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Mobilizing in a mental health crisis

July 20, 2011
by Neal Cash, Edward Gentile, DO, and Vanessa Seaney
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Six months after the shootings in Tucson, agencies share lessons on how to prepare and respond to a community tragedy involving mental health

Spontaneous memorials blossomed across the city, as clusters of Tucsonans gathered to comfort each other.

On Jan. 8, a mass shooting occurred in Tucson, Ariz., that killed six people and wounded 13 others, including U.S. Rep. Gabrielle Giffords. A nine-year-old girl, a federal judge and a well-known Giffords staff member were among those killed. Media from around the world poured into this close-knit community of almost a million people. Spontaneous memorials blossomed across the city, as clusters of Tucsonans gathered to comfort each other.

The shock of such violence on a lovely Saturday morning, the high profile of Rep. Giffords, and the diversity of the other victims gave thousands of Southern Arizonans the feeling of a close connection to the victims and meant that many would experience traumatic reactions of varying intensity.

County and state government asked Community Partnership of Southern Arizona (CPSA), which for 16 years has overseen public behavioral health services in Pima County, to coordinate a response to tragedy-related mental health needs in the community. We were fortunate to have a long-established executive team to lead our effort and many partners in other community systems and organizations that provided help.

CPSA and its providers mobilized with the support of local, state and federal agencies, advocate and consumer-run organizations, and many other partners, all the while ensuring the 30,000 people enrolled and already receiving services in our system received unbroken support. Our members with serious mental illness, in particular, were affected by media speculation about the accused gunman's mental health and the resulting flare-up of myths about mental illness and violence.

CPSA established an Emergency Operations Center (EOC) to coordinate and report on efforts and worked with its crisis-line provider to set up a Tucson Tragedy Support Line. At the same time, CPSA's team of crisis responders reached out to schools, religious institutions, and community groups to which the victims belonged. But these were only the most visible of CPSA's actions.
Tucsonans let it be known that the tragedy would not define their community. A movement toward unity and healing-encouraged by victims, witnesses and families-quickly gained momentum, resulting in the establishment of foundations, memorial scholarships, and other initiatives to generate sustainable, systemic benefits from the tragedy. Because of its deep community roots (CPSA was founded and is based in Tucson) and long-term relationships with several of the victims, CPSA became a natural partner in this movement.

CPSA's response to the tragedy continues, notably through increased Mental Health First Aid training sessions and expanded opportunities for public mental-health education. This work continues with many community partners, as well: local media, school systems, faith-based organizations, and others.

We hope that sharing some “lessons learned” from our experience can help you prepare in the event you're ever called upon to play a similar role.

Have a plan, but be ready to improvise

Everyone knows this, but it's worth restating: A good crisis-response plan will provide the foundation for mobilizing in a crisis. That foundation takes care of common elements of crisis preparation so you can better react to the unique, unanticipated aspects of the specific situation.

Neal cash
Neal Cash
Edward gentile, do
Edward Gentile, DO
Vanessa seaney
Vanessa Seaney

Consider these issues among the “foundation” elements of your crisis plan: Is your organization likely to be asked to work with governmental agencies in certain crisis or disaster situations? If so, you should:

  • Ask that your organization be made part of their disaster-response planning effort

  • Ask to participate in meetings of the governmental agency's response team. Determine how your organization and its leadership would relate to the lead agency and how you would fit within the larger crisis-team infrastructure.

  • Make sure your role definitions are clear. Determine where they intersect with, and how they differ from the roles of other organizations.

  • Make sure your plan can be activated outside normal business hours.

The CPSA-led response followed the county's disaster plan and paralleled the work of local law enforcement. The function of our Emergency Operations Center was driven by daily briefings with partners that included law enforcement, state and local government, first responders, faith-based organizations, CPSA crisis-service providers and the Red Cross.