Volume 5 Number 3
SPECIAL ARTICLES
The Evolving Nature of Disaster Mental Health Services
-George S. Everly, Jr., Ph.D.
-Alan Langlieb, M.D., M.P.H., M.B.A.
ABSTRACT: It may be said that the field of emergency/disaster mental health is a mental health sub-specialization that continues, even today, to quantitatively expand and qualitatively evolve. For this evolutionary process to continue successfully, greater sophistication must be realized both tactically, as well as strategically. This paper reviews the evolving nature of crisis intervention and emergency/disaster mental health. Three areas will be reviewed herein: the evolving goals of early intervention, tactical evolution, and the evolving nature of training in emergency/disaster mental health.
Lethal Predators: Psychpathic, Sadistic, and Sane
-Frank M. Ochberg, M.D.
-Alan C. Brantley, M.A.
-R.D. Hare, Ph.D.
-Peter D. Houk, J.D.
-Robert Ianni, J.D.
-Earl James, Ph.D.
-Mary Ellen O'Toole, Ph.D.
-Gregory Saathoff, M.D.
ABSTRACT: The violent criminals defined in this article are a small, exceptionally dangerous group of offenders designated by the authors as “lethal predators.” They have a history of sexual predation, have killed at least once, and are mentally abnormal but legally sane. They are highly likely to keep killing as long as they are free. Laws permitting civil commitment of dangerous and mentally abnormal sexual predators after they have completed criminal prison sentences have been upheld by the U.S. Supreme Court. Such laws can provide a legal means of keeping these highly dangerous killers confined so they cannot kill again.
Crisis Intervention, Crisis Counseling, Confidentiality, and Privilege
-Gary E. Jones, Ph.D., J.D., M.P.H.
ABSTRACT: In recent years, crisis intervention and emergency mental health have gained increased visibility, especially after the terrorist attacks of September 11, 2001. One issue that has not been adequately addressed is the concept and practice of communication with regards to confidentiality and privilege. This paper reviews key aspects of this important process.
RESEARCH
Precipitants of Psychiatric Patient Assults on Staff: Preliminary Empirical Inquiry pf the Assaulted Staff Action Program (ASAP)
-Raymond B. Flannery, Jr., Ph.D.
-M. Annette Hanson, M.D.
-James Rego, Jr.
-Andrew P. Walker, B.A.
ABSTRACT: Although there has been extensive empirical research on the characteristics of psychiatric patient assailants and their staff victims, there has been a dearth of empirical research on the nature of the precipitants of these patient/staff interactions. Building on the few earlier studies, this year-long, retrospective, empirical study of patient precipitants was conducted within the context of the Assaulted Staff Action Program (ASAP) in ten public sector health care facilities. Excessive sensory stimulation, staff restrictions on patient behaviors (restraints), and acute psychosis were the most frequently occurring precipitants. There were no specific patterns to patient assailant and staff victim characteristics by assault precipitant. The implications of this study and future research needs are addressed.
CASE STUDIES
Peer Support in Law Enforcement: Past, Present, and Future
-Richard L. Levenson, Jr., Psy.D., C.T.S.
-Lauren A. Dwyer, M.A., M.S.
ABSTRACT: Currently, the provision of mental health services to police officers referred for Posttraumatic Stress Disorder or after on-the-job trauma has been facilitated mostly by interested licensed psychologists and social workers who often have minimal experience working with the law enforcement community. Despite the heavy toll of work-related stressors on the morale and psyche of police officers, when under stress they are reluctant to seek professional psychological help as its use implies weakness, cowardice, and an inability to perform the job effectively. Peer support counseling can be used effectively whenever the target population is uniquely educated or occupationally trained. Peers offer a unique segue to groups who demonstrate resistance towards psychotherapy, possess religious or cultural characteristics which would complicate the provision of traditional mental health services, and/or believe it is not understood or misunderstood by the general population or mental health professionals. The peer support component of law enforcement and other emergency services agencies has contributed to an increase in professional mental health referrals and a decrease in on the job suicides, sick days, and poor work performance. Furthermore, peer participation in debriefings following a traumatic event, and peer support during a crisis facilitates the process of psychological closure and mourning and enables emergency services workers to cope more effectively with tragedy so they can continue to perform their jobs efficiently and with satisfaction.
Responding to a Murder/Suicide at a Rural Junior High School
-Andrew Seebold, M.B.A., C.E.A.P.
ABSTRACT: After a murder/suicide at the Red Lion Junior High School in Red Lion, Pennsylvania, (the second critical incident in two years for this school district), our crisis response team provided critical incident stress management (CISM) services, response coordination and ongoing support to the students, teachers, parents and community of this small town. Our unique response team was a diverse blend of professionals from the school district, Pennsylvania State Education Association, school psychologists, and the local employee assistance program (EAP). Within eight days, the school population had moved beyond a horrifying critical incident to begin the process of recovery.
EMERGENCY MENTAL HEALTH UPDATES
Selected Annotated Journal Resources
- Amy Athey, M.S.
- Kelly Doty, B.A.
BOOK REVIEWS - Patti White, Editor/Reviewer
Acceptance Groups for Survivors
-Book written by Nancy Bauser, M.S.W., A.C.S.W.
Terrorists, Victims and Society: Psychological Perspectives on Terrorism and Its Consequences
-Edited by Andrew Silke
