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Communication is the key to managing incidents that involve mass decontamination.

Jul

18

Research into public behaviour during incidents that involve mass decontamination provides long-overdue evidence that consideration of psychosocial factors is essential for the successful management of such incidents. Failure to consider such factors could delay the decontamination process, which could cost lives.

Doctoral student Holly Carter discusses the research that she is conducting for her PhD, supervised by Dr John Drury who is an expert in crowd behaviour.

My research aims to understand how members of the public are likely to behave during incidents involving decontamination, and how social psychological theories can aid this understanding. Decontamination is an intervention used by the emergency services in the event of a CBRN incident (one involving the release of a chemical, biological, radiological, or nuclear agent). It involves anyone who has potentially been contaminated being asked to remove their clothes and undergo a shower, to remove any potential contaminant from their skin.

As part of the research project, I conducted a review of small-scale incidents involving decontamination. This revealed that communication from emergency responders to members of the public was essential for the smooth-running of the decontamination process; failure to communicate effectively resulted in public non-compliance and anxiety. Non-compliance during an incident involving mass decontamination could have extremely serious consequences; it may result in increased spread of any contaminant (Edwards et al., 2006), and therefore increased numbers of dead and injured.

Yet, decontamination guidance documents for responders do not contain any guidance on communicating with members of the public! Furthermore, emergency responders do not receive any training on how to communicate with members of the public. Instead, a ‘control’ management strategy is often emphasised, based on the idea that members of the public will necessarily ‘panic’, and behave in a ‘disorderly’ way. Many policy makers and emergency responders share the view that: “Scenes of mass contamination are often scenes of collective hysteria, with hundreds of thousands of victims in a state of panic. Therefore, mass decontamination may require police, security, or rescue supervision to help control panic and keep order.” (Wikipedia, 2013).

I applied the social identity approach to develop recommendations for the management of mass decontamination. This approach  highlights that crowd events are typically intergroup encounters, in which the actions of one group can impact on the experiences and behaviour of another group.

My recommendations are the result of a variety of studies including: large scale mass decontamination field exercises; a visualisation experiment; and a mass decontamination field experiment. During the mass decontamination field experiment participants went through the decontamination process, as they would during a real incident.. During the experiment, participants received one of three responder communication strategies: “good” (health-focused information about decontamination, updates about actions responders were taking, sufficient practical information); “standard practice” (no health-focused information, no updates about actions responders were taking, sufficient practical information); and “poor” (no health-focused information, no updates about actions responders were taking, very basic practical information). The decontamination process progressed most efficiently in the good communication condition, and non-compliance and confusion were observed least often in this condition.

The field exercise, visualisation experiment, and field experiment showed that effective communication by emergency response personnel increased public compliance and cooperative behaviour, and that the relationship between effective communication and public compliance and cooperative behaviour could be explained by relevant social identity variables (e.g. perceptions of responder legitimacy, identification with both emergency responders and other members of the public, and collective agency).

Overall, this programme of research provides evidence that a consideration of psychosocial factors is essential for the successful management of incidents involving mass decontamination; failure to consider such factors could delay the decontamination process, which could cost lives.

We suggest four specific recommendations for managing incidents involving decontamination:

1) emergency responders should communicate openly with members of the public about actions they are taking;

2) emergency responders should communicate in a health-focused way about decontamination;

3) emergency responders should provide members of the public with sufficient practical information; and

4) emergency responders should respect public concerns about privacy.

Our findings underline the importance of training for emergency responders on ‘soft skills’ (such as communication, and the need to respect public needs for privacy); this has been neglected until now in favour of technical solutions, and hence technical preparation and training.