title: A psychosocial risk assessment and management framework to enhance response to CBRN terrorism threats and attacks.
abstract: Evidence in the disaster mental health literature indicates that psychosocial consequences of terrorism are a critical component of chemical, biological, radiological, and nuclear (CBRN) events, both at the clinical level and the normal behavioral and emotional levels. Planning for such psychosocial aspects should be an integral part of emergency preparedness. As Canada and other countries build the capacity to prevent, mitigate, and manage CBRN threats and events, it is important to recognize the range of social, psychological, emotional, spiritual, behavioral, and cognitive factors that may affect victims and their families, communities, children, the elderly, responders, decision makers, and others at all phases of terrorism, from threat to post-impact recovery. A structured process to assist CBRN emergency planners, decision makers, and responders in identifying psychosocial risks, vulnerable populations, resources, and interventions at various phases of a CBRN event to limit negative psychosocial impacts and promote resilience and adaptive responses is the essence of our psychosocial risk assessment and management (P-RAM) framework. This article presents the evidence base and conceptual underpinnings of the framework, the principles underlying its design, its key elements, and its use in the development of decision tools for responders, planners, decision makers, and the general public to better assess and manage psychosocial aspects of CBRN threats or attacks.
authors.affiliation: School of Psychology, Institute of Population Health, McLaughlin Centre, University of Ottawa, Ontario, Canada. louise.lemrye@uOttawa.ca
authors.forename: Louise
authors.initials: L
authors.lastname: Lemyre
authors.forename: Mélanie
authors.initials: M
authors.lastname: Clément
authors.forename: Wayne
authors.initials: W
authors.lastname: Corneil
authors.forename: Lorraine
authors.initials: L
authors.lastname: Craig
authors.forename: Paul
authors.initials: P
authors.lastname: Boutette
authors.forename: Michael
authors.initials: M
authors.lastname: Tyshenko
authors.forename: Nataliya
authors.initials: N
authors.lastname: Karyakina
authors.forename: Robert
authors.initials: R
authors.lastname: Clarke
authors.forename: Daniel
authors.initials: D
authors.lastname: Krewski
mesh_terms: D002170:Canada; D003142:Communication; D004189:Disaster Planning / Q000458:organization & administration; D006801:Humans; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D018570:Risk Assessment / Q000379:methods*; D012308:Risk Management; D012919:Social Behavior; D023481:Terrorism / Q000523:psychology*