F RAMEWORK OF R AD /N UC D ISASTER PSB R ESPONSE.

FRAMEWORK OF

RAD/NUC DISASTER

PSB RESPONSE

● Conceptual elements:Structure of the framework: problems,

goals, and strategies

● Applications:Using the framework for different

populations and time frames

OVERVIEW OF RAD/NUC DISASTER PSB

RESPONSE FRAMEWORK

Presenting problems: what's happening?

Goals: what needs to be accomplished?

Practical strategies: how do you do it?- includes techniques & procedures

CONCEPTUAL ELEMENTS OF FRAMEWORK

● Target group: who?General public

Disaster workers

● Time frame: when?Crisis phase

Longer term

FRAMEWORK APPLICATIONS

General public (crisis phase)Presenting problem Goals Strategies

General public (longer term)Presenting problem Goals Strategies

Disaster workers (crisis phase)Presenting problem Goals Strategies

Emotional, psychiatric, and behavioral responses

● Fear (eg, of exposure/contamination, of decon process)

● Emotional distress and grief

● Psychiatric illness – largely pre-existing

● Disorganized, disruptive, inappropriate, and harmful behaviors- eg, inappropriate evacuation when sheltering in place is safer

● Concerned treatment and information seekers can overwhelm medical and information providers (surge)

- eg, demand for medical assessment, potassium iodide

GENERAL PUBLIC / CRISIS PHASE

PSB PROBLEM THEMES

Social responses & attitudes● Rumors & misinformation● Distrust of authorities and institutions● Resistance to health authority measures

- eg, decon (eg, modesty/fear), antidotes

● Stigma 1987 Goiania, Brazil cesium-137 incident (medical equipment dismantled and

radioactive material shared around the community)- People avoided the area – tourist and trade industries tanked- Agricultural products would not sell- Hotels and some airline pilots refused to serve Goiania residents- Cars with Goiania license plates were stoned

GENERAL PUBLIC / CRISIS PHASE

PSB PROBLEM THEMES

General public (crisis phase)Presenting problem Goals Strategies

Fear Reduce fear, reassure Risk communication, PFA

Disorganized, disruptive, inappropriate, harmful behaviors Restore calm, keep people safe Risk communication, de-escalation, crowd

containment, redirection, conflict resolution

Surge of unexposed fearful people – overwhelming medical and information providers

Direct to appropriate medical care and information

Risk communication, crowd management, rapid assessment, triage

Rumors & misinformation Disseminate accurate and helpful information Risk communication

Distrust of and resistance to health authorities

Restore trust, persuade, achieve cooperation Risk communication

Emotional distress and grief Relieve distress PFA

Social stigma Change beliefs/attitudes Risk communication, public education

Psychiatric illness Provide acute care Rapid assessment, triage to crisis MH services

● Fear & apprehension- eg, of cancer, birth defects, long term health effects, mortality

● Emotional distress and grief

● Psychiatric illness – pre-existing and post-traumatic

● Misinformation & contamination stigma

● Social responses: spread of rumors & misinformation, distrust of authorities and institutions, anger and blame

● Responses to massive community & infrastructure disruption: helplessness, hopelessness, discouragement, demoralization, disillusionment, nihilism

GENERAL PUBLIC / LONGER TERM

PSB PROBLEM THEMES

General public (longer term)

Presenting problem Goals Strategies

Worry & apprehension Reduce worry, reassure Risk communication, PFA

Misinformation & contamination stigma Disseminate correct information, persuasion Risk communication

Emotional distress and grief Relieve distress PFA

Psychiatric illness TreatmentRebuild treatment infrastructures; ensure long term MH services; identify cases and connect to services

Community and infrastructure disruption, discouragement and demoralization Build community resilience

Public service announcements, commemorations, town hall meetings, social & faith-based community projects

● Fear for safety/wellbeing of self and family

● Distress, fatigue, "compassion fatigue," overwhelmed by suffering and destruction

● Interpersonal conflict among workers

● Disaster performance anxiety

● Unwillingness to report for duty or remain on post

● Neglect of self care

DISASTER WORKERS / CRISIS PHASE

PSB PROBLEM THEMES

Disaster workers (crisis phase)

Presenting problem Goals StrategiesFear for safety/wellbeing of self and family

Personal family assessment & decision-making

Information and problem-solving, personal pre-disaster planning

Distress, fatigue, "compassion fatigue," overwhelmed

Assess/address physical and emotional fatigue & distress

Self-awareness & care training; emotional and physical relief via Incident Command

Interpersonal conflict among workers Reduce conflict Incident Command, de-escalation, conflict resolution

Disaster performance anxiety Address performance anxiety Training, PFA

Unwillingness to report for duty or remain on post

Promote willingness to report for duty and remain

Deployment planning, training, risk communication, PFA, communication with family

Neglect of self care Assess/address own and coworkers’ needs for self care PFA self-care; relief via Incident Command