AI-enabled Disaster & Emergency Responders Support (AID+ERS)

Every year, thousands of disaster response personnel are deployed to natural and human-made disasters worldwide to provide immediate assistance. Disaster response personnel, including emergency responders, medical personnel, volunteers, and support staff, experience significant mental health and well-being challenges before, during, and after deployment to the field. Exposure to death and human suffering, threats to personal safety, long work hours, disrupted sleep, time away from home, and cumulative stress, are common experiences having adverse effects on mental well-being, functioning, and readiness. Mental health care is most helpful when immediately available for specific, urgent mental health needs. However, mental health support is often lacking or not considered a priority while deployed to the field, and personnel may not have access to or seek the help they need upon return home.

The magnitude of this problem is significant. According to data reported by SAMHSA, about 30 percent of first responders develop behavioral health conditions, including, but not limited to, depression and posttraumatic stress disorder (PTSD), as compared with 20 percent in the general population. Substance use and relationship problems are also prevalent, and the risk of suicide is also high among first responders. For example, EMS providers are 1.39 times more likely to die by suicide than the general public, even after adjusting for gender, age, race, and ethnicity (Vigil et al., 2018). Cultural stigma concerning mental health treatment is also a problem, creating a barrier to care. And According to the Emergency Event Database EM-DAT (https://www.emdat.be/), there were 387 natural hazards and disasters worldwide in 2022, affecting 185 million individuals and resulting in the loss of 30,704 lives. Heat waves caused over 16,000 excess deaths in Europe, while droughts affected 88.9 million people in Africa. Given projected and unforeseen climate and socio-political changes, more disasters and humanitarian crises are undoubtedly expected in the years ahead.

The impact of unaddressed behavioral health conditions among disaster relief personnel also extends to others. Family members' well-being is impacted when their loved ones' behavioral health needs are not addressed. The occupational functioning of disaster relief personnel after deployment is also affected, resulting in lower productivity and readiness for the next deployment. The financial burden on individuals and society is also significant. What’s needed is trusted, evidence-based, personalized, practical, and rapidly deployable mental health support that is immediately available and effective while personnel are deployed to the field and at home.

Our solution is a rapidly deployable technology-based tool that addresses disaster relief responders' mental health and psychological resilience needs before, during, and after natural and human-made disasters. Our solution is an AI-enabled mobile app that integrates an intelligent virtual agent (virtual human coach) to assist with symptom assessment, psychological resilience and readiness coaching, and targeted intervention. Intervention and coaching are based on the foundation of evidence-based clinical approaches and methodology, including cognitive behavioral techniques, user motivational assessment, self-assessments, and affective state sensing. The app is cross-cultural and fully customizable to users, considering their demographic and language preferences.

The app will assess and track symptoms (i.e., stress, sleep disruption, mood, anxiety) and trajectories across time and initiate follow-up check-ins and assessments before, during, and after user deployment to a disaster zone. At pre-deployment, the app will screen for symptoms via interactive dialogue and provide recommendations for psychological preparation. Using proven psychological resilience-building techniques, the virtual coach will provide brief education and symptom management skills training during this phase.  During deployment, the virtual coach will check in with the user at appropriate intervals (during the user's downtime or upon initiation by the user). The app will track self-reported cumulative stress, grief, mood, workload, perceived success, and social connectedness during this and post-deployment phases. 

Our solution is unique given the focus on the therapeutic relationship with the user and because it addresses the limitations of typical mobile health apps and conventional telehealth solutions for deployed disaster relief and support personnel. Our virtual human approach will facilitate the therapeutic relationship with an interactive and engaging focus on the individual needs of the user. User safety is at the forefront of our design. When additional care needs are identified, such as crisis intervention, the app will initiate appropriate intervention, make recommendations for further care, alert a family member, friend, or coworker that assistance is needed, and connect the user to national/international suicide prevention hotlines. Our app does not make clinical diagnoses but identifies and tracks symptoms to guide education and intervention and provide feedback to the user.

Our solution overcomes the technical limitations of existing mobile health apps. Ours does not require a continuous Internet connection at point-of-use. Instead, our solution will use local processing and computation until an Internet connection is re-established.

The target population of our solution is disaster response personnel worldwide.  These include frontline medical personnel, social workers, volunteers, security personnel, administrative support, supply personnel, and others in deployed environments. Usually, disaster relief behavioral health solutions are focused on the direct victims of the event, not relief responders. Our solution specifically targets the people who are frontline workers in disaster events.

Frontline disaster relief personnel experience persistent stressors and trauma during deployment that impact their psychological well-being. These stressors include direct exposure to the adverse effects of the disaster, cumulative stress from hearing survivors' stories, chronic stress from approaching victims who may reject assistance, feeling overwhelmed by the grief and sadness expressed by others, and feelings of inability to alleviate the pain of others. Other factors include long work hours for extended periods, lack of or insufficient supervision, and sometimes inadequate or inexperienced management and leadership that overlooks or exacerbates psychological distress among crisis personnel.

Our target population of disaster relief responders is also underserved by conventional behavioral health care while deployed and upon return home. Our solution will address the needs of disaster relief personnel by providing them with the behavioral health support they do not get through conventional means. Disaster response personnel would benefit from a reliable deployable technology-based solution capable of providing the needed support before, during, and after a disaster. And while on deployment, unlike conventional mental health support, our solution is available 24/7, as long as there is the capability to charge user-owned or provided mobile devices.

Our solution directly impacts the lives of disaster relief personnel by providing them with personalized mental health support and resilience tool. And while disaster relief personnel are the primary target group of our solution, disaster relief teams, and organizations will also benefit when their staff and volunteers are more effective and productive. Family members back home will also benefit, as will the persons and communities that disaster relief personnel serve while they are deployed.

Jose Florez-Arango, MD MS PhD., Co-Founder/Principal, is a Colombia ER-trained doctor, with broad experience in disaster management, and health informatician with experience in persuasive technology, mobile technology, telemedicine, and low-resources environments decision-making support. Dr Florez was a volunteer at the Colombian Red Cross and national coordinator of prehospital response. 

David D. Luxton PhD, MS, Co-Founder/Principal, is a licensed clinical psychologist, professor, and entrepreneur with expertise in behavioral health technology development. A former military psychologist and research scientist, he has authored more than 100 academic articles and book chapters in the fields of artificial intelligence, ethics, telemedicine, and psychological health. He is an Affiliate Professor in Psychiatry and Behavioral Sciences at the University of Washington School of Medicine in Seattle and the founder of Luxton Labs LLC, a behavioral health technologies research, development, and consulting company. Dr. Luxton has direct experience with developing technology-based clinical solutions for personnel (military and civilian) deployed to war zones and upon return home. He also has expertise in developing virtual intelligent agent technology, and experience assisting and leading technology start-ups. Dr. Luxton is also a US military veteran with expertise in emergency management and crisis response in deployed environments.

Drs. Florez-Arango and Luxton are uniquely positioned for project success given their backgrounds and experience with behavioral health technology development as well as direct connections to organizations for partnering in the testing and further development of the AID-ERS solution. 

We are working in the initial mockups of the integrated tool. We will be recruiting champion users to conduct a series of participatory design workshops. We will be recycling previous developments from previous work, as GuideView (a no code platform for structured multimedia knowledge encoding and distribution), ASRaDA, a mHealth tool for screening and referrals, a group of assets (Virtual Patients) for Augmented/Virtual Reality developed with the Center of Innovation on Mental Health at CUNY, and HADA developed at Universidad Pontificia Bolivariana, that will be converted into virtual coaches. 

None. We are in design and validation phase.

We are a team of clinician-researchers with experience in the design and development of innovative behavioral health technologies. Our backgrounds are in mobile health app development, health informatics, telemedicine, and AI, as well as in behavioral health crisis intervention and crisis relief. We are in an initial start-up phase, with a design prototype that requires funding to further develop, test, and deploy in the field. We have a team of consultants and collaborators on hand who can assist with all phases of development and testing, but we need immediate funding support for developers. We also have the necessary connections with disaster relief organizations to enhance development and test our solution in the field. 

To our knowledge, there are no deployable tools specifically tailored to supporting disaster responders' mental health. There are existing mobile health apps that are intended to serve similar occupational groups, such as police and military personnel and veterans, but none that focus on the unique needs of deployed disaster responders.

Our integrated intelligent conversational virtual agent (virtual coach) approach is focused on the therapeutic relationship and is innovative while based on a solid foundation of previous research. We are also using co-creation and user-centered design principles to integrate technologies in ways that have not been integrated before for the mental/behavioral health domain. Our design is also intended for deployed situations where Internet connectivity may be limited.

Our aim is to design our technological solution and clinical approach to the needs of diverse (i.e., occupational, demographic, and cultural backgrounds) persons in deployed environments. This has the potential to maximize outcomes and overcome the insufficiencies of existing tools and methods in the market.

1 year:  have completed usability and acceptability testing.  have deployed the tools within responders to a major disaster

5 years: have conducted efficacy evaluation in short-term and  long-term effects of disasters in responders mental health

The UN Targets that we are aiming include

3.C Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing States.

3.D Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks.

Our solution will contribute to strengthening the capacity in early warning, risk reduction and eventual management of mental health conditions of responders to disasters.  We expect to impact the awareness in metal health, increase the management and ultimate reduce the impact of severe mental health problems as suicide. 

• Awareness

• Resilience 

• Connectedness

• mobile technology

• AI

• Self organizing networks

We are a welcoming group to all people based on their skills, regardless of their race, sexual identity, religion, nationality or any other social label. We look to work with passionate individuals.

Dr Florez has been chair of Academic Diversity, Equity and Inclusion committee, and is an active member of the DEI committee in the American Medical Informatics Association (AMIA), and co-chair of the DEI Education, Governance and Policy subcommittee.   

We are looking for Research grants to conduct the acceptability and usability testing. In the future the software will be available in a subscription-based with governments, insurance companies and NGOs, we will consider  philanthropic sponsorships, that will facilitate the access to everyone.  

This is our first funding round