Mental Health

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SUBCOURSE MD0549 PSYCHOSOCIAL ISSUES: You, as a medical specialist, will find that each patient or casualty is a unique individual with his own specific problems and his own ways of attempting to deal with those problems. The lessons present psychosocial issues that will involve you directly. Being able to cope with these issues and to provide medical care are initial steps in your career.

FM 4-02-51 Combat and Operational Stress Control In our own Soldiers and in the enemy combatants, control of stress is often the decisive difference between victory and defeat across the operational continuum. Battles and wars are won more by controlling the will to fight than by killing all of the enemy combatants. Uncontrolled combat stress causes erratic or harmful behaviors, impair mission performance, and may result in disaster and defeat of COSC preventive measures. The COSC preventive measures are aimed at minimizing maladaptive stress reactions while promoting adaptive stress reactions, such as loyalty, selflessness, and acts of bravery. This manual provides doctrinal guidance for controlling excessive stress in combat and other operational environments. It identifies command and leadership responsibilities for COSC. It identifies COSC consultation, training, and education assistance available for units. This manual provides definitive guidance to BH personnel and CSC units for their COSC mission and for management of COSR and other behavioral disordered patients (BDPs). It identifies the requirements for COSC consultation, planning, coordination, rehearsal, and implementation of the COSC plan contained in the FHP annex of the operation order (OPORD).

Grief – Finding Your Way to Hope by Cynthia J. Koelker, MD ~ Grief – likely to be the primary emotion if the world around us collapses. Sure, everyone understands unhappiness, possibly even misery. But until you’ve gone through gut-wrenching loss and subsequent recovery, you cannot speak about grief knowledgeably.

Mental Health Emergencies Policies and Procedures This is a policy guideline for UW-Whitewater University, but contains some good information on identifying and reacting to psychologically aberrant behavior. [Link recovered 6/22/11]

Mental Health in Tough Times – Part I by Cynthia J. Koelker, MD ~ Any survivor of the Great Depression or of the Second World War will confirm that if one is lucky-enough to live through such an experience, one is still permanently scarred and unalterably changed for the rest of one’s life. Today, the times in which we live are difficult and uncertain, and the optimism for which Americans have long been famous has often been replaced by doubt and pessimism. As the 9.0 magnitude quake and tsunami in Japan have shown, reality can be very grim at times. How are we to cope with such things? What can you and your loved ones do to protect yourself against the hardships of daily life, but also for those disastrous “black swan” events? There are many answers to that question, but one of the most important is staying strong mentally and emotionally. Let’s review some of the ways available to us for attaining that goal. See also: Mental Health in Tough Times – Part I

Coping with Mental Health Crises and Emergencies Province of British Columbia, Canada, fact sheet with some info on overdoses and "How Families Can Help in a Mental Health Emergency." See Also: Alzheimer's Disease and Related Dementia; Anxiety Disorders; Bipolar Disorder; Childhood Sexual Abuse: A Mental Health Issue; Children, Youth and Mental Disorders; Depression; Mental Disorders, Addictions and the Question of Violence
[All links recovered 6/22/11]

Use Of Police And 911 For Mental Health And Psychological Emergencies Revised: By Michael G. Conner, Psy.D, Clinical, Medical & Family Psychologist: Not knowing when and how to involve 911, police and EMS is the main reason things don't go well. Familiarize yourself with how these community services work. The role of police and 911 when dealing with mental health and psychological emergencies is an extremely important public service. Few people appreciate how difficult and important the job is until they need help. Television reenactments and docudramas portray these jobs with an element of truth, but these jobs are far more complex and involve issues that the media never encounter. Unfortunately, the public's expectations and assumptions are invariably mistaken about what can or will happen when 911, Police or EMS are called upon to deal with mental health and psychological emergencies. Understanding what happens, and what can happen, may help if you ever anticipate the need to call 911, the police or EMS for assistance.

Emotional Rescue: Managing Meltdowns Psychological emergencies involving drugs -- hallucinogens, stimulants, and marijuana, primarily, but any other drug (or even no drug at all) will do in a pinch -- probably account for more crisis problems than physical overdoses and toxic reactions put together. Although drug-induced psychological crises are rarely fatal, they can be unpleasant -- and result in toxic memories and fears that can last a lifetime. They do, that is, unless an experienced person is around to help someone on the business end of a drug freak-out or other personal crisis to re-contextualize his or her fears and re-channel the experience...

Fun-to-read and factual, Do It Now pamphlets clarify the issues and point out options in the real-world choices that confront us all. For general audiences (high school & up), except where noted.

Suicide Reference Library The articles in the Suicide Reference Library are sorted into four sections. Suicide: Articles specifically about suicide: Theories, facts and information. Awareness: Articles about issues peripheral to suicide, including religious, social, historical, and social. Support: Articles offering help specifically for those who mourn the death of someone by suicide, and for those who reach out to help them. Education: Articles that discuss a variety of topics related to preventing and understanding suicide.

Psychological Intervention For Unresolved Grief By Edward J. Callahan, Ph.D.: The current paper grows out of treating unresolved grief in primary care, but treatment would be similar across settings. Treatment of unresolved grief reflects how grief is conceptualized. The intervention described here stems from a behavioral conceptualization of grieving. [Now only available in PDF format as part of Newsletter - see page 11]

"Early Psychological Intervention (EPI) Points of Consensus Document" NOVA is pleased to announce that we, along with our primary partners who provide Early Psychological Intervention (EPI) and spiritual care for victims and survivors of crimes and disaster, have jointly released an historic document (PDF) outlining our points of understanding and agreement. This document came into existence as a joint effort supported by the Emotional and Spiritual Care Committee of the National Voluntary Organizations Active in Disaster (NVOAD).

How to Get Help After A Victimization It can be helpful to take proactive steps in an attempt to prevent crime and to be better prepared for the effects of crime, should one occur. This information provides a brief introduction to a fairly complex subject, so it does not address all the factors that are relevant to the needs of all crime victims. Hopefully, the information will help you to use creative and effective methods to address the victimization.

COPING WITH DISASTERS [PDF] This manual outlines a variety of psychosocial interventions aimed at helping people cope with the emotional effects of disasters. It is intended for use by mental health workers, primary medical care workers, disaster relief workers, teachers, religious leaders, community leaders, and by governmental and organizational officials concerned with responses to disasters. It is intended as a field guide or as a basis for brief or extended training programs in how to respond to the psychosocial effects of disasters. [Link recovered 6/22/11]

Mental Health Response to Mass Violence and Terrorism: A Training Manual.: U.S. Department of Health and Human Services. DHHS Pub. No. SMA 3959. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, 2004. This manual contains "the basics" of what mental health providers, crime victim assistance professionals, and faith-based counselors need to know to provide appropriate mental health support following incidents involving criminal mass victimization. The manual is primarily for mental health professionals, yet all service providers will find much of the material to be useful. Program planners, administrators, and clinical supervisors must acquaint themselves with the information in this manual to develop mental health response programs, respond to emerging issues and needs, and address clinical challenges. Psychological support and treatment, crime victims' services, and spiritual guidance and support are essential components of a crisis response. Mass acts of violence and terrorism commonly have widespread community impacts as well. Mental health intervention targets affected individuals and families as well as the larger community. [Link recovered 6/22/11]

"Stress" Chapter 21 from the NOLS Wilderness Med. Book - Contains vital info on psychology of survival for both the rescuer and survivor. Includes recognition, reactions, treatment & management. Must read for any group leader!!

Post Disaster Stress Management (Report following Hurricane Keith in Belize, SA) The objectives were: To provide effective counseling for individuals affected directly or indirectly by a disaster in order to prevent or alleviate any psychological problems; To be psychologically equipped to cope in the healthiest way possible; To conduct an assessment of the mental health needs of post-disaster survivors.

Insights Into The Concept Of Stress The repeated exposure of emergency response personnel to disaster situations have a potentially deleterious effect on their psychological well-being, what can greatly affect the overall outcome of such situations, including the prognosis of the primary victims of the event. This workbook and its companion, Stress Management in Disasters, were designed to provide the basic training material for persons who will be providing such a service.

Stress Management In Disasters Along with its companion workbook, Insights into the Concept of Stress, this book was designed to provide the basic training material for persons who will be providing assistance in disaster situations, because they are themselves repeatedly exposed to very stressful situations.

Disaster Psychiatry Handbook - Guidelines written after the OK bombing. "The purpose of this article is to give the Oklahoma Psychiatric Association's perspective of the disaster and how we as an organization attempted to cope and assist Oklahoma in it's recovery. I have attempted to organize this experience in an outline form so other District Branches of the American Psychiatric Association may gain from our experience in developing programs that can be utilized in their areas when disasters occur. Although each disaster is different, it is my hope that others will be able to learn from our failures and successes."

Post-traumatic Therapy. Originally appeared in Psychotherapy, 28 (1), 5-15. [Spring 1991] Republished first in Wilson & Raphael's (1993) International Handbook of Traumatic Stress Syndromes and later in Everly & Lating's (1995) Psychotraumatology. This clinical article gives a detailed description of Frank Ochberg's approach towards therapy with trauma patients, and should be helpful to any clinicians working with this population. Individual sections discuss fundamental principles and techniques of posttraumatic therapy, including: education, discussing psychobiology, promoting holistic health, and psychotherapy. Two Appendices list proposed diagnostic criteria and symptoms for victimization disorder as a subcategory of traumatic stress.

Introduction to Survival Strategies. This is a version of an important chapter from Valent's 1998 book, From Survival to Fulfillment: A framework for the life-trauma dialectic, published in Philadelphia by Bruner/Mazel. Paul Valent describes eight survival strategies in response to trauma -- "stress responses which include specific adaptive and maladaptive, biological, psychological and social constituents". Valent's survival strategies evolved as discrete phylogenetic templates to aid survival following specific stressors. Together, survival strategies offer a framework for categorizing classes of traumatic responses and events beyond PTSD's typical fight or flight responses. When trauma responses are unsuccessful, this framework may also help clarify differences important in treatment. [Link recovered 6/22/11]

DISASTER RESPONSE AND RECOVERY: A HANDBOOK FOR MENTAL HEALTH PROFESSIONALS by Diane Myers, R.N., M.S.N. Monterey, California

Helping Children Cope with Disaster (FEMA) Disaster may strike quickly and without warning. These events can be frightening for adults, but they are traumatic for children if they don't know what to do. Download as pdf from SSRsi site.

FEMA FOR KIDS: RESOURCES FOR TEACHERS -- How to Talk to Children about the Threat of Biological Warfare or Terrorist Attack While FEMA advocates discussing the threat of natural disaster with children, and emphasizing what actions they should take to protect themselves - getting under heavy furniture in the event of an earthquake, for example - it is often much more difficult to talk about the threat of biological warfare or terrorist attack. The following information is provided by Dr. Lennis G. Echterling; from the Department of Psychology at James Madison University, in Virginia.

Exercise Helps Keep Your Psyche Fit -- Research shows exercise to be a viable, cost-effective treatment for depression and may help in the treatment of other mental disorders.

Stress Management Stress is the "wear and tear" our bodies experience as we adjust to our continually changing environment; it has physical and emotional effects on us and can create positive or negative feelings. As a positive influence, stress can help compel us to action; it can result in a new awareness and an exciting new perspective. As a negative influence, it can result in feelings of distrust, rejection, anger, and depression, which in turn can lead to health problems such as headaches, upset stomach, rashes, insomnia, ulcers, high blood pressure, heart disease, and stroke. With the death of a loved one, the birth of a child, a job promotion, or a new relationship, we experience stress as we readjust our lives. In so adjusting to different circumstances, stress will help or hinder us depending on how we react to it.

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