Disaster Behavioral Health Response: Orlando Mass Shooting

NASMHPD 2016 Annual Commissioners Meeting Orlando Mass Shooting Disaster

2 Mass Shooting at Pulse Nightclub Orlando, - 6/12/16 • 50 dead; 53 injured. • Deadliest mass shooting in U.S. history. • Worst act of terrorism on American soil since 9/11/01. • Over 90% of 49 victims of Hispanic origin; one half of those of Puerto Rican descent. • 90% were Florida residents.

3 Disaster Event Timeline • Began at 0200 hours (2:00am) with more than 300 people in Pulse night club at the time. • An officer working at Pulse responded to shots fired, and the incident quickly became a hostage situation. • Orlando Police Department (OPD) breeched the building from the rear to gain entry. • SWAT teams entered the club at 0500 hours (5:00am) to attempt hostage rescue. • The shooter was killed.

4 Response Efforts Timeline • Aspire Health Partners notified by OPD. • Cares Health System (CFCHS), DCF Central Region Office and Orange County Government coordinated efforts. • First effort: Centralize all behavioral health services information dissemination and responses. • Family Reunification Center opened June 12 (Day 1), at 2:30 p.m. • By 11:59 p.m. of June 12 (Day1), Orange County Medical Examiner’s Office had removed all the victims from the night club. • Within 48 hours all victims’ families were notified.

5 Response Efforts Timeline (continued) .Day 1 Sunday, June 12, 2016: Orange County Emergency Management Services (EMS) and Mental Health Responses were immediate. Aspire Health Partners at the Hampton Inn (Family Reunification Center).

.Days 2 and 3, Monday and Tuesday, June 13 and 14, 2016: Beardall Senior Center – Orange County Response with Providers and CFCHS, the Department’s Managing Entity for the Central Region.

.Days 4 to 10, beginning Wednesday, June 15, 2016: Family Assistance Center (FAC) – Camping World 3rd Floor - Behavioral Health/Compassionate Support.

6 Response Efforts Timeline (continued)

• Days 11 to Present Orlando United Assistance Center (OUAC)

• Community Agencies Donated  Food and Water  Gift Cards  Teddy Bears  Navigation/Compassionate Assistance  Furnishings and remodel provided by Disney

7 Coordinated Response

• City of Orlando – Leadership on the ground at Pulse and at . • Orange County – Emergency Management Service, Mental Health Response, Crisis Assistance. • Central Florida Cares Health System - Network/Statewide Mental Health Response. • Aspire Health Partners, Inc. – Crisis Response and deployment of staff to various sites. • Florida Crisis Emergency Response Team (CERT). • American Red Cross.

8 FAC Resources Available

• Department of Children • LGBTQ organizations: and Families - Access Zebra Coalition/The Center program (food stamps, • Victim Services Center benefits) • Immigration Consulate • Attorney General (Mexico, Columbia, Dominican Republic, Cuba, • Social Security Ecuador, El Salvador) Administration • 211 Heart of United Way • FBI/ATF/LEO I&R/Spirit Project data • Child Care Services system • Legal Services • Funeral Businesses • Red Cross • Airlines • Pet Alliance; Dog Therapy

9 Florida’s Disaster Experience

Natural disasters: tropical storms, floods, hurricanes, Haiti’s earthquake. • 1992 Hurricane Andrew – 15 direct deaths in Florida. • 2000 – 2015: 32 named hurricanes; total 82 direct deaths in Florida. • 2010 earthquake in Haiti – Florida’s response

10 Florida’s Response to the Earthquake in Haiti

• Florida provided aid in Haiti and in Florida.

• DCF provided services; later received SERG awards. – 3,300 outreach/public education events to 204,000 persons. – Generated 2,364 assessment referrals. – 1,420 enrolled individuals accepted counseling services.

11 Florida’s Response to the Earthquake in Haiti (continued)

• About 66% served were Florida residents who experienced traumatic losses among extended family and social circles. • About 29% served were repatriated from Haiti to South Florida through international disaster response activity. • About 9% served were medical trauma patients evacuated from the island under conditions of humanitarian parole.

12 Florida’s Experience with this Man-Made Disaster

• Florida’s track record responding to natural disasters. • Federal agencies prepared to respond. • Orlando’s/Orange County’s experience with natural disasters. • Readiness and responsiveness of community mental health agencies.

13 • CFCHS, the Central Region Managing Entity, was able to access the appropriate licensed and experienced counselors from across the state to deploy to Orlando to assist.

• The Managing Entity structure allows for management of services at a region/local level. This structure contributed to immediately accessing the professionals needed to respond.

14 15 16 Response differences from our natural disasters:

• Florida Department of Law Enforcement.

• Response work with crime related agencies: FBI, U. S. Department of Justice, U.S. Department of Homeland Security, and the Florida Attorney General.

17 Issues After the Mass Shooting: • Families not being informed of loved ones status. • No money, no accommodations. • Not being able to provide them with credible information. • Media relentless with needing to photograph grieving families. (Angel Wings group helped with this). • Food donations. • Verification of staff.

18 Our Substance Abuse and Mental Health (SAMH) Service Delivery Relationship with Orlando

• The Central Region’s SAMH Receiving System is a trendsetter in Florida. • Law Enforcement have Crisis Intervention Team trained officers. • The System of Care Grant. • The Criminal Justice Reinvestment Grant.

19 Orlando’s Needs As a Result of the Mass Shooting: • Increase in demand for outpatient services. • Need to reach those impacted but not seeking services at assistance centers. • Increase in trauma treatment capacity. • Increase capacity of local LGBTQ organizations to meet the needs of this target population.

20 Orlando Mass Shooting

Credit: Orlando Sentinel YouTube Channel •Community united. •Community rallied around the families.

https://www.youtube.com/watch?v=jLGjINTavpw&index=2&list=PLK GEX7EuJlHaJSLKfbhTBjsG3DbZ_IeVX

21 Credit: The Orlando Sentinel

Orlando Blood Donation Line after 6/12/16 Mass Shooting

22 50,000 attend a vigil in Orlando

Credit: The Orlando Sentinel

23 Memorial established outside Pulse nightclub

Credit:

Credit: CFCHS

24 Recommendations • Do not expect that being prepared prepares you for the emotional impact across all agencies involved. Counselors, first responders, medical examiners, hospital staff, victim advocates, etc., are impacted emotionally.

• Debriefing is critical with counselors, first responders, medical examiners, hospital staff, victim advocates.

• Be prepared for the ripple effect…in Florida you can travel 1-2 hours anywhere. We are seeing persons seeking services across the state.

25 Recommendations (continued) • Disaster still fresh. • Increase Disaster Preparedness staff. • Contact Federal agencies for information and resources. • Federal funding resources: – SERG – Antiterrorism Emergency Assistance Program • Training on assisting with family notification. • Social media use important. • Such disasters are impacting more communities.

26 How Do We Define Success? • Relatively easy to define success with natural disasters: – The timeliness to restore services. – Disaster relief sites, Disaster Resource Centers (DRCs) demobilize. – Housing of Victims no longer needed. – There comes a time to return homes, buildings, beaches, and roads to normalcy.

• We have few in-house measures for success for this type of disaster. − How can we measure restoration? − How can we measure the return to normalcy? − What is the new normal?

27 Massachusetts’ Card to Orlando

28 Orlando’s Card to Massachusetts

29 John N. Bryant Assistant Secretary

[email protected] (850) 921-8461

30