| The
APNS-EMO Memorandum of Understanding for Post-Disaster Psychological
Services
Psychological assistance to victims of a major emergency or consultation
to agencies providing emergency relief can be done most effectively
by psychologists and other mental health workers if there is a framework
for emergency response.
The Association of Psychologists of Nova Scotia (APNS) through
its Post-Trauma Services Committee (the Committee) has established
this Protocol for use by psychologists and other interested parties
in the event of a major emergency. This Protocol is intended to
be part of the Memorandum of Agreement between the APNS and the
Emergency Measures Organization of Nova Scotia (EMO).
Major emergency defined
Although it is well recognized that psychological trauma
takes place in many situations, and unusual events involving one
or several people may traumatize participants, a definition of major
emergency requires that the event go beyond individual or small-scale
experiences. A major emergency may be natural (e.g., a hurricane)
or person-made (e.g., a gas explosion in a major urban centre).
Major emergencies affect large numbers of people and require the
mobilization of many resources. The time involved in dealing with
those emergencies typically extends beyond a few hours and many
run for days and weeks.
The number of people affected and their needs for psychological
assistance is important in this definition. A major emergency requires
a wide-ranging response from many agencies and their personnel.
Normal services in place to assist people in crisis will be overwhelmed.
Thus, a major emergency is a situation which:
affects large numbers of people to the point of traumatization;
requires large numbers of personnel from many agencies working together
under a pre-established response plan; and overtaxes the normal
capacity of agencies or systems sanctioned to respond to crisis.
In developing this Protocol, it was abundantly clear that, in many
instances, events occur which affect people severely yet the events
themselves do not meet the definition of a major emergency (e.g.;
small-scale trauma). These events are often referred to as critical
incidents. They might well call for psychological intervention,
but an intervention would typically be done without implementing
this Protocol.
Psychologists are already involved in establishing and working
in critical incident stress management programs. In times of major
emergency, this Protocol would supersede specific, individual programs
and psychologists would be encouraged to work together as part of
the overall response.
Victims defined
Primary victims are those people directly affected by the
major emergency. Potential secondary victims are family and significant
others related to the primary victims, witnesses and workers assisting
primary victims.
When providing psychological services to victims, priority will
be given to those most directly affected, as determined by brief
assessment and triage reports from psychological/medical teams and/or
EMO personnel.
Services to be provided
Ordinarily, within 72 hours of the conclusion of the emergency,
short-term psychological services (i.e., defusing, debriefing, crisis
intervention) will be provided. Usually the services will be provided
over the course of 1 or 2 days. However, contingencies may be expected
that may make the precise time of intervention difficult to predict.
Factors such as extended emergency operations, weather conditions,
availability of personnel and facilities may dictate an altered
response time and pattern. These short-term services will be provided
without charge to the recipients.
Services beyond those described above will not fall under this
Protocol and will not be provided pro bono. Psychologists will take
note of their ethical obligations regarding the welfare of the individual
and will take care that victims unable to pay for private services
are referred to public agencies. Caution will be exercised so that
appropriate referrals are made. If necessary, victims will be assisted
in making the transition between short-term assistance and longer-term
treatment.
Membership in the APNS Disaster Response Network (the Network)
Membership in this Network is restricted to psychologists
and psychologists on the candidate register (Nova Scotia Board of
Examiners in Psychology) who have the appropriate training and experience
which qualifies them to provide post-emergency psychological services.
Nova Scotia psychologists are surveyed annually to indicate their
interest in and qualifications for serving in the Network. Psychologists
may also join at any other time by contacting the Post-Trauma Services
Committee Chairperson.
Psychologists who are responding to a major emergency as part of
the APNS Disaster Response Network, would do so under the aegis
of a pre-established emergency plan and not as freelance professionals.
Emergency Measures Organization:
ITS ROLE
This Protocol is meant to be activated only in the event of a major
emergency. In situations meeting this definition, the EMO normally
will be the coordinating agency and responsible for contacting the
Post-Trauma Services Committee to request assistance. The Committee’s
Disaster Response Coordinator (DRC) has the responsibility and authority
to consult with appropriate EMO officials in the event of a known
major emergency, but may not activate the Protocol without the request
of the Director of EMO. The EMO will keep the DRC informed of the
current contact phone numbers in the event of a major emergency.
Requests from agencies other than the EMO must be referred to EMO
before any action is taken.
The EMO agrees, within budgetary limitations, to accept the mileage,
accommodations and meal expenses of the requested APNS members while
they are acting in a volunteer capacity at a major emergency. Provincial
rates shall apply and this coverage shall cease when the APNS member
is no longer acting in a volunteer capacity.
Under the provision of the Volunteer Emergency Services Workers’
Agreement, the EMO will provide Workers’ Compensation coverage
to the APNS members while they are acting as volunteers on behalf
of EMO.
Committee activity and its responsiblity to APNS
As indicated in the mandate for the Post-Trauma Services
Committee, it is expected that whenever this Protocol is put into
effect, time will be of the essence thus full discussion of the
Committee’s activity by the APNS Executive will be impossible.
It is the responsibility of the Chairperson of the Committee to
consult with the President or President-Elect of APNS as quickly
as possible to keep the Executive informed and to request appropriate
guidance when necessary.
Relationship to other agencies
As noted above, the EMO is the only agency empowered to activate
this Protocol for emergency response. However, requests from sources
other than the EMO may occur. For example, information about emergency
plans may be requested by the media; certain government agencies
may wish to know how members of the Network are selected; and groups
may wish to learn of a Committee member with major emergency or
critical incident experience and a willingness to address the topic
with their group.
In cases such as these, the Committee, working through the Chairperson,
the DRC and the APNS Executive, will make responses deemed appropriate
to its mandate and resources.
Major emergency response protocol
In the event of a major emergency, it will be the responsibility
of the Director of EMO to contact the Post-Trauma Services Committee.
In most cases, this contact will be with the Committee’s Disaster
Response Coordinator (DRC).
In order to provide continuous and timely services, it may be that
a Committee Member rather than the DRC must be contacted by EMO.
In this case, the contacted Committee member will serve as the interim
DRC for the response.
A list of Committee members, including names, addresses, fax and
phone numbers and the sequence in which they should be contacted
by EMO, will be given to EMO at least once per year. The list will
be updated as Committee member’s change and forwarded to EMO
whenever changes have occurred.
Upon being contacted by EMO, the DRC will attempt to:
- Determine the exact nature and location of the emergency and
who is in charge at the site. A careful, detailed consultation
with EMO at this point, to the degree any consultation is possible,
will net savings in time later on.
- Ascertain, in specific terms, what response is needed and what
resources are available to meet the need. Bear in mind that telephone
service in the area of the emergency may be unavailable due to
physical damage or overload.
- Contact the Network member(s) who are able to make a response
of either an indirect or direct nature. This will mean establishing
a team(s) and a leader(s) for teams.
- Establish whatever limits must be placed on the Network members’
terms of service for the specific emergency with the members.
These limits will also be communicated to EMO by the DRC before
an actual response is made.
- Arrange for suitable meeting space for team(s) to carry on their
work.
- Meet the team(s) and leader(s) either at the emergency site
or a staging area nearby for both a briefing by the DRC and EMO.
This meeting may well be a joint meeting and may include other
helping agencies.
- Contact the Committee Chair who will be responsible for informing
the APNS Executive of the current situation and ask for guidance
if need be.
- Carry out a response organized by the Committee. It is the responsibility
of Network members to work as a team and keep the team leader(s)
informed of all aspects of operations as frequently as possible.
The DRC has the authority to make assignments of psychologists
to the teams and to oversee operations during the response.
- Develop daily plans of action during the emergency to be revised
as often as circumstances warrant.
- Arrange for the mental health needs of team members as the emergency
unfolds making certain that adequate opportunities exist for debriefing
of team members as needed.
- Carry out a detailed review of the emergency response after
it has been concluded and follow up on any unfinished business
of team members.
- When necessary, accept directions from EMO officials on site.
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