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Health Services Research & Development

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2006 HSR&D National Meeting Abstract


3038 — Evacuation of SMI Veterans During Natural Disasters

Author List:
Mittal D (CAVHS)
McClain C (CAVHS)
Hamilton F (CAVHS)
Clothier J (CAVHS)
Labbate L (CAVHS)
Martone L (CAVHS)
Besancon F (CAVHS)
Moore S (CAVHS)

Objectives:
Due to recent hurricanes, evacuation from two VISN 16 locations in Mississippi and Louisiana became necessary. The evacuations were rapidly planned with no precedence and provided valuable experience to all involved in the evacuation of seriously mentally ill (SMI) persons. We wish to inform mental health professionals/disaster teams on the issues pertaining to effective evacuation of SMI persons.

Methods:
Three teams were rapidly deployed by the CAVHCS Mental Health Service, MIRECC clinical director, and the administration to evacuate forty SMI veterans from inpatient and residential care settings in Biloxi, MS and Alexandria, LA. These teams consisted of psychiatrists, nurses, social workers, and LPNs. Administration acted swiftly to arrange evacuations and mobilized resources for the evacuation teams quickly.

Results:
Circumstances prevented ready availability of clinical information about the patients needing evacuation. Most patients did not know that they were being moved to another facility until approached by the evacuating team. While most evacuating patients seemed to understand and cooperated with evacuation despite their psychotic disorder, some required education and medications to ensure safe transfer. Evacuation teams anticipated the needs of the SMI patients and carried medications, food, supplies, and members of a variety of disciplines to assist with safe and expeditious evacuation.

Implications:
We offer recommendations to prepare teams to meet the needs of SMI evacuees. Evacuation teams will be multidisciplinary and size will depend on the number and needs of persons needing evacuation. Clinician to clinician communication is critical and evacuees should be informed of the situation prior to evacuation. The transferring facility should focus on preparing the patients, informing their next of kin, and arranging routine medications for the journey. Appropriate seating within the vehicle needs to be assessed to ensure safety and minimize distraction to the drivers. Supplies should include sanitation and hygiene products, food and beverages, and a medication chest. With an aging veteran SMI population, the team needs to be ready to meet routine needs and arrange emergent treatment for acute physical needs of the evacuees.

Impacts:
Disaster response teams should prepare to specifically meet the needs of SMIs.


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