Crisis Response

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CRISIS  RESPONSE  & DISASTER  MENTAL  HEALTH 

This section introduces the foundational concepts and presents basic information on crisis response and disaster mental health. The terms crisis response, crisis management, and crisis intervention are discussed and the imperative difference between crisis intervention and treatment is explained. Efforts to organize and prepare at the State level are presented along with disaster mental health standards of care.

Crisis Response
(Crisis Management vs. Crisis Intervention)

Crisis Response refers to all the advance planning and actions taken to address natural and man-made disasters, crises, critical incidents, and tragic events.

Crisis Management is the process by which an organization deals with a major event that threatens to harm the organization, its stakeholders, or the general public. Crisis Management targets the event. It is the planning and actions taken to deal with the actual incident.

Crisis Intervention is emergency psychological care aimed at assisting individuals in a crisis situation to restore equilibrium to their biopsychosocial functioning and to minimize the potential for psychological trauma. Crisis Intervention targets the stress reactions to the event. It is the planning and actions taken to deal with the emotional consequences of the incident. Intervention teams are frequently called Disaster Mental Health Teams, Crisis Response Teams or Critical Incident Stress Management (CISM) Teams.

Crisis Management and Crisis Intervention operations affect each other’s mission. Effective Crisis Management minimizes stress reactions in the aftermath of the event and supports emotional recovery. It is crucial that Crisis Response plans require inclusion and integration of current best practices in the delivery of crisis intervention services by mental health professionals into existing emergency preparedness, response, recovery, and healthcare systems. Crisis Response Teams must fit into the Crisis Management structure and culture. Emergency Operations Centers should have a Crisis Intervention Liaison so Crisis Response Teams can be effectively deployed. Interventions, appropriately selected and applied, support Crisis Management operations.


Model Of Care
(Crisis Intervention vs. Treatment) 

Crisis intervention targets the response, not the event. Thus, crisis and disaster mental health interventions must be predicated upon assessment of need. A critical incident is a sudden, disturbing or unusually challenging event that generates a strong emotional and cognitive reaction (crisis) and has the potential to create significant human distress. It can be a state of intensified arousal accompanied by strong cognitive, physical, emotional, behavioral, and spiritual reactions as a result of the exposure to the critical incident. It can result in a psychological crisis; an acute response to a trauma, disaster, or other critical incident wherein psychological homeostasis (balance) is disrupted, one’s usual coping mechanisms have failed, and there is evidence of significant distress, impairment, and inability to function.

Crisis Intervention is a short-term, acute intervention designed to mitigate the stress reactions associated with a specific incident. It is not psychotherapy, but emotional first aid. Crisis Intervention vs. Psychotherapy Chart

The purpose of Crisis Intervention is to mitigate adverse reactions, facilitate coping and planning, assist in identifying and accessing available supports, normalize reactions to the crisis, and assess capacities and need for further support or referral to the next level of care. The goals of Crisis Intervention are: (1) to stabilize, (2) reduce symptoms, and (3) return to adaptive functioning or to facilitate access to continued care. When these three goals are reached, you’re done!

Crisis Intervention is not a substitute for psychotherapy. Rather, intervention strategies and tactics are elements within the Crisis Response system designed to precede and complement psychotherapy as part of the full continuum of care.

California Disaster Mental Health Coalition (CDMHC)

The California Disaster Mental Health Coalition is a statewide, multidisciplinary organization that assists during disasters through networking, coordination, consultation, and information sharing. CAMFT is the founding member and has been working since 2003 to improve disaster mental health services across disciplines. Three members of the Crisis Response Education and Resource Committee represent CAMFT on the Coalition.

 



California Mental/Behavioral Health Disaster Framework

The Framework provides a comprehensive concept of operations and guidance document to the disaster mental and behavior health community in California. CAMFT was part of the Core Work Group that provided guidance to ensure this document included appropriate and helpful topics and  information, including traditional emergency operations plan elements, recommended actions, and useful references and resources.  See California Mental Behavioral Health Disaster Planning Project.

 

Disaster Mental Health Core Competencies

The former California Department of Mental Health last updated the Disaster Mental Health Core Competencies in 2010. In 2012 the Disaster Framework Core Working Group added the document to Appendix D because there was consensus that the Core Competencies remain comprehensive, widely supported, and set crucial guidelines for the training of disaster mental health service providers in ‘best practices’ and evidence-based interventions. Some additional recommendations were added in Appendix E.