Imperative inclusion of disaster mental health in preparedness exercises: Lessons learned

The exercise of Disaster Mental Health (DMH) skills, a vital element to all disaster response and recovery efforts, is noticeably absent from federal guidelines, documentation, and practice. Specifically, Homeland Security Exercise and Evaluation Program (HSEEP) guidance, designed for localities to effectively test local plans and participate in multi-jurisdictional exercises, contains limited inclusion of disaster mental health activity or interventions. Federal HSEEP guidelines are intended for increased interoperability, but leave out tools that would be appropriate to DMH practice. In order to address this gap, we partnered with Philadelphia's Department of Behavioral Health, the Commonwealth of Pennsylvania, and the four counties local to Philadelphia to implement and evaluate three (3) DMH functional exercises. Using HSEEP guidelines, we developed an evaluation tool that utilized qualitative and quantitative data to assess PFA skills practice, Incident Command, and Communication. This presentation describes the exercise model, which followed the HSEEP protocol for a consistent, comparable, and functional evaluation regardless of scale of exercise. Here we present the results of the evaluation as well as important lessons learned from the adaptation of exercise and evaluation tools: 1) HSEEP materials require modification and specialized development to support the inclusion of disaster mental health exercises, 2) evaluators need specialized training in order to generate reliable observations; and 3) practice of disaster mental health plans and skills prior to a disaster event is imperative for adequate responder preparation. Recommendations for tailoring federal HSEEP guidance for DMH exercises and other highlights of the After Action findings are presented.