Professor John Drury

Understanding and improving relationships between responders

and the public using crowd psychology:

CBRN mass decontamination

CBRN

(Chemical, Biological, Radiological, Nuclear)

Procedure:

(a) quarantine (not dispersal) for

(b) decontamination

Background

• Increased risk of incidents involving chemical, biological, radiological, or nuclear (CBRN) agents.

• Planning for incidents has neglected public psychology and behaviour.

• Quarantine and decon: A stressful emergency response procedure

• Decon may be more stressful for the public than the incident itself (e.g. Holloway et al., 1997).

• Significance: lack of compliance, risk!

4

The research

• A unique collaboration between Public Health England and social psychologists

• Using crowd psychology to improve practices

• Enhancing relationships between crowd and responders

The problem – what we found

Decon guidance instructions:• Crowd ‘panic’ and ‘disorder’ assumed

as endogenous• Communication neglected• Management strategy emphasises

‘control’ of the public instead

Field exercises (drills)• Emphasis on technical aspects

(equipment) over social relationships

Small decon incidents • Public complained of lack of

information, lack of concern for their dignity

• These concerns made them less willing to comply with decontamination!

• Increased risk of spreading contaminants!

CBRN

Objectives:

• To change practices ->• To motivate the public to self-organize

Why? 1. Issues of legitimacy in use of coercion2. There may not be enough ES personnel in the right place to

enforce the order!

The social identity approach

• The dominant model in the psychology of groups and crowds in Europe and North America

‘Social identity’

– ‘those aspects of an

individual's self-concept

based upon their social

group or category

memberships, together

with their emotional,

evaluative and other

psychological correlates’

(Tajfel, 1978, p. 63)

• A social identity is defined and

evaluated in relation to other

groups

‘SOCIAL IDENTITY’

• We all have personal identities

• We also each have multiple social

identities

• Social identities are based on

SOCIAL CATEGORIES

Turner et al. (1987)

Personal identity:

• That which makes me unique, different from you

• My ‘personality’

Social identities:

• English

• Man United fans

• Psychologists

• Crowd specialists

• Men

Tajfel & Turner (1979)

Variability of identity according to group context

Science faculty

Arts faculty

Clerical staff

Psych Biology Physics Arts faculty

John Hani Biologists Physicists

John Hani Bill Fred

Faculty

Science faculty

Psychologists

John

More inclusive

More exclusive

Consequences: When there is shared

social identity in a crowd…

There is more likely to be social support

– People give social support

– People expect social support

Drury, Novelli & Stott (2014) Euro J Social Psych

Shared social identity makes coordination in a crowd easier

• Because there is shared understanding and expected support for valued group behaviour…

Mexican wave Queuing crowd

Developing hypotheses: Research

on policing of football crowds

Portugal Euro 2004: A natural experiment:

Coercive vs facilitative policing

• Fans perceived facilitative policing as more legitimate than they expected

• Fans maintained strong bonds with fans from other countries

• After the event, but not before, identification with England fans correlated with ‘similarity to police’ in match cities

Portugal Euro 2004: A natural

experiment

Results: qualitative/PSP

Self-regulation:

– “I feel that the majority of fans who follow England now do so to support the team and will not tolerate their enjoyment as supporters curtailed by people out for trouble”

– “One guy had a go at a Portuguese supporter when they scored… there were looks of derision toward the England fan from everyone else”

Applying social psych to CBRN decon

• Testing our hypotheses:

– Effective responder communication – respecting needs

– reduce anxiety

– increase cooperation

– increase compliance

– Why? Good communications enhance the legitimacy of the responders’ actions and increases identification with them

Observation and survey at a field exercise

• ‘Big city’ multi-agency exercise

• 115 volunteers completed a pre-exercise and post-exercise questionnaire.

18

Observation and survey at a field exercise

Results

• Good coms enhanced legitimacy and enhanced identification and compliance

19

Practicalinformation

Privacy

Legitimacy

Goodcommunication

Low anxiety

Co-operative behaviour

Compliance

.37

.23

.30

.67

.62

.33

.52

.38

.03

.29

e4

e6

e5

e1

Shared identity responders

Shared identity public

.42

.18

.45

e2

e3

.72

.38

.29

.34

Mass decontamination experiment

• 112 volunteers• Three different communications conditions:

• Theory-based (respect needs)• Standard-practice• Brief

Four different types of data collected:1. Timings for how long each group took to go

through decontamination2. Observational data3. Quantitative questionnaire data4. Qualitative questionnaire data

20

Mass decontamination experiment

Procedure

• Participants listened to a scenario

• Then removed outer clothing and showered in mock incident

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1. Effective responder communication

2. Enhanced the legitimacy of the responders’ actions

3. Increased identification with them

4. Reduced anxiety, increased cooperation, less confusion, increased compliance, better decon

An experiment: Results

Carter, H., Drury, J., Amlôt, R., Rubin, G. J., & Williams, R. (2014). PLoS One 9(3): e89846. DOI: 10.1371/journal.pone.0089846

Recommendations• 1. Emergency responders should

communicate openly and honestly with members of the public about the actions they are taking.

Carter, H., Drury, J., Rubin, G. J., Williams, R., & Amlôt, R. (2015). Applying crowd

psychology to develop recommendations for the management of mass decontamination.

Health Security, 13(1), 45-53. doi: 10.1089/hs.2014.0061

Recommendations2. Emergency responders should communicate in a health-focused way about decontamination.

24

Recommendations• 2. Emergency responders should

communicate in a health-focused way about decontamination.

• WHY decontamination is necessary

25

Recommendations• 2. Emergency responders should

communicate in a health-focused way about decontamination.

• WHY decontamination is necessary

• HOW decontamination will protect someone, and their loved ones

26

Recommendations• 2. Emergency responders should

communicate in a health-focused way about decontamination.

• WHY decontamination is necessary

• HOW decontamination will protect someone, and their loved ones

• WHAT the process will involve

27

Recommendations• 3. Emergency responders should provide

members of the public with sufficient practical information during the decontamination process.

28

Recommendations• 4. Emergency responders should respect

public needs for privacy and modesty.

29

Conclusion

• Effective communication changes relationships increases compliance

• These four recommendations could improve behavioural and psychological outcomes –could save lives

• Applicable across a range of mass emergencies and disasters

30

Key message and implications

• Use of ‘soft skills’ (communications, respect) can change social identification in emergencies and save lives

• These ideas are being recognized and used by CBRN responder organizations

31

References

• Biomedical Advanced Research and Development Authority (2016) Primary Response Incident Scene Management (PRISM) Guidance for Chemical Incidents. Volume 1: Strategic Guidance for Mass Casualty Disrobe and Decontamination. BARDA; Washington.

• Carter, H., Drury, J., Rubin, G. J., Williams, R., & Amlôt, R. (2012). Public experiences of mass casualty decontamination. Biosecurity and Bioterrorism, 10(3), 280-289.

• Carter, H., Drury, J., Amlôt, R., Rubin, G. J., & Williams, R. (2013c). Perceived responder legitimacy and group identification predict cooperation and compliance in a mass decontamination field exercise. Basic and Applied Social Psychology, 35(6), 575-585.

• Carter, H., Drury, J., Rubin, G. J., Williams, R., & Amlôt, R. (2013a). Communication during mass casualty decontamination: highlighting the gaps. International Journal of Emergency Services, 2(1), 29-48.

• Carter, H., Drury, J., Rubin, G. J., Williams, R., & Amlôt, R. (2013b). The effect of communication on anxiety and compliance during mass decontamination. Disaster Prevention and Management, 22(2), 132-147.

• Carter, H., Drury, J., Rubin, G. J., Williams, R., & Amlôt, R. (2014a). Effective responder communication improves efficiency and psychological outcomes in a mass decontamination field experiment: implications for public behaviour in the event of a chemical incident. PLoS One, 9(3), e89846.

• Carter, H., Drury, J., Rubin, G. J., Williams, R., & Amlôt, R. (2014b). Emergency responders’ experiences of and expectations regarding decontamination. International Journal of Emergency Services, 3(2), 179-192.

• Carter, H., Drury, J., Rubin, G. J., Williams, R., & Amlôt, R. (2015a). Applying crowd psychology to develop recommendations for the management of mass decontamination. Health Security, 13(1), 45-53.

• Carter, H., Drury, J., Amlôt, R., Rubin, G. J., & Williams, R. (2015b). Effective responder communication, perceived responder legitimacy, and group identification predict public cooperation and compliance in a mass decontamination visualization experiment. Journal of Applied Social Psychology, 45, 173-189.

• Hanley, C. (1999, December 7). Residents sickened by pesticide cloud; ag officials insider changing rules. Latino News. • Harvard School of Public Health Emergency Preparedness and Response Exercise Program. (2013). Proposed minimum decontamination capabilities

for hospitals in Massachusetts. Boston, MA: Harvard School of Public Health.• NATO (2009). Psychosocial care for people affected by disasters and major incidents: A model for designing, delivering and managing psychosocial

services for people involved in major incidents, conflict, disasters and terrorism. Brussels: NATO.• United States Fire Administration. (1997). Fire department response to biological threat at B'nai B'rith headquarters. Washington, DC: United States

Fire Administration.• US Department of Homeland Security, US Department of Health and Human Services. (2014). Patient decontamination in a mass chemical exposure

incident: National planning guidance for communities. Washington, DC: US Department of Homeland Security, US Department of Health and Human Services.

• Vogt, B. M., & Sorensen, J. H. (2002). How clean is safe? Improving the effectiveness of decontamination of structures and people following chemical and biological incidents. Tennessee: Oak Ridge National Laboratory.

Acknowledgements

Dr Holly Carter (PHE)

Dr Richard Amlôt (PHE)

Dr James Rubin (King’s College London)

Professor Richard Williams (University of

South Wales)