CIDRAP: HHS experts air mental health planning for pandemic

Lisa Schnirring * Staff Writer
Feb 18, 2009 (CIDRAP News) –

From stigmatization of people exposed to the virus to maintaining methadone treatment facilities, public health officials need to plan for a wide spectrum of mental health challenges that would likely emerge during an influenza pandemic, federal officials said today at a US Department of Health and Human Services (HHS) live Web seminar (webinar).

Dana Taylor, chief of emergency medical services at the Substance Abuse and Mental Health Services Administration (SAMHSA), urged pandemic planners to think more broadly than just how the pandemic events will affect people's feelings and emotions. He said that public perceptions and conclusions will affect their decision-making and behavior, which will be especially important when public health officials need their compliance with social distancing measures and other pandemic-related actions.

Taylor said pandemic planners can work with their communities now to build resilience and can use a process that mental health professionals call "stress inoculation."

"The more an individual knows what to expect, the more mitigation of fear and panic," said Taylor, who suggested that pandemic planners can use prepandemic stages to identify credible and trustworthy leaders who can address the public during a pandemic.

Brian McKernan, a technical assistance team manager at SAMHSA, emphasized that mental health pandemic planning is already well underway in several states, including California, Colorado, Ohio, Texas, and New Jersey. Some have already planned ways to ensure adequate supplies of psychiatric medications for mental health in-patient and outpatient facilities, while others have developed resources to address more general needs such as stress reduction. He also said federal officials have addressed mental health planning in a supplement to the HHS pandemic flu plan.

McKernan urged webinar viewers to consider training people to provide psychological first aid, a well established, practical approach to contacting and engaging people and assessing their mental health needs in an emergency setting. Having these first aid providers will help alleviate the strain on traditional mental health providers during a pandemic, he said, "And it's designed for use by paraprofessionals."

Linda Ligenza, a public health advisor to SAMHSA, said the Red Cross has developed a psychological first aid protocol, adding that each state has a disaster mental health coordinator.

She advised pandemic planners to identify groups ahead of time who might be especially vulnerable to pandemic disruptions, such as frail, elderly people and those with disabilities or chronic illnesses who depend on other people for their care.

The experts also singled out children as another vulnerable group. Taylor urged parents and guardians to use a tone of voice that projects security when talking to children about pandemic topics and limiting the information to age-appropriate topics that they can participate in, such as instructing smaller children about proper hand-washing technique.

"It's vital to limit what they watch on television. They don't need to be overwhelmed by the trauma," he said.

Healthcare workers will also require mental health support, McKernan said. For example, public health officials can plan ahead to ease workers' contact with their families during tough working conditions through Internet chat rooms or message boards. Also, he said healthcare workers and their families might face stigmatization because of possible exposure to the virus.

Taylor said that unlike during the 1918 pandemic, today's public health officials can make creative use of technology to deliver mental health services to wide groups of people during a pandemic.

After a pandemic ends, mental health services will gravitate back to face-to-face interventions focusing on those who were most impacted and suffered multiple losses, the experts said. However, they urged viewers to consider public ways to make a mental health connection after the pandemic, such as convening a community memorial on a pandemic anniversary date.