December 8, 2006

School disaster response plan formed

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School disaster response plan formed

When a school system is hit by disaster — man-made, like a school shooting, or natural, like a tornado wreaking havoc on a community — it's not just the physical health of the students, faculty and staff that may be at risk, but their mental health as well.

Vanderbilt University Medical Center's Mental Health Center has been awarded a grant from the State Department of Education to work with school systems to be better prepared for a disaster and to develop a network of mental health providers across the state who will be trained to work with faculty, staff and students when a disaster occurs.

It's an extension of what Vanderbilt has been doing informally for quite some time.

Vanderbilt has significant experience integrating mental health services into the schools, and has contracts already in place with various Middle Tennessee school systems with 14 therapists providing services within the schools for school-based therapy. Schools are required to have a disaster mental health plan as part of their larger disaster plan, but Vanderbilt's involvement in putting the network support piece into place, will help make sure that the plans are dusted off and ready to be implemented, if needed.

The grant is called TSP (Tennessee Schools PREPARE). PREPARE is an acronym for: “Providing support. Reaching Educators, Parents/students, And Restoring community with Effective interventions.”

“Informally we've been the agency that the school systems have leaned on to respond locally to these kind of events,” said Michael Cull, M.S.N., associate in Psychiatry and executive director of the Vanderbilt Mental Health Center. For example, in March 2005 when a school bus driver was shot and killed by a 14-year-old male student in Stewart County, the state asked the Vanderbilt group to provide mental health assistance for the faculty and staff of the Stewart county school system. A Vanderbilt team went to Stewart County for three days to debrief teachers and other staff.

“The Stewart County situation was not a mass shooting, but the staff had a high level of fear when we got there,” Cull said. “The word got out that the student who shot the bus driver was coming to one of the schools there, and people were scared. A lot of our work was around that, and many of the staff weren't really available to be supportive of the students because of that,” he said.

In addition, since it was such a small community, and the student who shot the driver had been in school there since elementary school and had a sister in elementary school, the event impacted the entire school community. “Everybody there knew him; they knew the bus driver,” Cull said. “In addition to driving a bus, she was a special ed. assistant at the high school, so there was a tight connection all around, at all the schools.”

The first year of the grant will be spent holding focus groups and getting the word out about the program. Training in school systems will begin next year.

Stephan Heckers, M.D., chair of the Department of Psychiatry, said the grant takes advantage of Vanderbilt's expertise in the area of school-based mental health services. “It's a great example of state government partnering with the academic community to improve services to children,” he said.

Rene Love, M.S.N., A.P.R.N., associate in psychiatry and director of the program, said that the Vanderbilt group will help school staff come up with a plan and a checklist of sorts for when a critical incident occurs, things that may not be in the disaster manual — having phone numbers readily available and a list of key mental health providers in the community to be linked with for support. “We will help provide some structure and organization to train key people in regions who can then provide training on the local level,” she said. “And we will be available to by phone, or to go, if needed,” Love said.

The ideal situation if an event has occurred off campus is to get the faculty and staff together to talk prior to students walking through the door, then to talk to the students with a more prepared staff in place, Love said. “We talk to the staff about how it's affected them, and about what they might see in their students or in themselves that is normal, versus what they might see in someone who needs to be referred for psychotherapy.”

Love said there are many different protocols available for mental health disaster plans. “We are looking at evidence-based protocols to find out what the best practice model is for the state to utilize. But every situation will be different depending on what's going on. We'd like to focus on prevention if we could — never having this happen — but in reality, this does happen,” she said. “So what we have to focus on now is 'are we ready? Are we prepared?'”