop an assessment tool specific to victims of mass violence and terrorism.
Who are the regional coordinators available to assist in instances of Mass Violence in Florida?
1.  AMcCown
 I am not familiar with the system in Florida. You may want to check with the Florida Emergency Management System or the Florida Attorney General's Office. Another resource would be to check with the Center for Mental Health Services (www.mentalhealth.orgcmhs) to find out who in Florida is responsible for the Crisis Counseling Grants because they will be familiar with the mental health response in Florida. If you send me your email address, I will check with some of my colleagues in Florida to see if I can locate the information for you. I can be reached at angela.mccown@txdps.state.tx.us
2.  Arlene Cameron
 It may differ a little from county to county but I can give you a short run down for our area. Law Enforcement generally leads the coordination. There is an EOC (emergency operation center) set up with members from law enforcement, county government, health dept, road dept. etc. Probably FDLE would be the coordinator in a mass violence situation. Until they arrive it will be your county EOC. Hope that helps a little.
We know that stress and trauma can be particularly difficult for teenagers. We saw this in the aftermath of 9-11 and again with Hurricane Katrina when teens were displaced away from their homes lives and friends. Do you have suggestions for service providers and educators on ways to help reduce the stress and address the trauma specifically for teenagers?
1.  Angie McCown
 Although teens certainly need to be reunited with their families if there has been any separation due to the disaster, they also have a need to reconnect with peers. Group interventions with peers that involve some experiential activities give teens the opportunity to process their experience and to enhance their coping skills with the support of their peers. Journaling, creating collages or other art forms can also be helpful to teens. Some teens have a need to be involved in the recovery process - this gives them some sense of control over what happend and aids in their own recovery. Finally, I think it is important to partner with the schools to develop reasonable plan to complete school curriculum while building in opportunities to heal.
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