Intervention Response Plan

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The local police have asked our team develop an Interagency Mental Health and Crisis Intervention Response Plan that includes local, state, and federal crisis intervention agencies and other emergency and private resources for the purpose of responding to a terrorist event or natural disaster. The chief has informed you that he is concerned that many cities, including his own, do not have a written mental health response plan for critical incidents.

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Critical Incidents & EffectsCritical IncidentsAccidental Shootings of InnocentWrongful IncarcerationsPhysical EffectsDamaging to Police DepartmentsFinancial EffectsCostly LawsuitsSocietal EffectsDistrust in Police Departments

**Critical incidents that could occur by not having a mental health and crisis intervention team can be, but are not limited to, accidental shootings of the mentally ill or wrongful incarceration of the mentally ill. When a police officer or police department does not have the knowledge on how to address a situation that involves a person who is mentally ill, the situation can escalate quickly. Police officers who are not trained can cause a situation to become potentially deadly on accident because defusing a mentally ill person can be different from defusing a person who is mentally sane. In the event that an incident does turn deadly, especially when it is an officer who shoots a mentally ill individual, the physical effects are damaging to the police department because the community may lose faith and trust in their officers, and finacially, the police department may be sued for wrongful deaths or shootings.

Physical, Financial, & Societal EffectsEffects VictimsFirst RespondersCommunitiesPlan for the CrisisSpend More Effort, Time, & Money on Education of Police Officers, Fire Fighters, and Departments

**The physical, financial, and societal effects of a mental health crisis is not limited to the police officers and their departments. When a crisis happens where someone is shot or killed, the effects are felt by victims, first responders and the community. The victim in such a situation is not limited to the person who was injured or killed, the victims are the family and friends. These people are now faced with a financial cost of planning and preparing a funeral or paying expensive medical bills. The first responders in these situations may also face a problem with remorse, guilt, and shame. The communities also suffer because they have lost a friend, family member, neighbor, or co-workers. In the event that something tragic happened, it would be the goal of the committee to spend extra time, money, and resources to educate the community, police officers, firefighters, and any other city departments that respond to crisis situations.

HUMAN SERVICE DELIVERY ORGANIZATIONSFederalNational Alliance on Mental Illness (NAMI)Community mental health legislationCrisis response servicesEarly identification & interventionAdapt AmericaCrisis Hotline (7 days/24 hr.)Mobile Crisis outreach teamsMobile Crisis response technologySuicide prevention

**The NAMI organization has develop many plans for mental illness interventions. They conduct yearly seminars which are given to parents who have children in school, regarding mental health, depression, and suicide awareness. They have established a 24-hour hotline to perform assessment and referrals. They also have walk-in crisis services and crisis stabilization units with the capacity for immediate clinical intervention, triage and stabilization. They have mandatory training requirements in many states for suicide assessment, treatment, and management (National Alliance on Mental Illness, 2013).Adapt America offers many services including the mobile crisis response technology. This technology software is used to support the mobile crisis response team. It provided tools to incorporate crisis phones, application, email, smart phones and GPS tracking devices to deliver the right information to the right people at the right time. They also offer suicide prevention, which aims to identify and provide services to people who are at high risk for suicidal behavior (Adapt America, 2009).

HUMAN SERVICE DELIVERY ORGANIZATIONSLOCALSTATECrisis Preparation & Recovery Inc. (CPR)Critical incident stress management24 hr. crisis service to hospitalsCrisis management servicesMedication management

Banner Psychiatric CenterProvides Crisis Intervention (7 days/24 hrs.)Use of Crisis associatesAccess to basic needs (Medication, food)Referrals (Ongoing mental health services & other community resources)

**The Banner Psychiatric Center provides crisis intervention services seven days a week, 24 hours a day. Their center offers an observation area for patients and is always staffed with psychiatric providers, nurses, behavioral health technicians, and crisis interventionists. There is always at least one psychiatric provider on duty to provide face-to face assessments and crisis counseling. They offer the basic needs of the patient such as medication and food. They also provide referrals to ongoing mental health services and other community resources (Banner Behavioral Health, 2014).The Crisis Preparation and Recovery Inc. (CPR) offers disaster crisis management consulting. They offer great experience in Emergency Management, Emergency Operations Plan development and Shelter Management. This is all done in compliance with ADA and FEMA standards. This organizations medical staff is highly prepared and trained to handle any medical issues and is on stand 24 hours a day to help assist ( Crisis Prevention and Recovery, Inc., 2013).

Crisis InterventionPersonal Loss: Bereavement and GriefDuring Crisis the most heart break mind altering affect is often the loss of a loved one.

Types of LossDeath of a SpouseLoss Due to Care-givingDeath of a ChildBereavement in ChildhoodTraumatic Death/Traumatic Grief

**When encountering many different crisis situations from natural disaster to everyday activities the greatest loss we face is the loss of a loved one. This may lead to stress, trauma and/or grief. The members of the IRT will encounter many varying situations in which the personal loss will be involved in the incident.

Bereavement is a period of sorrow following the death of a significant other (Humphrey, 2009, p. 6). It is an objective state or condition of deprivation that is especiallycaused by death and is then followed or accompanied by grief. (James & Gillilans, 2013)

Grief is a psychic state or condition of mental anguish or emotional suffering and a result or anticipation of the bereavement (Pine, 1996). Grief is highly unique and multidimensional; a persons affective, behavioral, and cognitive makeup and the contextual and ecosystemic influences that operate on it dictate what the grief experience will be. (James & Gillilans, 2013)

Death of a Spouse is an unimaginable loss that seems almost impossible to describe. This type of loss may leave a feeling of numbness as well as physical & emotional pain.Loss of a love one in which caregiving was involved such as spouse or parents Caregiving is a major issue for spouses and parents. Such a loss can be a great burden on the other in addition to typical grievance. For example, an individual who losses their caregiver may feel lost without the assistance; whereas, an individual who loses the individual they have been providing care for is also facing a create life changing event in addition to the emotional disturbance caused by death.Death of a Child is potentially the greatest and hardest loss to endure as natural parents expect and want their children to outlive them as this is the normal cycle of life.Children who experience the death of a parent or sibling may show overt signs of bereavement, but sometimes their grief may be covert, leading caregivers to assume that the children are not affected by the loss.Traumatic Death or sudden unexpected death from incidents such as vehicular accidents, murder or some other cause of sudden death increase the complications involved in the mourning process.

Crisis InterventionPersonal Loss: Bereavement and GriefThe Dual Process Model1. Identify and explore both loss and restoration stressors and the

specific avoidance and confrontation responses the client uses.2. Keep in mind that an initial period when the client is fixed in a loss

orientation is normal. Identify evidence (or lack thereof) of oscillation as time moves forward.3. Normalize and validate the dual process model by explaining how

it works and why it applies to the clients particular situation.4. Address problematic avoidance such as excessive alcohol/drug

use, extreme denial, suppression of emotion, or acting out.5. Do not push clients toward restoration. Let the oscillation work.

**The dual process model is a method in which mental health issues are addressed immediately upon contact to sure empathetic response toward victims and/or survivors. This process also assist the individual in dealing with every stage of mourning with the exception of restoration as it is necessary for the individual to find their own path to restoration. Such a process will be extremely effective in an incident which involves loss by death, to include incidents of natural disasters, man-made-disasters, and even acts of terrorism in which multiple deaths occur often.

What the specific crisis response duties of those individual organizations will be in the event of a terrorist attack Phases of duties

**Terrorist incidents may include a sequence of timed events intended to create further harm, often against those responding to help the initial victims. Terrorist events may be accompanied by armed resistance, the use of weapons, booby traps or other secondary events.Law enforcement personnel cant be everywhere all the time. Informed and concerned citizens can take a proactive role in helping to make their community a safer place. The major role of the organization would be to deal with the victims following the immediate aftermath of a terrorist attack. The organization will be responsible for the pre-event phase, the emergency phase, the intermediate phase and the long term phase.

Emergency crisis response plan must address: The Golden Hour - take the lead; delay equals denialWaves of Response- police/medical- media- parents- looky-loos & gawkers; super-heroes; cottage industry typesFirst 24 hoursDuration of crisisRebuilding/Recovery

**Fires, explosions and hazardous material released, whether caused by a terrorist incident, natural or technological disaster are always dangerous situations. The team will have to act as first responders and assist with things such as:Public safety to coordinate incident responseTake control until cavalrys arrival Assist individuals in harms way to safetyDeny entry to unauthorized personnelEstablish perimeters and operational zonesLearn and initiate Incident Command SystemEstablish a safe refuge for the publicBegin media control

The first twenty four hours after a terrorist attack are the most scariest and crucial times for victims. They will need immediate assistance in order to maintain public health and safety concerns.

Emergency crisis response plan must address: Prevention & Intervention (mitigation)- steps to reduce or eliminate risk to life and propertyPreparedness- process of planning a rapid, coordinated and effective responseResponse- action steps to take during a crisisRecovery- restoring the teaching and learning environment after a crisis; must include mental health recovery

**According to "Fema" (1999),Crisis management refers to measures to identify, acquire, and plan the use of resources needed to anticipate, prevent, and/or resolve a threat or act of terrorism. The Federal Government exercises primary authority to prevent, preempt, and terminate threats or acts of terrorism and to apprehend and prosecute the perpetrators. Consequence management refers to measures to protect public health and safety, restore essential government services, and provide emergency relief to governments, businesses, and individuals affected by the consequences of terrorism. ("Fema", 1999) The main purpose of terrorist is to cause bodily harm as well as mental harm to the victims. The response team has to be able to address the mental health needs of the victims on a short and long term basis. The major way that we can fight back is to rebuild immediately, not just building but our individual selves.

*The psychological response is one of the most important factors to one that a crisis intervention team needs to focus on when concentrating on the help in the mental status of individuals that are affected with disaster areas. The recommended approach is to have the most mental assistance facilities and response teams available to respond more efficiently to disaster areas. The pictures above represent the community that should ban together, lend a helpful hand, and often times are hard to the signs pf help that are being represented.

REFERENCESAdapt America.(2009).Retrieved from http://www.adaptusa.com/emercrisisservices.phpBanner Behavioral Health.(2014).Retrieved from http://www.bannerhealth.com/Locations/Arizona/Banner+Behavioral+Health/Services/Emergency+Services+and+Behavioral+Crisis/Banner+Psychiatric+Center.htmCrisis Prevention and Recovery, Inc..(2013).Retrieved from http://cpr.mtninet.com/FEMA Rapid Response Information System http://www.rris.fema.gov FEMA. (1999). Retrieved from http://www.au.af.mil/au/awc/awcgate/frp/frpterr.htmJames, R. & Gillilans, B. (2013). Crisis Intervention Strategies, Seventh Edition. ISBN: 9781111186777National Alliance on Mental Illness.(2013).Retrieved from http://www.nami.org/Content/NavigationMenu/State_Advocacy/Tools_for_Leaders/2013StateLegislationReportFinal.pdf

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**Critical incidents that could occur by not having a mental health and crisis intervention team can be, but are not limited to, accidental shootings of the mentally ill or wrongful incarceration of the mentally ill. When a police officer or police department does not have the knowledge on how to address a situation that involves a person who is mentally ill, the situation can escalate quickly. Police officers who are not trained can cause a situation to become potentially deadly on accident because defusing a mentally ill person can be different from defusing a person who is mentally sane. In the event that an incident does turn deadly, especially when it is an officer who shoots a mentally ill individual, the physical effects are damaging to the police department because the community may lose faith and trust in their officers, and finacially, the police department may be sued for wrongful deaths or shootings. **The physical, financial, and societal effects of a mental health crisis is not limited to the police officers and their departments. When a crisis happens where someone is shot or killed, the effects are felt by victims, first responders and the community. The victim in such a situation is not limited to the person who was injured or killed, the victims are the family and friends. These people are now faced with a financial cost of planning and preparing a funeral or paying expensive medical bills. The first responders in these situations may also face a problem with remorse, guilt, and shame. The communities also suffer because they have lost a friend, family member, neighbor, or co-workers. In the event that something tragic happened, it would be the goal of the committee to spend extra time, money, and resources to educate the community, police officers, firefighters, and any other city departments that respond to crisis situations.**The NAMI organization has develop many plans for mental illness interventions. They conduct yearly seminars which are given to parents who have children in school, regarding mental health, depression, and suicide awareness. They have established a 24-hour hotline to perform assessment and referrals. They also have walk-in crisis services and crisis stabilization units with the capacity for immediate clinical intervention, triage and stabilization. They have mandatory training requirements in many states for suicide assessment, treatment, and management (National Alliance on Mental Illness, 2013).Adapt America offers many services including the mobile crisis response technology. This technology software is used to support the mobile crisis response team. It provided tools to incorporate crisis phones, application, email, smart phones and GPS tracking devices to deliver the right information to the right people at the right time. They also offer suicide prevention, which aims to identify and provide services to people who are at high risk for suicidal behavior (Adapt America, 2009).

**The Banner Psychiatric Center provides crisis intervention services seven days a week, 24 hours a day. Their center offers an observation area for patients and is always staffed with psychiatric providers, nurses, behavioral health technicians, and crisis interventionists. There is always at least one psychiatric provider on duty to provide face-to face assessments and crisis counseling. They offer the basic needs of the patient such as medication and food. They also provide referrals to ongoing mental health services and other community resources (Banner Behavioral Health, 2014).The Crisis Preparation and Recovery Inc. (CPR) offers disaster crisis management consulting. They offer great experience in Emergency Management, Emergency Operations Plan development and Shelter Management. This is all done in compliance with ADA and FEMA standards. This organizations medical staff is highly prepared and trained to handle any medical issues and is on stand 24 hours a day to help assist ( Crisis Prevention and Recovery, Inc., 2013).

**When encountering many different crisis situations from natural disaster to everyday activities the greatest loss we face is the loss of a loved one. This may lead to stress, trauma and/or grief. The members of the IRT will encounter many varying situations in which the personal loss will be involved in the incident.

Bereavement is a period of sorrow following the death of a significant other (Humphrey, 2009, p. 6). It is an objective state or condition of deprivation that is especiallycaused by death and is then followed or accompanied by grief. (James & Gillilans, 2013)

Grief is a psychic state or condition of mental anguish or emotional suffering and a result or anticipation of the bereavement (Pine, 1996). Grief is highly unique and multidimensional; a persons affective, behavioral, and cognitive makeup and the contextual and ecosystemic influences that operate on it dictate what the grief experience will be. (James & Gillilans, 2013)

Death of a Spouse is an unimaginable loss that seems almost impossible to describe. This type of loss may leave a feeling of numbness as well as physical & emotional pain.Loss of a love one in which caregiving was involved such as spouse or parents Caregiving is a major issue for spouses and parents. Such a loss can be a great burden on the other in addition to typical grievance. For example, an individual who losses their caregiver may feel lost without the assistance; whereas, an individual who loses the individual they have been providing care for is also facing a create life changing event in addition to the emotional disturbance caused by death.Death of a Child is potentially the greatest and hardest loss to endure as natural parents expect and want their children to outlive them as this is the normal cycle of life.Children who experience the death of a parent or sibling may show overt signs of bereavement, but sometimes their grief may be covert, leading caregivers to assume that the children are not affected by the loss.Traumatic Death or sudden unexpected death from incidents such as vehicular accidents, murder or some other cause of sudden death increase the complications involved in the mourning process. **The dual process model is a method in which mental health issues are addressed immediately upon contact to sure empathetic response toward victims and/or survivors. This process also assist the individual in dealing with every stage of mourning with the exception of restoration as it is necessary for the individual to find their own path to restoration. Such a process will be extremely effective in an incident which involves loss by death, to include incidents of natural disasters, man-made-disasters, and even acts of terrorism in which multiple deaths occur often.**Terrorist incidents may include a sequence of timed events intended to create further harm, often against those responding to help the initial victims. Terrorist events may be accompanied by armed resistance, the use of weapons, booby traps or other secondary events.Law enforcement personnel cant be everywhere all the time. Informed and concerned citizens can take a proactive role in helping to make their community a safer place. The major role of the organization would be to deal with the victims following the immediate aftermath of a terrorist attack. The organization will be responsible for the pre-event phase, the emergency phase, the intermediate phase and the long term phase.**Fires, explosions and hazardous material released, whether caused by a terrorist incident, natural or technological disaster are always dangerous situations. The team will have to act as first responders and assist with things such as:Public safety to coordinate incident responseTake control until cavalrys arrival Assist individuals in harms way to safetyDeny entry to unauthorized personnelEstablish perimeters and operational zonesLearn and initiate Incident Command SystemEstablish a safe refuge for the publicBegin media control

The first twenty four hours after a terrorist attack are the most scariest and crucial times for victims. They will need immediate assistance in order to maintain public health and safety concerns.**According to "Fema" (1999),Crisis management refers to measures to identify, acquire, and plan the use of resources needed to anticipate, prevent, and/or resolve a threat or act of terrorism. The Federal Government exercises primary authority to prevent, preempt, and terminate threats or acts of terrorism and to apprehend and prosecute the perpetrators. Consequence management refers to measures to protect public health and safety, restore essential government services, and provide emergency relief to governments, businesses, and individuals affected by the consequences of terrorism. ("Fema", 1999) The main purpose of terrorist is to cause bodily harm as well as mental harm to the victims. The response team has to be able to address the mental health needs of the victims on a short and long term basis. The major way that we can fight back is to rebuild immediately, not just building but our individual selves.*The psychological response is one of the most important factors to one that a crisis intervention team needs to focus on when concentrating on the help in the mental status of individuals that are affected with disaster areas. The recommended approach is to have the most mental assistance facilities and response teams available to respond more efficiently to disaster areas. The pictures above represent the community that should ban together, lend a helpful hand, and often times are hard to the signs pf help that are being represented.*