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National Guard Psychological Health

National Guard Psychological Health. National Association of State Mental Health Program Directors 27 JUL 2014. National Guard Manpower. Army National Guard 77% 350,000. Air National Guard 23% 107,000. Majority of Guard members are “traditional” or “part-timers”

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National Guard Psychological Health

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  1. National Guard Psychological Health National Association of State Mental Health Program Directors 27 JUL 2014

  2. National Guard Manpower Army National Guard 77% 350,000 Air National Guard 23% 107,000 • Majority of Guard members are “traditional” or “part-timers” • 80-85% traditional; 15-20% Active Duty (AGR – Active Guard and Reserve – T32 at State level)

  3. DoD Psychological Health Concept

  4. National Guard Status & Benefits SMC – State Military Code WKCMP – Workman’s Compensation

  5. ARNG DPH Status AK VT WA ME ND MT NH MN OR WI MI NY RI ID SD CT WY PA NJ IA DE OH NE NV IN MD IL UT DC WV VA CO CA KS MO KY NC GU TN OK SC AR AZ NM HI GA MS AL LA TX FL Green = DPH Service Yellow = Additional DPH PR VI

  6. ANG DPH Status GSU WING & GSU WING

  7. Transition Assistance Family Programs State and Wing DPHs Service Members & Families Yellow Ribbon Chaplain Support Employer Support State and Wing Guard Teams

  8. NGB INTEGRATED SERVICES DELIVERY MODEL State Coalition HHS VISN Mental Health PHS SFPD DPH Governor’s Office Family Readiness Volunteers Child and Youth Vet Center Federal Services ESGR National Guard Services State Directors Mental Health and Substance Abuse Adjutant General NCA State Directors Of VA NG Chaplains VHA VBA FACs Legal Services National Guard STATE JOINT FORCE HEADQUARTERS Army Community Service Financial Services Training Support MPF/’ MILPO Fed, State, Local & Private Orgs. Services Information VSO Military Medical Community Medical Hold (CBHCO) All assets in support of the NG member and families TRICARE Community Services DoD Services AW2: Army Wounded Warrior Civilian Medical Community Community Mental Health WTU Military Severely Injured Center Air Wounded Warrior Military One Source

  9. NGB Psych Health DOMOPS • Directors of Psychological Health (DPH) have responded to numerous emergencies and disasters since program inception in 2009. • DPHs provide Psychological First Aid (PFA) and Traumatic Event Management (TEM) services. • PFA is the nationally recognized method of providing mental health-related support to those impacted by emergencies and disasters (Red Cross, the VA, etc.). • TEM is the U. S. Army’s method of providing psychosocial support for Service members who have experienced traumatic events, including unit fatalities. • DPHs who have completed training in PFA and TEM are prioritized for deployment to sites of declared emergencies or disasters involving a response by the National Guard.

  10. Psychological First Aid/Traumatic Event Management By July 18, the program will have 78 PFA & TEM-trained professionals. By the end of August, it is anticipated the program will have over 90 PFA/TEM trained professionals. This effort is geographically diverse so that the program will have the capacity to address major incidents in any part of the country.

  11. Washington State: “The Oso Mudslide” Date March 22, 2014 Time 10:37 a.m. Location Oso, Washington Cause Suspected soil saturation from heavy rainfall. Deaths 42 Injuries 4 serious Missing 1 Property damage 49 homes and other structures destroyed http://en.wikipedia.org/wiki/2014_Oso_mudslide BeforeSlide http://www.dailymail.co.uk/news/article-2588991/Incredible-shots-devastation-caused-Washington-landslide-left-14-dead-revealed-geologists-warned-dangers-1999.html

  12. Washington State: “The Oso Mudslide” Impact The March 2014 landslide engulfed 49 homes and other structures in an unincorporated neighborhood known as "Steelhead Haven" 4 mi (6.4 km) east of Oso, Washington.It also dammed the river, causing extensive flooding upstream as well as blocking State Route 530, the main route to the town of Darrington (population 1,347), approximately 15 miles east of Oso.The natural rock and mineral formation (referred to by geologists as a “geological feature") with the most recent activity in the area of Oso is known as the Hazel Landslide; the most recent landslide event is being referred to in the media as "the Oso mudslide".Excluding landslides caused by volcanic eruptions, earthquakes or dam collapses, the Oso slide is the deadliest single landslide event in United States history. http://en.wikipedia.org/wiki/2014_Oso_mudslide After Slide http://www.dailymail.co.uk/news/article-2588991/Incredible-shots-devastation-caused-Washington-landslide-left-14-dead-revealed-geologists-warned-dangers-1999.html

  13. NGPHP After Action Report: OSO Mudslide Response • Background • Mudslide killed 42 people and left many homeless. • National Guard Service Members (N = 400+) responding included both ANG (from both WANG and CONG) and ARNG (WANG) for approximately 3 weeks. • SM responders, working with civilian responders, moved rapidly from rescue operations to recovery. This involved digging up bodies and body parts. • DPHs from WANG, ANG and ARNG deployed to site in rotating schedule • Wing Commanders and ARNG DSS supported DPH response. • State Chaplain requested DPH support to work with on-site Chaplains. • NGPHP Leadership coordinated efforts with civilian and National Guard leadership • Provided DPHs with American Red Cross manuals on assisting those who are coping with mass casualty recovery operations. • Regular Behavioral Health Situation Reports (BH-SITREPs) were provided to NGB by the DPHs addressing their experiences and recommendations • Chaplains played major role on the scene addressing support needs for SMs, but did not always include DPHs in a coordinated effort.

  14. Lessons Learned • Psychological Health support to National Guard disaster response include: • DPHs need contact with their state mental health agency officials responsible for implementation of ESF 8 to determine how DPHs fit into state plans. • DPHs from both ANG and ARNG within a state/territory must communicate and develop a coordinated plan regarding how they will work together in the event of a local emergency/disaster. • Wing and NG medical authorities responsible for force health support need to coordinate with Chaplains on how DPHs will be integrated into the response process. • Development of a psychological screening process for responders, detecting who might have a problem with responding to this type of incident. • Development of a system to identify SMs who were exposed to traumatic scenes to provide for targeted follow up.

  15. Lessons Learned • Communication from NBG to local National Guard officials • Development of ANG and ARNG joint response teams. The size of the on-site team would be negotiated relative to the scope of the incident and number of SMs deployed. Additional considerations include: • DPHs licensed in the state, but not in-state DPHs, may serve as back-ups to the DPHs when short staffed. • BHO’s, as available, may also be included in the rotational system. • The contractor will arrange for transportation, per diem and lodging costs for DPHs. • Actual DPH service hours will be adapted to DPH’s personal schedule and limitations. The model used is based on the Red Cross system, which would have staff working a typical shift of 8 hours, but no more than 12 hours. • Length of deployments for one week with a period of overlap for orientation for the oncoming DPH. • Pre-deployment briefings to provide SMs with normal/expected psychosocial reactions to disasters. • Planned visits to, or near, the site as essential to understand what SMs were dealing with on a daily basis. • Creative recommendations to assist SMs after returning from the site to the Readiness Center, including arranging for “comfort dogs” and massages by local massage therapists for responders.

  16. Psychological Health Relative to the ARNG MEDOPS Planning Model The ARNG Surgeon’s Office Domestic Operations phase-oriented model for response to emergencies and disasters summarized:

  17. Future Focus: NGB Psychological Health • NG Psychological Health: Long-term and Enduring Program • Joint Staff: High Risk Behavioral Health Working Group • Office of the Vice-President: Working Group on Military MH and SP • CNGB Top-Down security Review: Psychological Health • NGB-VA MOU: NGCC Notification for high risk cases • Psychological Health for DOMOPS event National Guard responders

  18. RADM Joan Hunter, NGB JSG-PH joan.f.hunter.mil@mail.mil LTC Laura Wheeler, ARNG Laura.a.wheeler.mil@mail.mil Lt Col Darrick Cunningham, ANG Darrick.cunningham@ang.af.mil

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