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All-Hazards Mental Health

All-Hazards Mental Health. Michael T. “Mick” Maurer, PhD, MHA Department of Applied Psychology, NYU Steinhardt School of Education And

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All-Hazards Mental Health

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  1. All-Hazards Mental Health Michael T. “Mick” Maurer, PhD, MHA Department of Applied Psychology, NYU Steinhardt School of Education And Business Continuity and Homeland Security Certificate Program The Center for Management Division of Business and Legal Studies NYU School for Continuing & Professional Studies 

  2. www.mickmaurer.com

  3. Short-term temporal perspectives of contemporary New Jerseyans • “We should never talk about what we will do in 100 years; it is too far off to be dealt with.”Mayor of a New Jersey coastal municipality, 1997 • “Let's hold off on major (hazard land use) policy decisions for the next 40 or 50 years.”President of a NJ property owner lobbying group, 1997 www.mickmaurer.com

  4. New Jersey’s natural hazards 1883 Newark blizzard 1917 South Cape Maycoastal storm 1955 flood Blairstown2002 Pine Barrensfire 2002 drought Boonton Reservoir www.mickmaurer.com

  5. Hazard = f(Risk, Exposure, Resistance, Resilience) Risk(e.g. tropical storm-driven waves at Belmar)Exposure “ …recent population increases, as evidenced by the 2000 census, result in more people and property at risk from (New Jersey’s) coastal hazards. With the prospect of accelerated rates of sea level rise, this vulnerability is likely to increase." • ResistanceResilience (Strathmere geotextile tube under dunes) The post-disaster ability to return to a pre-existing state or to achieve a new desired state; sometimes indexed by speed of recovery www.mickmaurer.com

  6. NJ’s Major 20th C Natural Disasters www.mickmaurer.com

  7. NJ FEDERAL DISASTER DECLARATIONS 1992-99Note: “90% of the disasters that occur in the U.S. do not result in a Federal Disaster declaration. ” National Conference of Insurance Legislators, 2002 www.mickmaurer.com

  8. A worsening burden of hazard • Record-settingdisaster costs • Tropical Storm Floyd (1999) - >$1.0 Billion • Repeat of 1903 Passaic floods estimated - $3.5 Billion • Larger numbers ofimpacted people • Recent drought emergency orders affected NJ’s 8 million+ residents for weeks to months • Ocean County storms now affect population >2,500% larger than 1900 • Unprecedentedlevels of disruption • Airport & highways closings affect region & nation www.mickmaurer.com

  9. Population Change: A Driver of Exposure www.mickmaurer.com

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  11. 20th Century Hazard Trends • Drought & floods • Worsened; urbanized; spreading statewide • Blizzards • Declined; urbanized; becoming aestheticizedperformances and communal catharses • Forest fires • Reconfigured; more numerous but smaller; more human-caused; worsened at forest edges; continuing catastrophe potential • Coastal storms • Sensitized fear of hurricanes but other storms more common and more destructive www.mickmaurer.com

  12. Droughts www.mickmaurer.com

  13. Urban drought perceived as an increasing policy problem • 1895 - No newspaper reports • 1915 - Handful of reports about crops • 1930 - Concern about future shortages • “A few years of such dry summers as that of 1930 and the communities of Northern New Jersey would lack sufficient potable water, unless relief in the meantime hadbeen contrived.” NYT, 10/17/30 • 1957 - Pres. Eisenhower refuses to issue disaster declaration for NJ • “The basic problem is how to atone for lack of foresight and inadequate distribution facilities in the suburbs. The outward thrust into the suburbs since 1950 appears to have caught water plants there unprepared.” NYT, 7/22/57 • 1965 - Pres. Johnson issues drought disaster declaration for NJ • 1974 - Gov. Byrne issues 1st drought Executive Order. • “…the largest municipalities in New Jersey…depend on reservoirs in the heavily populated areas, where runoffs after heavy rains and snowfalls are considerably reduced because of the development of open spaces.” NYT, 6/5/74 • 1999 - Complex problems demand sophisticated responses • “…state and local governments and the news media have failed to recognize drought as a complex set of phenomena that demand long range regional planning and hard decisions after the inevitable rains come and the emergency decrees fade away. … In general there should be a more robust public debate about how the government functions in a liberal democracy in times of emergency.” NYT, 8/15/99 www.mickmaurer.com

  14. Urban Blizzards - THEN • Threatens • Life (hypothermia) • Heating supplies (coal barges) • Food supplies (milk trains, bread) • City transportation (ferries, freight wagons) • “The time may not come within the present century when the newspaper will not be hampered in its work of news collecting by storms of such intemperate violence as that which swept the earth yesterday, but progress is making in that direction, and ultimately no doubt the telegraphic system of the entire country will be as secure from damage by wind and storm …” New York Times, March 13, 1888 www.mickmaurer.com

  15. Urban blizzards - NOW • Threatens • Transportation (especially roads, airports) • Benefits • Social solidarity • Aesthetics • Sense of wellbeing • “Sudden destruction of the normal order had its virtues this weekend. What after all is so delightful about being strapped rigidly into the normal order?… The blizzard had elbowed (people) off the treadmill and provided a gentle adventure” New York Times, January 9, 1996 www.mickmaurer.com

  16. New Jersey forest fires by decade, 1902-2000 “Whatever else they do, men in the Pine Barrens are fire-fighters throughout their lives” John McPhee, 1967 www.mickmaurer.com

  17. PERCEIVED CAUSES OF NJ FOREST FIRES www.mickmaurer.com

  18. "Huddled masses" as hazard agents • “Hundreds ofuneducated immigrantshave invaded the Pines, owing to the cheapness of the land and proximity to large cities. Few of these have brought with them European forestry ideas, and many of the most disastrous fires are those which they carelessly set in clearing their farms.” (State Geologist, 1899, p. 289) • “Many of the sufferers are poor Italians, who obtained small clearings andenlarged them by degrees.” (New York Times, April 30, 1900) • In September 1895 one fire was “set by anItalianback-firing in the wrong way” and another was “set accidentally by Italianscooking in the woods”. (State Geologist, 1899, p. 164.) www.mickmaurer.com

  19. General Findings • The burden of hazard has grown and shifted repeatedly as New Jersey added population and investments at different rates in different areas that are themselves differentially exposed to natural risks. • Broad unplanned societal changes have affected the hazard ecology of New Jersey at least as much as the deliberate efforts of hazard management agencies and individuals. www.mickmaurer.com

  20. Value of NJ experience to policy making - I • State's leading role in national research & policy • First systematic study of forest fire in USA • First USGS reports on flooding • Formative research on beach processes • Capitalize on this experienceespecially with respect to innovations for the future • Continuing trend towards broader perspectives • Broader interpretations of hazard issues • Broader solutions • We will increasingly have to think in interdisciplinary ways that mediate among conflicting conceptions and contradictory goals. www.mickmaurer.com

  21. Value of NJ experience to policy making - II • Natural hazards and disasters provide a basis for public intervention and open up opportunities for institutional innovation • Without the threat of fires would there be Pinelands regulation? • Without the 1955 Delaware floods would there be a DRBC? • Disjunctive change can fundamentally restructure old arguments; beware of relying on assumptions about continuation of current trends • Limitations of relying on tightly coupled prediction & response systems • No hurricanes BUT • Plenty of tropical storms and nor’easters • Inland impacts instead of coastal ones • Plan for surprises; consider kinds of risk as well as degrees ofrisk; shift emphasis “upstream” to mitigation of material losses "New Jersey hazards in the 20th century" Mitchell - November 16, 2004 www.mickmaurer.com

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  23. “Terrorism is the deliberate and systematic assault on civilians to inspire fear for political ends.” “Terrorism is the intentional use of, or threat to use violence against civilians or against civilian targets, in order to attain political aims.” www.mickmaurer.com

  24. ‘Suicide’ Bombings To be a 'shahid' or not to be… Public Transport – Haifa , Dec 2 , 2001 www.mickmaurer.com

  25. METROPOLITAN DESK | September 10, 2004, Friday Terror in the Age of Eisenhower; Recalling the Mad Bomber, Whose Rampage Shook New York By CHARLES DELAFUENTE (NYT) 1226 words Late Edition - Final , Section B , Page 1 , Column2 There was a bomber on the loose in New York City. On the evening of Dec. 2, 1956, 1,500 people were at the Brooklyn Paramount Theater watching ''War and Peace'' when a pipe bomb beneath a seat exploded at 7:50 p.m. Six people were injured, including Abraham Blumenthal, who was lifted out of his seat by the blast. The next day, Police Commissioner Stephen P. Kennedy ordered what he called the ''greatest manhunt in the history of the Police Department.'' www.mickmaurer.com

  26. At the time of that bombing, the police had been searching for the man known as the Mad Bomber for years. He first struck in the city in 1940 and 1941, planting two bombs that did not explode. He resurfaced in 1951, planting 22 bombs that did explode and several more that did not. Bombs were left in crowded public places: train, bus and subway stations, Macy's, movie theaters, office buildings and the New York Public Library. The fact that a place had been bombed before was no assurance that it was subsequently safe. Grand Central Terminal was the site of five bombs; there were three at Pennsylvania Station;two were planted at the Port Authority Bus Terminal; and two at Radio City Music Hall.Fifteen people were injured by the bombs. www.mickmaurer.com

  27. Though no one was killed, the city's nerves were rubbed raw. ''There was a lot of fear, especially in the subways,''recalled Arthur Gelb, a former managing editor of The New York Times. ''People thought twice before taking the subway,'' said Mr. Gelb, who was a Times reporter during the series of attacks. ''Many people took buses because they felt the subways were where he would attack.'' www.mickmaurer.com

  28. There have been other bombers in New York, both before and after the Mad Bomber. German saboteurs struck in 1916, during World War I, and attackers believed to be Bolsheviks planted a bomb on Wall Street in 1920. Another serial attacker, known as the Sunday Bomber, left bombs in a subway car, a subway station, the Staten Island Ferry and public buildings in late 1960, killing one person. That bomber was never caught. • Members of the Weather Underground, a radical group, committed at least a dozen bombings in New York in 1969 and 1970 to protest the war in Vietnam. The only fatalities were three of the radicals, who were killed when a townhouse in the Village, described by the police as a bomb factory, exploded. • And in 1974, the Armed Forces of National Liberation, better known as F.A.L.N., the initials of its Spanish name, began a decade-long bombing campaign in New York that killed five people. • But no one person left as many bombs around the city as the Mad Bomber did. www.mickmaurer.com

  29. Copyright 2005 The New York Times Company When Mr. Metesky appeared in court, he''resembled a beaming church deacon,''according to an account of the proceedings in The Times. He was clinging to a copy of The Journal-American, whose headline proclaimed ''LETTERS TO JOURNAL TRAP THE MAD BOMBER.'' There was quite a bit of surprise that the Mad Bomber, who had terrorized the city for years,turned out to be so ordinary looking.''Nobody,''Mr. Pelleck said,''knew it was going to turn out to be this doddering old man.'' Photos: Police officers put a container holding a bomb into a protected van at Grand Central Terminal in 1956. Right, pieces of letters to the police from the Mad Bomber. (Photo by New York Police Department); (Photo by Neal Boenzi/The New York Times)(pg. B1); George P. Metesky, 53, at the jail in Waterbury, Conn., shortly after his arrest in January 1957. He was later brought to New York for trial. (Photo by Edward Hausner/The New York Times)(pg. B6) www.mickmaurer.com

  30. Population Exposure model www.mickmaurer.com

  31. www.mickmaurer.com

  32. Natural vs. Human-Caused Disasters Source: CMHS. Psychosocial Issues for Children and Families in Disasters. A Guide for the Primary Care Physician. Washington, D.C.: U.S. Department of Health and Human Services; Publication No. (SMA) 96-3077, 1996. www.mickmaurer.com

  33. Percentage Distribution of the Population By Race and Hispanic Origin(Includes foreign and native-born populations) * Persons of Hispanic/Latino origin may be of any race. Groups listed under “Race” are not of Hispanic origin.** Includes American Indians, Alaska Natives, and Aleuts.Source: U.S. Department of Commerce, Bureau of the Census. (2000). Projections of the resident population by race, Hispanic origin, and nativity: Middle series, 1999 to 2100. Washington, DC: U.S. Department of Commerce. www.mickmaurer.com

  34. www.mickmaurer.com

  35. Disaster Projects Confront Distrust • Several disaster crisis counseling projects supported by the Federal Government have had to address the distrust of ethnic minority groups and their reluctance to use available resources. For example, following the 1994 California earthquake, the disaster crisis counseling project found that many immigrants’ distrust of government posed a barrier to their use of disaster services. Likewise, some of the survivors of a hurricane in Alabama were immigrants from Asian Communist countries who did not trust any government and were not accustomed to receiving Government assistance. California Final Report, 1995 • Alabama Final Report, 1999 www.mickmaurer.com

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  37. Damage from Mississippi Tornadoes Unequal • In the late 1950s, several tornadoes struck rural Mississippi. The only persons killed were black. A subsequent study found that many people in the black community had great difficulty in coming to terms with this disaster. They did not understand how a just God could discriminate in such a fashion between white and black. Perry and Perry, 1959 www.mickmaurer.com

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  39. Civil Unrest Causes Emotional Problems for Refugees • The civil unrest and fires in Los Angeles that came in the wake of the Rodney King verdict affected a community inhabited by many refugees from Central America and Asia. For immigrants who came from war-torn countries, the Los Angeles disturbances reactivated fears and emotions associated with their homeland. Many experienced increased agitation, depression, confusion, and recollections of prior bereavements. California Final Report, 1994 www.mickmaurer.com

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  41. Disaster Strikes a Highly Diverse Community • On January 17, 1994, a major earthquake struck Los Angeles and Ventura Counties. The Northridge earthquake was the largest and most violent to hit an urban area in the United States since the 1906 San Francisco quake. The post-disaster recovery effort provided mental health services to 1.9 million persons, representing myriad ethnic groups, special populations, and lifestyles. • The size and scope of the two affected counties, as well as the ethnic diversity of their residents, constituted a challenge to disaster mental health providers. For example, Ventura County is home to many undocumented migrant farm workers, the majority of whom do not speak English and are mistrustful of government at any level. Language and cultural barriers had to be overcome for persons from several Asian cultures as well. The diverse population in the affected areas also included other special populations, such as physically challenged persons and runaway youth, two groups that required special outreach strategies. California Final Report, 1995 www.mickmaurer.com

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  43. Vulnerable Groups Underserved by Science and Technology • Elderly shut-ins during heat and cold waves • Illegal immigrants crossing southern border • Victims fearful of revealing identities • Publics vulnerable to terrorist attacks at home, in workplace, in mass transit, at play www.mickmaurer.com

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  45. Common Stress Reactions • Behavioral • Increase or decrease in activity level • Substance use or abuse (alcohol or drugs) • Difficulty communicating or listening • Irritability, outbursts of anger, frequent arguments • Inability to rest or relax • Decline in job performance; absenteeism • Frequent crying • Hyper-vigilance or excessive worry • Avoidance of activities or places that trigger memories • Becoming accident prone www.mickmaurer.com

  46. Physical • Gastrointestinal problems • Headaches, other aches and pains • Visual disturbances • Weight loss or gain • Sweating or chills • Tremors or muscle twitching • Being easily startled • Chronic fatigue or sleep disturbances • Immune system disorders • Psychological/Emotional • Feeling heroic, euphoric, or invulnerable • Denial • Anxiety or fear • Depression • Guilt • Apathy • Grief www.mickmaurer.com

  47. Thinking • Memory problems • Disorientation and confusion • Slow thought processes; lack of concentration • Difficulty setting priorities or making decisions • Loss of objectivity • Social • Isolation • Blaming • Difficulty in giving or accepting support or help • Inability to experience pleasure or have fun • (Adapted from CMHS, 2004) www.mickmaurer.com

  48. Extreme Stress Reactions Post Traumatic Stress Disorders (PTSD) Type I, II, III - Associated Disorders • Major Depressive Episode • Posttraumatic Stress Disorder • Generalized Anxiety Disorder • Panic Disorder - Associated Complications • Suicide • Substance Abuse • Self-Medication www.mickmaurer.com

  49. Crisis Counseling Programs for the Rural Community CHARACTERISTICS OF RURAL AREAS • High poverty levels • Increasing percentage of older adults • High unemployment • High levels of social and health related problems • Pockets of minorities within a largely homogeneous population • Heavy dependence on agricultural, oil, mining, or tourism related businesses • Large numbers of people involved with and reliant upon organized religion www.mickmaurer.com

  50. Challenges Encountered by Rural Crisis Counseling Programs • Emotional Isolation and Independence of the Rural Population • Reaching Farm Families • Geographic Isolation • Accessing Hard-to-Reach Groups • Cultural Values in Rural Populations -Individualism - Mental Health Stigma - Spiritual Traditions www.mickmaurer.com

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