Preparedness Planning: Evaluating the Quality of Healthcare Disaster Mental Health Plans

A key component of healthcare emergency preparedness plans is provision for the mental and psychosocial well-being of the healthcare community - workers, patients and their families - during a disaster. To date there have been few efforts to measure the quality of these provisions. In 2006-07, The NYC Department of Health and Mental Hygiene evaluated local hospitals' mental health emergency response plans(MH-ERPs). Here we present a promising method for evaluating MH-ERPs, findings and recommendations.

Twenty-eight MH-ERPs were assessed on six attributes: 1) healthcare community involvement in planning (HCI), 2) integration with Hospital Incident Command Systems (iHICS), 3) utilization of mental health support strategies, 4) provision for supporting staff and patient's family needs, 5) education/training, and 6) additional mental health staff acquisition. Scoring was based on presence and quality of each attribute. Quality was measured in terms of detail and specificity (0=lowest to 4=highest). For example, presence of mental health staff's Job Action Sheets is a key attribute of iHICS; whether these sheets are generic or fitted to the hospital's ICS indicates quality.

90% of plans contained attributes of all six dimensions. HCI was omitted most (73% of MH-ERPs). The average (mean) quality score was 2.35. Quality was greatest in family support planning (mean =3.56) and lowest in planning for staff education and training (mean=2.15).

Hospital MH-ERPs often lack hospital-specific details to make them truly useful. Measuring MH-ERP quality can illuminate hidden strengths and weakness in the healthcare preparedness efforts and provides government with evidence-based direction for funding initiatives.