Cheryll BowersStephens, M.D., M.B.A.

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Leading a Mental Health Care System Impacted by
A Severe Natural Disaster __________ National
Association of State Mental Health Program
Directors Winter 2005 Commissioners Meeting
Cheryll Bowers-Stephens, M.D., M.B.A. Assistant
Secretary for the Office of Mental
Health Louisiana Department of Health
Hospitals Presented December 12, 2005
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News Report Clip
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State of Mental Health Service Prior to
Hurricane Katrina

• According to 2004 census Louisianas population
  is 4,515,770
• 903,154 individuals estimated to have a mental
  disorder within one year
• 179,848 adults (18) have a serious mental
  illness
• Anywhere from 65,554 to 77,473 children have a
  serious mental illness
• 45,979 individuals were served by the Louisiana
  Office of Mental Health in 2004

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Disaster Preparedness
DHH Disaster Task Force

• 4,000 DHH Employees Trained in 2004
• SNS Disaster Mental Health Training

Disaster Response Plans For each OMH Hospital
and Region Including Planning for SNS, SARBOS,
and TMOSA

• 350 OMH and OAD Employees Trained in May 2005
• All Hazards Response Planning
• Crisis Counseling Intervention With Special
  Populations
• Disaster Mental Health Intervention in Incidents
  Involving Mass Casualties

Staff Call Out Registry Prepared
Disaster Response Drills Including Practice
Evacuations of OMH Hospitals
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Pre-Incident Activities
Evacuated Southeast Louisiana State Hospital and
New Orleans Adolescent Hospital to Eastern
Louisiana Mental Health System

• Activated OEP Command Center
• DHH Operations

• Activated Special Needs Shelter (SNS) Operations
• New Orleans
• Baton Rouge
• Terrebonne Parish
• Lafayette
• Lake Charles
• Alexandria
• Monroe

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Katrina Approaches

• Hurricane Katrina is the most devastating natural
  disaster to occur in the United States.
• As a Category IV hurricane, winds of nearly 150
  miles per hour tore through the Eastern Parishes
  of Louisiana and the Coastal cities in
  Mississippi.
• The hurricane winds tore boats from their
  moorings, ripped homes apart, destroyed
  infrastructure and toppled hundred year old trees
  like saplings.
• Cities and towns in Eastern Louisiana were
  devastated by the force of the winds.

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Katrina Hits

• A storm surge of nearly thirty feet inundated the
  streets and bayous of coastal Louisiana,
  destroying anything left behind by the hurricane
  force winds.

• Not everyone evacuated, and when the levees
  holding the waters of Lake Ponchartrain gave way
  24 hours after the storm had passed, thousands in
  the New Orleans Metropolitan area raced for high
  ground.

• The inundation was so fast that many were forced
  to scramble up into their attics or rooftops in a
  fight for their lives.

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Incident Response

• SARBO
• New Orleans

OCD Command Center
OPH Command Center

• TMOSA
• New Orleans
• Baton Rouge

7 Mobile Crisis Teams
Behavioral Health Command Center
Family Call Center
SAMHSA Emergency Response Grant

• Emergency Response Sites
• OPH Command Center
• TMOSA
• SARBO
• NOPD Sites
• OEP Tent Cities for Police Units (Baton Rouge)
• Baton Rouge Sites

• Special Needs Shelters
• New Orleans
• Baton Rouge
• Houma/Terrebonne
• Lafayette
• Lake Charles
• Alexandria
• Monroe

Evacuation of Charity Hospital in New Orleans
Acute Unit to Central Louisiana State Hospital
Initial Crisis Counseling Grant
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Katrinas Impact on the Mental Health System in
Louisiana

• Estimated 3.2 million individuals in need of
  crisis counseling services
• 1,034,428 registrations have been submitted for
  FEMA assistance throughout the declared parishes
• Preliminary Population-level needs assessment
  loss of homes overcrowded living situations
  economic loss chronic health concerns
  significant need for mental health counseling

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The Severity of Katrinas Impact

• Analysis of research from the National Center
  for Post-traumatic Stress Disorder has shown that
  in communities moderately exposed to the
  destruction caused by a natural disaster, 5-10
  of the affected population will experience
  clinically significant issues as a result of the
  event. An additional 5-10 will experience
  issues that are sub-clinical but still require
  support. In severely exposed communities,
  25-30 of the population will experience
  clinically significant issues and an additional
  10-20 will fall into the sub-clinical category.

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Displaced Children from Hurricanes Katrina and
Rita

• Over 189,000 children in Louisiana displaced
  following Hurricanes Katrina and Rita
• Approximately 1500 displaced children ages 0-6
  with concentrations in 21 parishes

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Priorities in Recovery and Rebuilding

• First Responders Services and Support
• Statewide Acute Care Crisis Intervention System
• Mental Health, Substance Abuse, and Development
  Disability
• Integrating Behavioral Health and Primary Care

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Hurricane Katrina Emergency Response
Documentation Plan

• Evacuations of OMH Facilities and Provision of
  Inpatient Mental Health Services
• Maintaining Adequate Mental Health Workforce
• Disaster Relief Mental Health Services (DeWolfe
  Population Exposure Model)

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DeWolfe Disaster Population Model

• Seriously injured victims and bereaved family
  members
• Victims with high exposure to trauma and victims
  evacuated from disaster zone
• Bereaved extended family members and friends,
  rescue/recovery workers with prolonged exposure,
  medical examiners office staff, and other
  service providers involved with death
  notification and bereaved families
• Persons who have lost homes, jobs, pets, valued
  possessions,
• Mental health providers, clergy, chaplains,
  spiritual leaders, emergency health providers,
  school personnel, and media personnel
• Government officials and other groups that
  identify with the target population
• Businesses with financial impacts, and
• Community at large

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LESSONS LEARNED

• Evacuate Inpatient Facilities
  Safeguard/Stockpile Medications
• Shore Up Infrastructure Organizational
  Structure/ Incident Command
• Redundant Communication Systems
• Key Public Information Mental Health Disaster
  Response

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ISP/RSP Crisis Counseling ProgramLouisiana
Spirit

• Individual Outcomes
• Community Outcomes
• Population Outcomes

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• Comments

Office of Mental Health Louisiana Department of
Health Hospitals