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| In 2002, the American Psychosomatic Society created the APS Task Force on the Biopsychosocial Impact of Terrorism and Disasters. The Task Force was initially chaired by APS members Frederick Stoddard and Robert Ursano, and is currently chaired by Cheryl Koopman. The APS Task Force set out to collaborate with other stakeholder organizations to develop panels of invited experts to explore the state of scientific knowledge about unexplained medical symptoms, amplified health concerns, and mental disorders that may occur following chemical, biological, or radiological terrorist attacks, and outbreaks. Our aim was to summarize the scientific knowledge necessary to make critical triage assumptions; identify important gaps in the scientific knowledge base; make recommendations on how to proceed to resolve such gaps; and propose a psychiatric triage model. The ultimate goal has been to develop and pilot test evidence-based, algorithmic protocols for accurate and efficient identification, triage, and management of health risks and psychiatric casualties that could pose a threat to our public health emergency response capability. In the spring of 2003, with the support of APS leadership, a team consisting of Steven Locke, Michael McDonald, Dori Reissman, Robert DeMartino, Victor Weedn, Glen Nowak, and Ann Norwood developed the Psychosocial Dimensions of Biodefense Preparedness and Response (PDBPR) Initiative. With the assistance of the APS staff, the team convened expert panel meetings during the spring and fall of 2003. Dori B. Reissman of the Centers for Disease Control and Prevention (CDC), provided federal steering, meeting facilitation, project guidance and oversight. We held two meetings, hosted by Georgetown Medical Center, and organized by Veritas Health Solutions (Steven Locke, principal) and Global Health Initiatives (Michael McDonald, principal), with support from APS, CDC, the Substance Abuse and Mental Health Services Administration (SAMHSA), and the National Institute of Mental Health (NIMH). During the first meeting at Georgetown in June, 2003, four expert panels were created: 1) Scientific basis for assessment of multiple unexplained physical symptoms (Charles Engel and Arthur Barsky, co-chairs); 2) Risk communication (Glen Nowak, chair); 3) Management of contact (or social) distance (Stephen Prior, chair); and 4) Technology solutions (Victor Weedn, chair). Each of these panels produced a written report, one of which has been published (1) and another which has been submitted for publication. These four reports were all summarized in the final report prepared for the CDC. After the scientific underpinnings were elucidated, a fifth panel, “ First-line medical triage” (Kurt Kroenke, chair) was created in November 2003, and their report was completed January 31, 2004 and included in the final PDBPR Initiative report that was submitted to the CDC in May, 2004. Thanks to the American Psychosomatic Society's ongoing support of this initiative, whose importance has been underscored by the recent threat of pandemic avian flu as well as the various hurricane disasters in 2004-2005, we are making this report to the CDC available on this website. Steven Locke, MD Michael McDonald, DrPH Dori Reissman, MD, MPH References: 1. Weedn VW, McDonald MD, Locke SE, Schreiber M, Friedman RH, Temoshok LR, Newell RG. Managing the community response to bioterrorist threats. IEEE-Engineering Med Biol Soc 2004; 23:162-170) CDC REPORT |
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