Conference Examines Disaster Behavioral Health

By Army Sgt. 1st Class Gail Braymen
Special to American Forces Press Service

July 14, 2008 - The physical consequences of a pandemic influenza in the United States -- potentially millions of people either sick or dead, schools and businesses closed, store shelves empty -- are obviously apparent and top any disaster recovery to-do list. But what about the invisible, not-so-obvious results of a national catastrophe? Specifically, what about Americans' mental health?

That's the question more than 200 mental and behavioral health specialists gathered to discuss at the Continental Divide Disaster Behavioral Health Conference here last week. U.S. Northern Command, along with the University of Colorado at Colorado Springs and the Colorado Department of Human Services, sponsored the three-day event.

"The idea of disaster mental health, or disaster behavioral health, is kind of a specialty within the area of mental health in general, and it's gaining speed and momentum quickly," said Air Force Lt. Col. Lisa Sayegh, NorthCom's command mental health officer, who cited high rates of post-traumatic stress disorder, depression, suicides and substance abuse after Hurricane Katrina struck the U.S. Gulf Coast in 2005.

"There's a great need for people to be trained and able to respond in a disaster event from a mental health or psychological standpoint," Sayegh said.

Two other prominent issues contributing to increased incidences of mental health disorders in recent years, Sayegh said, are the terrorist attacks of Sept. 11, 2001, and the focus on a possible pandemic influenza.

NorthCom, which provides defense support of civil authorities during emergencies or disasters when ordered by the president or secretary or defense, is the first and only of the country's 10 combatant commands to have a mental health officer, command officials said.

"NorthCom has recognized the need to have mental health as part of its package for the surgeon's office," Sayegh said. "I'm just pleased, as a mental health practitioner myself, that the [Department of Defense] and other levels of medical care in our country are taking notice of the importance of mental health and what we can do to help increase our psychological resilience to either everyday stressors or a catastrophic stressor."

In 1918 and 1919, a pandemic influenza killed 650,000 Americans, Navy Capt. (Dr.) James Terbush, NorthCom's command surgeon, said. Experts use data from that pandemic to model what could happen in a 21st-century event.

"So many aspects of the pandemic revolve around human behaviors -- what we think people are likely to do and, in contrast, what we hope that they'll do," he said.

The public health measures, or behaviors, that the public would be directed to do, especially "social distancing" -- staying home instead of going to work or school or other group functions -- all affect mental health.

"Social distancing -- staying in your house -- that's a hard thing to do," Sayegh said.

But because social distancing may be one of the most effective ways to help control the spread of a pandemic flu, mental and behavioral health experts are searching for methods to help people do it safely and sanely.

As a military organization, NorthCom is concerned not only about public health, but also about the health of its own personnel. The 1918 pandemic influenza hit people between the ages of 20 and 40 hardest, Terbush said, and today's military is "likely to be exceptionally affected by the virus unless we prepare properly."

That preparation includes planning to help troops stay mentally healthy, Sayegh said, especially if they are required to perform traumatic duties.

The Disaster Behavioral Health Conference was the first time many, if not most, of the conference participants met military health professionals and learned about the military's pandemic response plans.

"NorthCom brings the unique organizational capacity, but also the unique perspective, of the military and their whole interaction with the rest of the civilian population," said Dr. Chip Benight, professor of psychology and director of the University of Colorado at Colorado Springs' CU Trauma, Health and Hazards Center. "We discovered this, obviously, in [Hurricane] Katrina, where we have to create these partnerships and these relationships, or else we're not going to be able to function in a way that's most effective in terms of preventing not only physical problems in terms of deaths, obviously, and injuries, but in terms of mental health support and resilience, which we need to find ways to enhance."

Creating and strengthening relationships among representatives of local, state and federal agencies was an important part of the conference, agreed Dr. Curt Drennan, Colorado Department of Human Services disaster behavioral health planner and coordinator and manager of the Disaster Planning and Response Team for the Division of Behavioral Health.

"The goal here is to build greater understanding of culture, of capacity, of resources, and then to really build the relationships between individuals within those areas of expertise and fields and specialty areas so that we can more effectively work together when we really need to work together," Drennan said.

Before the conference, he added, he was not aware of the "extreme level of expertise and capacity" within the Defense Department.

"It's kind of relieving for myself, in my position, that's for sure," Drennan said. "It's like, OK, this is a bigger community, this is a broader set of resources."

U.S. Northern Command was established on Oct. 1, 2002, to anticipate and conduct homeland defense and civil support operations within the assigned area of responsibility to defend, protect and secure the United States and its interests. Its geographic area includes the continental United States and Alaska.

(Army Sgt. 1st Class Gail Braymen serves in the North American Aerospace Defense Command and U.S. Northern Command Public Affairs Office.)