Promoting disaster mental health preparedness among faith-based organizations in allegheny county, pennsylvania



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PROMOTING DISASTER MENTAL HEALTH PREPAREDNESS AMONG FAITH-BASED ORGANIZATIONS IN ALLEGHENY COUNTY, PENNSYLVANIA

by

Adam Thomas Gray

BA, Geneva College, 2011

Submitted to the Graduate Faculty of

Department of Behavioral and Community Health Sciences

Graduate School of Public Health in partial fulfillment

of the requirements for the degree of

Master of Public Health

University of Pittsburgh

2015






UNIVERSITY OF PITTSBURGH

GRADUATE SCHOOL OF PUBLIC HEALTH

This essay is submitted

by

Adam Thomas Gray


on
April 23, 2015

and approved by


Essay Advisor:

Elizabeth M. Felter, DrPH ______________________________________

Visiting Assistant Professor

Department of Behavioral and Community Health Sciences

Graduate School of Public Health

University of Pittsburgh

Essay Reader:

Rhobert W. Evans, PhD ______________________________________

Associate Professor

Department of Epidemiology

Graduate School of Public Health

University of Pittsburgh







Copyright © by Adam Thomas Gray

2015




ABSTRACT

Elizabeth M. Felter, DrPH
PROMOTING DISASTER MENTAL HEALTH PREPAREDNESS AMONG FAITH-BASED ORGANIZATIONS IN ALLEGHENY COUNTY, PENNSYLVANIA

Adam Thomas Gray, MPH

University of Pittsburgh, 2015

Psychological resiliency to disasters has been a growing focus of emergency management in recent years. The major psychosocial impacts of disasters include stress-induced psychological disorders, relational problems, increased substance abuse, and the disruption of beneficial social networks. These outcomes negatively impact resilience at individual and community levels. Demands for mental health interventions following disaster can rapidly overwhelm mental health providers’ ability to meet mental health needs. Recent literature has proposed training unlicensed mental health providers to augment the services of licensed mental health providers and chaplains. This paper describes an effort to strengthen disaster mental health response capacity through the integration of faith-based organizations as providers of disaster mental health and Spiritual Care services. This project was sponsored through collaboration between Christian Associates of Southwest Pennsylvania and the Allegheny County Department of Human Services.

Outreach was conducted in eight communities in Eastern Allegheny County over a one-year period. Outreach activities involved interviewing faith leaders, presenting to ministerial associations, and organizing informational meetings. The three goals of the community outreach were to educate faith-based organizations about the role of faith-based organizations in disasters, to provide a point of contact for further information, and to encourage participation with the Allegheny County Volunteer Organizations Active in Disaster (VOAD). At the end of the outreach period, fifty-seven organizations were contacted, a total of four congregations expressed an interest in becoming active in disaster response, and four ministerial organizations began discussing their role in disaster preparedness and response.

Outreach activities resulted in marginal success in promoting continued participation. Four primary barriers became apparent: frequent leadership turnover, funding limitations, competing time commitments, and volunteer liability concerns. Additionally, a major finding suggests that an active VOAD is a crucial component of sustaining a well-organized reserve of volunteer personnel with a readiness to respond. This community organizing effort holds public health significance by identifying how faith-based organizations may potentially be a community resource to help alleviate the burden of psychiatric stress.









TABLE OF CONTEN


1.0 Introduction 1

2.0 Review of literature 3

1.1epidemiology of disaster mental health 4

1.1.1Individual and community risk factors 7

1.1.2Protective factors 9

1.2Sociological impacts 10

1.2.1Social resilience 11

1.2.2Social vulnerability 12

1.3The “Whole Community Approach to Emergency Management” and community-based disaster mental health- Principles for planning and intervention 13

1.4Case identification, triage, and intervention: A framework for service delivery 15

1.4.1Case identification 16

1.4.2Triage 17

1.5Mental health interventions to reduce traumatic stress 19

1.5.1Psychological debriefing and critical incident stress debriefing 20

1.5.2Cognitive-behavioral therapy 21

1.5.3Psychological first aid 22

1.5.4Spiritual care 24

1.5.5A comparison of psychological first aid and spiritual care 26

1.5.6Community-based interventions 27

1.6Limitations of disaster mental health research 28

3.0 Description of Allegheny County Department of Human Services, Office of Behavioral Health 30

4.0 Description of Christian Associates of Southwest Pennsylvania 33

5.0 Methods 35

1.7Phase one: Review of previous Spiritual Care and Incident Command System training 38

1.8Phase two: Follow-up 39

1.9Phase three: Outreach 40

1.10Phase four: Reporting to Christian associates and the Allegheny COunty Office of BEhavioral Health 41

6.0 Results 42

7.0 Discussion and recommendations 43

1.11Frequent faith-based organization leadership turnover 44

1.12Funding limitations 45

1.13Competing time commitments 47

1.14Volunteer liability concerns 48

1.15The need for a recognized PFA/ Spiritual Care credential 50

1.16The need for an organized VOAD 51

8.0 Conclusions 52

9.0 Public health significance 55

Appendix A 56

Appendix B 59


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