Geriatric Mental Health Disaster and Emergency Preparedness

78 Geriatric Mental Health Disaster and Emergency Preparedness
needs is helpful. For example, a perception of racism or unjust delivery of
services during a disaster can decrease the likelihood of a person’s engagement
of those services provided. If the government or disaster response
agency is perceived as not doing the right thing or not having an
individual’s best interest in mind , people are unlikely to follow its suggestions.
This frame of thinking, unfortunately, was prominent within the
African American population when Hurricane Katrina struck New Orleans.
Weems, et al. (2007), while not finding any significant relationship
between degree of perceived racism and expressed symptoms as
measured by the Brief Symptom Inventory, report finding a negative
relationship between perceived level of social support and symptomatology.
Perceived racism would likely disrupt a person’s sense of social
connectedness and likely have deleterious effects on his or her recovery
over a longer period of time.
A strategy that mitigates the risk posed by past or current psychological
issues, and that likely facilitates recovery across a broad range of
other services, is the establishment of working relationships with survivors.
In fact, one might say it is paramount to synergize most, if not all,
recovery efforts. Whether buffering the effects of perceived racism, providing
hope and interpersonal connection, or taking the edge off a person
with a paranoid disposition, engagement in recovery-oriented behavior is
embedded in an interpersonal context. While treatment options for the
mentally ill are discussed in chapter 10, they are mentioned here due to
their potential effect on basic operational engagement to promote basic
safety. The dissemination of accurate information, for example, is a critical
component of disaster management under any circumstance; it is rendered
ineffective by an individual who rejects it. The acceptance of information
implies trust, and strong interpersonal connections at many levels
are instrumental in this process.
Given this context, the preparation of disaster responders in the areas
of mental health, and in particular geriatric mental health, is critical.
This training should not only emphasize specific techniques of psychological
first aid and supportive communication at the level of individual
intervention, but it should also reflect the larger context within which disaster
mental health unfolds. A representative example of such a training
model was initiated and carried out in New York State via a joint effort
of the respective departments of mental health (NYSOMH) and health
(NYSDOH) in conjunction with the University of Rochester ’s Disaster
Mental Health Program. The Disaster Mental Health: A Critical Response
(University of Rochester, 2005) curriculum is a train-the-trainer initiative