View this presentation. - National Association of State Mental Health

Report
UNCLASSIFIED
National Guard
Psychological Health
National Association of State Mental
Health Program Directors
27 JUL 2014
UNCLASSIFIED
UNCLASSIFIED
National Guard Manpower
Army
National
Guard
77%
350,000
Air
National
Guard
23%
107,000
Majority of Guard members are “traditional” or “part-timers”
80-85% traditional; 15-20% Active Duty (AGR – Active Guard and Reserve – T32 at State level)
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DoD Psychological Health Concept
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UNCLASSIFIED
UNCLASSIFIED
National Guard Status & Benefits
Command
DRILL
Governor
SAD
Governor
T32AD
Governor
T10AD
President
Legal
SMC
SMC
SMC
UCMJ
Pay
Federal
State
Federal
Federal
Medical
Retirement
Points
Retirement
Commissary
PX/MWR
Bonus
LOD
WKCMP
TRICARE
TRICARE
2/day
None
1/day
1/day
Age 60
None
20 yr AD
20 yr AD
Yes
No
Yes
Yes
Yes
No
No
No
TA/GI Bill
Yes
No
Yes
Yes
USERRA
Yes
No
Yes
Yes
SMC – State Military Code
WKCMP – Workman’s Compensation
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ARNG DPH Status
AK
VT
WA
ND
MT
NH
MN
OR
ID
WI
SD
WY
UT
CO
HI
OK
NM
OH
IL IN
KS
MO
WV VA
KY
RI
CT
NJ
DE
MD
DC
NC
TN
SC
AR
MS AL
TX
NY
PA
GU
AZ
MI
IA
NE
NV
CA
ME
GA
LA
FL
Green = DPH Service
Yellow = Additional DPH
PR
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VI
UNCLASSIFIED
UNCLASSIFIED
ANG DPH Status
GSU
WING & GSU
WING
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UNCLASSIFIED
UNCLASSIFIED
State and Wing Guard Teams
Transition
Assistance
Family
Programs
Service
Members
& Families
Yellow
Ribbon
Chaplain
Support
State and
Wing
DPHs
Employer
Support
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UNCLASSIFIED
UNCLASSIFIED
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UNCLASSIFIED
UNCLASSIFIED
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UNCLASSIFIED
NGB INTEGRATED SERVICES
DELIVERY MODEL
HHS
VISN
Mental Health
PHS
Vet
Center
Federal Services
VBA
Family Readiness Child and
Volunteers
Youth
Governor’s
Office
State Directors
Of VA
State Directors
Mental Health and
Substance Abuse
Adjutant
General
Army
Community
Service
Financial
Services
MPF/’
MILPO
Services
Information
VSO
All assets in support of the NG member and families TRICARE
Community Services
Community
Mental
Health
Legal
Services
FACs
Support
National Guard
STATE JOINT FORCE HEADQUARTERS
Civilian
Medical Community
National
Guard
Services
NG
Chaplains
Training
Fed, State, Local
& Private Orgs.
DPH
ESGR
NCA
VHA
SFPD
WTU
AW2: Army
Wounded Warrior
Military One
Source
DoD
Services
Air Wounded
Warrior
Military Medical
Community
Medical Hold
(CBHCO)
Military Severely
Injured Center
UNCLASSIFIED
UNCLASSIFIED
NGB Psych Health DOMOPS

Directors of Psychological Health (DPH) have responded to numerous
emergencies and disasters since program inception in 2009.

DPHs provide Psychological First Aid (PFA) and Traumatic Event Management
(TEM) services.

PFA is the nationally recognized method of providing mental health-related
support to those impacted by emergencies and disasters (Red Cross, the
VA, etc.).

TEM is the U. S. Army’s method of providing psychosocial support for Service
members who have experienced traumatic events, including unit fatalities.

DPHs who have completed training in PFA and TEM are prioritized for
deployment to sites of declared emergencies or disasters involving a response
by the National Guard.
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UNCLASSIFIED
UNCLASSIFIED
Psychological First Aid/Traumatic Event Management
By July 18, the program will have 78 PFA & TEM-trained professionals. By the
end of August, it is anticipated the program will have over 90 PFA/TEM trained
professionals. This effort is geographically diverse so that the program will
have the capacity to address major incidents in any part of the country.
ANG STAFF
TRAINED
ARNG STAFF
TRAINED
TOTAL
25
(July 2013July 2014)
53
(March 2009July 2014)
78
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UNCLASSIFIED
UNCLASSIFIED
Date
March 22, 2014
Time
10:37 a.m.
Location
Oso, Washington
Cause
Suspected soil saturation
from heavy rainfall.
Deaths
42
Injuries
4 serious
Missing
1
Property damage
Before Slide
Washington State: “The Oso Mudslide”
49 homes and other structures destroyed
http://en.wikipedia.org/wiki/2014_Oso_mudslide
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http://www.dailymail.co.uk/news/article2588991/Incredible-shots-devastation-causedWashington-landslide-left-14-dead-revealedgeologists-warned-dangers-1999.html
UNCLASSIFIED
UNCLASSIFIED
The March 2014 landslide engulfed 49 homes and
other structures in an unincorporated neighborhood
known as "Steelhead Haven" 4 mi (6.4 km) east of
Oso, Washington. It also dammed the river, causing
extensive flooding upstream as well as blocking
State Route 530, the main route to the town of
Darrington (population 1,347), approximately 15
miles east of Oso. The natural rock and mineral
formation (referred to by geologists as a “geological
feature") with the most recent activity in the area of
Oso is known as the Hazel Landslide; the most
recent landslide event is being referred to in the
media as "the Oso mudslide". Excluding
landslides caused by volcanic eruptions,
earthquakes or dam collapses, the Oso slide is
the deadliest single landslide event in United
States history.
After Slide
Washington State: “The Oso Mudslide” Impact
http://en.wikipedia.org/wiki/2014_Oso_mudslide
http://www.dailymail.co.uk/news/article-2588991/Incredibleshots-devastation-caused-Washington-landslide-left-14-deadrevealed-geologists-warned-dangers-1999.html
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UNCLASSIFIED
UNCLASSIFIED
NGPHP After Action Report: OSO Mudslide Response
 Background
• Mudslide killed 42 people and left many homeless.
• National Guard Service Members (N = 400+) responding included both ANG (from both WANG
and CONG) and ARNG (WANG) for approximately 3 weeks.
• SM responders, working with civilian responders, moved rapidly from rescue operations to
recovery. This involved digging up bodies and body parts.
 DPHs from WANG, ANG and ARNG deployed to site in rotating schedule
• Wing Commanders and ARNG DSS supported DPH response.
• State Chaplain requested DPH support to work with on-site Chaplains.
 NGPHP Leadership coordinated efforts with civilian and National Guard leadership
• Provided DPHs with American Red Cross manuals on assisting those who are coping
with mass casualty recovery operations.
 Regular Behavioral Health Situation Reports (BH-SITREPs) were provided to NGB by the
DPHs addressing their experiences and recommendations
 Chaplains played major role on the scene addressing support needs for SMs, but did not
always include DPHs in a coordinated effort.
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UNCLASSIFIED
UNCLASSIFIED
Lessons Learned
Psychological Health support to National Guard disaster response include:
 DPHs need contact with their state mental health agency officials responsible for
implementation of ESF 8 to determine how DPHs fit into state plans.
 DPHs from both ANG and ARNG within a state/territory must communicate and develop a
coordinated plan regarding how they will work together in the event of a local
emergency/disaster.
 Wing and NG medical authorities responsible for force health support need to coordinate with
Chaplains on how DPHs will be integrated into the response process.
 Development of a psychological screening process for responders, detecting who might have
a problem with responding to this type of incident.
 Development of a system to identify SMs who were exposed to traumatic scenes to provide for
targeted follow up.
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UNCLASSIFIED
UNCLASSIFIED
Lessons Learned
 Communication from NBG to local National Guard officials
 Development of ANG and ARNG joint response teams. The size of the on-site team would be
negotiated relative to the scope of the incident and number of SMs deployed. Additional
considerations include:
 DPHs licensed in the state, but not in-state DPHs, may serve as back-ups to the DPHs
when short staffed.
 BHO’s, as available, may also be included in the rotational system.
 The contractor will arrange for transportation, per diem and lodging costs for DPHs.
 Actual DPH service hours will be adapted to DPH’s personal schedule and limitations.
The model used is based on the Red Cross system, which would have staff working a
typical shift of 8 hours, but no more than 12 hours.
 Length of deployments for one week with a period of overlap for orientation for the
oncoming DPH.
 Pre-deployment briefings to provide SMs with normal/expected psychosocial reactions to
disasters.
 Planned visits to, or near, the site as essential to understand what SMs were dealing with
on a daily basis.
 Creative recommendations to assist SMs after returning from the site to the Readiness Center,
including arranging for “comfort dogs” and massages by local massage therapists for responders.
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UNCLASSIFIED
UNCLASSIFIED
The ARNG
Surgeon’s Office
Domestic
Operations phaseoriented model for
response to
emergencies and
disasters
summarized:
Psychological Health Relative to the
ARNG MEDOPS Planning Model
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UNCLASSIFIED
UNCLASSIFIED
Future Focus: NGB Psychological Health
•NG Psychological Health: Long-term and Enduring Program
•Joint Staff: High Risk Behavioral Health Working Group
•Office of the Vice-President: Working Group on Military MH and SP
•CNGB Top-Down security Review: Psychological Health
•NGB-VA MOU: NGCC Notification for high risk cases
•Psychological Health for DOMOPS event National Guard responders
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UNCLASSIFIED
UNCLASSIFIED
RADM Joan Hunter, NGB JSG-PH
[email protected]
LTC Laura Wheeler, ARNG
[email protected]
Lt Col Darrick Cunningham, ANG
[email protected]
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UNCLASSIFIED

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