Page 107 - Creating Spiritual and Psychological Resilience

76 Creating Spiritual and Psychological Resilence

as well in the aftermath of disasters. This chapter is based largely on the
lessons learned from these collaborations as well as the author’s training
as a forensic psychiatrist.
In my experience as a disaster responder, by far the largest obstacle to
effective response has been a lack of communication between different pro-
viders. Altogether too often, the rapid development of systems to respond
to disasters fails to consider the range of individuals who are either active
in the disaster or should be active in the disaster. Systems that tradition-
ally work effectively in parallel without tremendous communication, such
as the worlds of psychiatry and the clergy, are more likely to underesti-
mate than overestimate the need for cross-referrals. This tendency can be
exacerbated by competitive instincts that are activated by the disaster and
a lack of familiarity or comfort with the areas of overlap and complemen-
tarity between these fields.

Practical Correlations

The result of communication failure can lead to substantial ethical, if not
legal liabilities. The following three vignettes suggest the range of liability
that can occur from such poor coordination:

Vignette 1
After a hurricane in a nearby town, a church decides to convert its basement
into a temporary shelter for those who have lost their homes. Reverend Jones
organizes members of the congregation to provide various services and to stay
available at the church basement around the clock. Other local organizations
began offering the church aid, including food, spare clothes, and daycare ser-
vices for the children; and the local emergency management agency arranges
a system of transportation to get people from the shelter to the local FEMA
office. Rev. Jones set strict rules concerning the use of drugs and alcohol in the
building or on the ground. One night, a man who appears drunk is asked to
leave the building. It soon becomes clear that the person believes that he is hav-
ing an argument with the President of the United States about the hurricane.
He believes that the president is watching and listening to him from a satellite.
The man is malodorous and drooling, and the volunteer who is in charge in
the church basement concludes that this man is not drunk but quite disturbed.
So, instead of being asked to leave, an ambulance is called to refer the person
to a local hospital where they may be able to provide care for the individual.
An hour later, the hospital calls and says that there are no psychiatric beds