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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:

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. Arrange for suitable meeting space for team(s) to carry on their work.
  6. 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.
  7. Contact the Committee Chair who will be responsible for informing the APNS Executive of the current situation and ask for guidance if need be.
  8. 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.
  9. Develop daily plans of action during the emergency to be revised as often as circumstances warrant.
  10. 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.
  11. Carry out a detailed review of the emergency response after it has been concluded and follow up on any unfinished business of team members.
  12. When necessary, accept directions from EMO officials on site.

 

Further Reading:


Nature of Services Provided

Committee's Terms of Reference

APNS-EMO Memorandum of Understanding

2001 Annual Report

2002 Annual Report

Reading List and On-line Resources

Post-Trauma Services Home

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