Pediatric Disaster Behavioral Health (PDBH) Toolkit

What is demobilization? 

Demobilization marks the transition from response to recovery after an incident/disaster. For hospitals, it means returning personnel and resources to their day-to-day responsibilities, getting back to “new normal” and/or baseline levels of function. 

Key things to know:

Disaster responders can be at risk for post-deployment behavioral health impacts related to their exposure to traumatic and high stress events as a part of their roles. It is not uncommon during the demobilization phase for staff to experience new symptoms of anxiety, depression, and burnout. Symptoms of stress often do not appear during the active response, when staff are extremely busy and focused on their actions and activities, with limited time for reflection. It is only later, when the distraction is lessened and there is room to begin to process the event, that distress symptoms may emerge. This is sometimes referred to as “post deployment syndrome.”  

Factors related to this can include:

• Traumatic experiences such as exposure to life threat, mutilating injuries, and patient suffering.
• Separation from family and social support systems. Additional reluctance to share traumatic experiences with friends and family out of concern for their emotional status can lead to isolation.
• Challenges of adapting back to “normal life” such as feeling less sense of purpose, loss of the adrenaline that often accompanies deployment, and loss of team support

What increases resilience?

Certain factors during deployment can increase post-deployment resilience, including team cohesion and support, relationship/marital satisfaction, and psychological “hardiness.”  

Immediate along with later-term (a few months) check-in following deployment may be helpful in identifying responders who are experiencing more severe symptoms, although not predictive of future Post-Traumatic Stress Disorder (PTSD).

Demobilization recommendations for those involved in response work include:

• Establishment of a new daily routine
• Healthy habits such as exercise, healthy eating
• Focusing on increasing social connection, spending time with friends and family
• Finding other ways to increase sense of purpose such as volunteer activities
• Avoiding unhealthy coping strategies such as increased use of alcohol or becoming more socially isolated. 

Avoiding constant media exposure and searching for information related to the event(s) or response. 

Additional information is available for mental health resistance and deployment⁴² , as well as mental health for first responders⁴³ – please see the Resource Catalogue. Additionally, this toolkit provides a Primer on Professional and Personal Wellness Considerations and SAMHSA has a wide variety of resources tailored to support first survivors, first responders, health care professionals, and their families.