Since its inception, consultative relationships have been a cornerstone of CSTS’s mission, including a wide variety of partner organizations both inside and outside government, and internationally. Such collaborations build bridges that provide opportunities to contribute our resources and expertise in the service of others and to monitor real time needs of partners and stakeholders. The following are examples of some of our long-standing consultations as well as some new consultations in 2017.
NATIONAL ASSOCIATION OF STATE MENTAL HEALTH PROGRAM DIRECTORS (NASMHPD)
For more than a decade, CSTS has had a long-standing relationship with NASMHPD, a membership organization representing state mental health authorities (Commissioners). The Commissioners are responsible for directing the public mental health system in their states. The state public mental health systems are largely responsible for preparedness, response, and recovery from many large and small scale disasters. CSTS assists the Commissioners in addressing the many challenges inherent in those systems. Many military families and veterans are served by the state public mental health systems. CSTS and NASMHPD leadership are in frequent contact to share experiences and meet mutual needs.
Following the leadership change at NASMHPD with the appointment of a new Executive Director, the two organizations have continued to be in regular contact and sustain a close partnership. It is common following disasters for the Center to provide unsolicited general and targeted public information to NASMHPD for distribution to impacted states. In addition, it is common for NASMHPD to request help and specialized information and consultation regarding individual events.
SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION (SAMHSA)
SAMHSA is one of the oldest and most important federal partners for CSTS. This relationship goes back to SAMHSA’s founding in 1992. Located within the Department of Health and Human Services, SAMHSA is the lead federal entity responsible for supporting and improving mental health services in the nation. A Center Associate Director continues to serve on the Disaster Distress Helpline (DDH) Steering Committee to provide guidance and feedback to this SAMHSA-funded resource that assists those needing help in their recovery from disasters.
2017 saw continued work between the two organizations including review of documents and programs, in light of changing SAMHSA staffing, and meetings with CSTS leadership to update ongoing collaborative activities and explore additional opportunities.
NATIONAL CENTER FOR DISASTER MEDICINE AND PUBLIC HEALTH (NCDMPH)
In addition to partnering with NCDMPH on the global “Crisis Leadership” symposium, a Center
Scientist was the featured presenter for the first 2017 NCDMPH Webinar series, presenting on “Disaster Behavioral Health: Education Fact Sheets to Enhance Preparedness and Response.” This presentation drew greater participation than any previous NCDMPH webinar with 250+ attendees from over 80 different federal agencies and private entities working in disaster management and public health.
At the request of our partners at the NCDMPH who oversee disaster training for the USU MPH program, two CSTS staff presented an afternoon seminar Critical Concepts in Disaster Behavioral Health” to ten Joint Service, interdisciplinary MPH students. Two members of the Center’s leadership team serve as Associate Editors for the journal Disaster Medicine and Public Health, a publication based in NCDMPH. This partnership within USU continues to develop into an extremely productive one for both entities. Our missions and goals are complimentary and the combined experience and expertise of leaders in both organizations is creating much creative planning. Ongoing partnerships are in development for 2018 and beyond.
CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC)
Two members of the Center’s leadership team participated in an exploratory consultation to five members of the Deployment Risk Mitigation Unit in CDC’s Office of Preparedness and Response. The goal was to learn about that Unit’s mission and needs and to explore the possibility of an ongoing partnership with CSTS. This is a relatively new Unit, formed during the Ebola response, with the primary mission of enhancing the health, safety, and well-being of deployed CDC staff and their loved ones. A wide variety of areas of potential collaboration were explored including research, knowledge consolidation and sharing and organizational and systems consultation from CSTS. Follow-up activities are planned.
AMERICAN PSYCHIATRIC ASSOCIATION (APA)
CSTS has extended its knowledge and reach by working with national medical associations, such as the APA, through education and training on disaster mental health. CSTS helped establish the APA’s Committee on Disaster Psychiatry in 1992, and the Center Director continued this year in his role as Chair of the committee. This year, CSTS Scientists provided formal and informal disaster consultation and education resources to APA District Branches in response to a wide range of disaster events, including the severe hurricanes in Florida, Texas, and Puerto Rico; recurrent wildfires in California; and mass shootings at the First Baptist Church in Texas and the Route 81 concert in Las Vegas.
Consultation services include guidance and resources on enhancing preparedness, response and recovery following disasters. Education fact sheets serve as an important resource for District Branches to assist them in rapidly disseminating critical, time-sensitive, actionable information to reduce distress, optimize well-being, and improve functioning of patients and other community members.
At the APA Annual Meeting, CSTS Scientists presented a workshop on climate-related disasters and mental health, addressing issues such as psychological and behavioral responses, populations most vulnerable to the impacts of climate-related disasters, and evidence-based early interventions to reduce distress and enhance well-being. The audience of 67 psychiatrists from across the globe participated in a series of interactive case-based learning sessions to apply and reinforce content.
At the Annual Conference for the Institute of Psychiatric Services, which was organized by the APA, a Center scientist presented to an audience of 58 international psychiatrists on the mental health aspects and climate-related disasters. The presentation served as a springboard for discussions about how to become more engaged in disaster mental health care and efforts to address mental health effects of climate-related disasters through effective preparedness and response.
NATIONAL CHILD TRAUMATIC STRESS NETWORK (NCTSN)
The Center worked with NCTSN in partnering with the Network’s Military and Veteran Families Program in their efforts to develop and implement trauma-informed, evidenced-based interventions and approaches to military children and families. CSTS also serves as a NCTSN Treatment and Services Adaptation Center (Category II site), which involves providing expertise on specific types of traumatic events experienced by military families, as well as programs and providers that specialize in treatment and services for military communities.
MILITARY CHILD EDUCATION COALITION (MCEC)
The MCEC seeks to identify and address issues specific to children with military connections. A center scientist presented at MCEC’s 2017 annual meeting to discuss military children’s access to mental health services
GLOBAL HEALTH ENGAGEMENT
The Global Health Engagement focus at USU has continued to evolve and solidify over recent years. Following a 2017 USU School of Medicine Strategic Planning meeting to discuss the mission of the School of Medicine as it relates to the DoD’s initiatives in addressing national security, global health and global health engagement, USU decided to consolidate these activities into the USU Center for Global Health Engagement (CGHE). CSTS has worked closely to increase CGHE’s understanding of the roles of CSTS and the Department of Psychiatry, and the Center regularly participates in briefings by CGHE for all relevant USU stakeholders.
In related activities, the Center Scientists provided consultation to the Harvard Program in Refugee Trauma in support of their work with the Syrian American Medical Society and their efforts to remotely supervise Syrian civilian healthcare providers delivering care to combat casualties. The consultation explored issues related to trauma exposure, moral injury, training and supervision in the context of delivering remote healthcare consultation and supervision.
CSTS translated the first two in a series of CSTS disaster education fact sheets into Mandarin. This is to support colleagues, friends, the Chinese-American population, and others following disasters in China (e.g., the Southeast Asian Tsunami). This translation project will ultimately result in 10 disaster education fact sheets translated into Mandarin and Spanish to expand the reach of our disaster preparedness and response education resources.
INTERNATIONAL OUTREACH
The Center sent a scientist to Baghdad, Iraq to support the DoD on a Defense Institute for Medi- cal Operations (DIMO) mission. DIMO facilitates healthcare education and training to international partners by utilizing subject matter experts (SMEs) from the DoD to develop curriculum and teach courses around the world. On this mission, CSTS provided global mental health education and training by sharing the fundamentals of Disaster Psychiatry with the Iraqi Special Forces and the principles of setting up a Military Behavioral Health Care System to military medical leadership. At the same time, the team coordinated efforts with the U.S. assets, helping prioritize future efforts. The 28 participants included seasoned combat medics, new recruits, senior medical officers from the Iraqi Ministry of Defense, and faculty from the Iraqi Military Medical School.
CSTS hosted a delegation of Iraqi mental health practitioners, educators and service providers as part of an International Visitor Leadership Program (IVLP) sponsored by the U.S. State Department. The delegation consulted with Center Scientists on how to support post-war recovery of Iraq, with particular focus on the psychosocial rehabilitation of traumatized children and youth. The participants discussed a variety of complex psycho-social challenges that Iraqi children face, including traumatic exposures, sectarian aggression and violence, as well as inadequate infrastructure to meet their needs. CSTS encouraged programmatic public health approaches to address the problems (e.g., preventive health strategies, school based interventions), discussed trauma-informed evidence based clinical practices and recommended making connections with other large U.S. organizations that address child trauma, such as the federally funded and SAMHSA administered National Child Traumatic Stress Network (NCTSN).
The Center was selected to support the USU U.S. Forces Korea (USFK) task force. The task force provides needs assessment to the military line and medical commands in South Korea to optimize their training and education of medical concerns related to radiologic and nuclear threats. Center Scientists assist with reviewing policy and procedure for enhancement recommendations, as well as providing education and training to personnel to assist USFK in optimizing their preparedness and response efforts in the face of real or threatened radiologic or nuclear events.