DoD Enhancing Emergency Medical Readiness to Address New Global Challenges
By Dialogo July 29, 2013
With the rise of recent natural disasters, global pandemic disease threats and traumatic mass casualty incidents, the U.S. Military Health System is taking several steps to better prepare all its installations worldwide to respond to, assist in and recover from public health emergencies.
The Defense Office of Force Health Protection & Readiness (FHP&R) recently helped develop and update two military-wide policies that require Department of Defense (DoD) installations across the globe to adopt enhanced public health emergency management capabilities and civil support measures.
The new measures stem largely from experiences gained during the 2009 H1N1 Pandemic Influenza outbreak, and were reinforced by a DoD review following the tragic mass shooting of U.S. Military personnel at Fort Hood in November 2009. The policies have become ever more prescient given the spate of recent disasters such as Hurricane Sandy, school and movie theater shootings, the Boston Marathon bombings, Oklahoma tornado and emerging global infectious disease like the H7N9 influenza strain in China and a respiratory syndrome coronavirus (MERS CoV) in the Middle East.
The H1N1 flu strain that caused a global pandemic in 2009 led DoD to develop emergency vaccination prioritization and health prevention programs during the crisis to protect personnel and preserve mission readiness, while the August 2010 Fort Hood review sought to broaden DoD’s force health protection approaches to better reflect today’s challenging security environment and included recommendations to build medical provider readiness, mutual aid agreements and mental health care following disasters.
As a result, FHP&R developed a DoD-wide public health emergency management (PHEM) policy approved in March 2010 and updated in June 2012, and provided input into another for Installation Emergency Management, approved in 2009 and updated in November 2010, for the military services to implement enhanced public health emergency capabilities on installations worldwide.
According to CAPT D. W. Chen, director of FHP&R’s Civil Military Medicine Division, which oversees the public health policy, “Both are key for installations and will guide what base commanders will do before and during a public health emergency. What’s vitally important is getting ready for emerging illnesses like H7N9 and MERS CoV, and having policies in place that help us prepare for that.”
They are aimed at better preparing DoD installations to respond to emergencies, protect personnel, save lives and restore operations. DoD installations worldwide are developing implementation plans and multidisciplinary working groups with a base emergency manager and health representatives.
The military services are identifying and training individuals to develop and implement PHEM plans on each base, while FHP&R monitors progress and hosts informational meetings. They also teach classes to convey foundational PHEM concepts.
A key component included in the updated policies following the Fort Hood recommendations is addressing psychological health needs after mass shootings and other disasters. Disaster Mental Health (DMH) plans will now be developed for each installation and coordinated with other emergency management plans, and the services will establish a Disaster Mental Health Response (DMHR) team at each installation to provide prevention, outreach, screening, psychological first aid, education and referral services, as well as include mental health, spiritual and family support components to individuals, both victims and first responders, or groups who are exposed to an all-hazards incident and may be at risk for anxiety, depression, etc. and may need to be assessed for mental health care needs.
The main idea is for each installation to have access to psychological health assets during and after an emergency. “The point … is to foster communication between the (emergency) managers and the mental health contact on their installation in order to coordinate planning for a disaster or emergency,” LCDR Nelson, USPHS policy analyst for FHP&R’s Psychological Health Strategic Operations Directorate (PHSO), said.
The resulting inclusion of mental health in the new instructions is aimed at having DoD installations establish enhanced public health teams and plans ahead of time so that any localized emergency response will be well coordinated and augmented appropriately. PHSO director Lt. Col. Theresa Lawson said the subtlety is having mental health service providers in place not only to respond properly during a disaster but also who can follow up sometimes weeks later. For example, first responders may not experience stress symptoms immediately after an incident because they are focused on addressing victims’ acute care needs.
Bases inside and outside the U.S. are affected by the new measures, which additionally require DoD to support and assist U.S. civil authorities in public health emergencies, natural or manmade disasters as directed, and coordinate emergency preparedness training, response and recovery capabilities with state, local and tribal governments, other military departments and host country partners.