Monday, December 20, 2010

What's the connection between IPM and mental health?

I returned last week from the annual conference of the Entomological Society of America--or, as I heard it referred to by a (non-entomologist) hotel visitor, "that Bug's Life group". With over 3100 attendees this year the ESA meeting is probably the largest gathering of professional entomologists in the world, with papers ranging from highly technical reports on new molecular biology techniques to an artist's perspective on the aesthetic beauty of insects.  Regardless of your interest or background, there's always something of interest at ESA.

While a number of sessions and talks were devoted to bed bugs this year, one of the most interesting perspectives I heard was from Dr. Christiana Bratiotis of the Boston University School of Social Work.  She addressed a symposium on how to engage people from diverse backgrounds in urban IPM. Bratiotis's expertise is on hoarding behavior, but she addressed the wider question of how to recognize and deal with people who, for a variety of physical or mental reasons, pose a special challenge to the PMP. 

Making IPM work, Bratiotis said, is especially difficult when pest control customers suffer from a variety of mental and emotional disorders, cognitive limitations, and limitations due to age. Some of the primary mental illnesses likely to be encountered by anyone in the service industry include depression, anxiety, hoarding (of both belongings and animals), schizophrenia and psychoses.  Personality disorders include obsessive-compulsive disorder, histrionics, borderline personalities, and narcissistic personality disorder. In addition, cognitive limitations in the mentally challenged and older adults, as well as visual and hearing deficits in many people can lead to difficulties with communication and getting clients to recognize and report pest control problems.

Mental health disorders, especially, can lead to unexpected encounters with a pest control technician, such as the violently angry customer, or the customer hallucinating about unseen pests in walls or crawling on skin at night (delusory parasitosis).   Add to this that the PMP may be one of the few visitors that a depressed or reclusive person may have in his or her home for months (even years), and the stage is set for some interesting interactions.

Mental health problems are far more common that most of us realize.  According to the National Institutes of Mental Health, approximately 6% of the U.S. adult population suffers from severe mental illness.  Over 26% of American adults experience some form of mental disorder in any given 12 month period.  The chance of any of us experiencing a mental disorder of some form over our lifetime is approximately 46%. Clearly, this is not a minor issue.

The relevance of Bratiotis's paper to pest management is obvious, yet I'd wager that most of us in the pest control industry rarely give much thought to how many of our clientele are struggling with mental and emotional health issues.  I know I tend to approach most people with the attitude that they will be just like me--that they will have the same needs and desires, that they will approach problems rationally, and they will be looking for solutions in their own and others' best interests. Sadly, this is not a valid assumption for many people.

If your company's PMPs interact with dozens to hundreds of people daily, having tools and skills to recognize and deal with mental health issues is essential.  If you're an employer with one or more employees, you need skills to recognize and deal with mental illness within your staff as well.  This point came home tragically to the Dallas pest control community last August, when an employee of one of our local companies shot and killed a co-worker in an incident almost certainly due to mental illness.

According to Bratiotis, learning a few simple phrases or techniques can, in many cases, help a PMP better deal with customers who are not acting or thinking rationally.  For the person with obsessive-compulsive disorder, who is fearful that they must perform in a specific manner to get rid of pests, affirmation is important.  Assure them that things don't have to be done perfectly to make a big improvement.  For the emotionally unstable or angry customer the best response may be, "I can see you're not doing well today.  I'll come back when you're feeling better." A self-centered (narcissistic) person should be affirmed and empowered to be part of the pest control solution.

Recognize that some problem clients may simply be visually- or auditory-impaired.  Such limitations do not necessarily imply cognitive (thinking) disorder or mental illness, but they can present similar challenges for the PMP.  Visually-impaired clients may not be able to read notices or see the bed bugs or cockroaches in their home.  Auditory-impaired clients may not hear instructions or reports, even though they nod or imply that they do.  Technicians should be aware and on the lookout that some clients will fall in these categories, and will need extra help.

In many cases outside help may be called for.  Letting the apartment manager know what's going on with a problem tenant is important for multi-family housing accounts.  Elderly or mentally challenged customers may need a personal care attendant or access to support services that can help with residence clean-up.  Extreme cases of hoarding will likely also require the help of a professional. 

Additional suggestions include:
  • Help identify resource people or agencies that can help a physically or mentally challenged person (this means educating yourself about the social and mental health resources in your community).
  • Schedule ongoing follow-up and monitoring. Knowing that someone cares and plans to return can make a significant difference in rate of compliance with challenged customers.
  • When making sanitation recommendations to challenged customers, break suggestions down into manageable tasks.  Breaking a recommendation into small steps can make all the difference between progress and paralysis.
  • Realize that many of your customers may be struggling with mental and physical challenges that may not be immediately apparent.  Liberal praise and encouragement  is especially important for these customers when they make an effort to participate in the IPM effort.
Finally, get to know some of the mental health professionals in your community.  These folks may be willing to conduct awareness training and provide resources for your staff.  Conversely, your knowledge and expertise may be of value to the health care community.  It was obvious to me after last week's paper that we in the IPM business need to communicate more with social workers and mental health physicians.

    Friday, December 10, 2010

    U.S. EPA celebrates the 40 year mark

    Cuyahoga River fire
    Like Hurricane Katrina and climate change, and the honey bee decline today, the Cuyahoga River fire in 1969 caught people's attention about the state of our environment like headlines never did.

    I was in high school when the Environmental Protection Agency opened its doors 40 years ago today. That might not seem like something a high school student would be interested in, but as a budding environmentalist, passionate outdoor enthusiast and Earth Day organizer, I was very interested.

    At the time of the late 60's protection of the environment was not a high priority for our government. Concerns about waste disposal, clean air and water, pesticides and wildlife were growing and regularly reported in newspapers and magazines. Thanks in large part to the EPA, there is much to celebrate about the state of our U.S. environment. Streams run cleaner, food is (arguably) safer, the air is much clearer in most parts of the country, and standards for pesticide safety have never been higher. The bald eagle is back, as are peregrine falcons and ospreys and brown pelicans.

    We're certainly not without challenges and controversies today. Rapid climate change has even our best scientists perplexed about causes and solutions. Fisheries continue to decline. Pockets of unhealthy air persist. Toxic chemical waste proliferates, even with (or because of) our technological advances to computers. Trash in our streams seems worse than ever thanks to our ubiquitous plastic. Oil hasn't run out, though we see the limits to fossil fuel based energy more clearly than ever. Worldwide, more species have vanished, or are threatened, than we might have guessed 40 years ago.

    With all the popular hue and cry about shrinking big government, I for one am thankful that our country had the foresight forty years ago to set up an independent agency to guard our natural heritage.

    I know that government itself needs its watchdogs, and EPA is no exception. Nevertheless, I fear that in our scramble to cut budgets, we may forget the progress of the past 40 years, and lose sight of the need for an independent arm of government with an interest in the future of our world at its heart. A strong environmental ethic is exactly the export we need in this era of global exploitation of the environment. Just look at the Aral Sea (formerly USSR, today Kazakhstan and Uzbekistan) and the Yangtze River valley (China) and many of the other environmental disaster areas if you need a reminder of what unrestrained environmental exploitation looks like.

    Here's a toast to all the dedicated workers at the EPA who have worked so hard to please Congress and Presidents past, while keeping their eyes on the prize of a cleaner world.

    Saturday, December 4, 2010

    Rodenticide changes explained

    Bell Laboratories has done a nice job laying out the 2011 EPA changes to rodenticide rules in a new website  These changes will affect what formulations you use and will result in significant label changes.  So don't be caught flat-footed come June.  The changes will impact all manufacturers, retailers, distributors, professional, agricultural and home users of rodenticides.

    Speaking of home users, it might be a good idea to let your customers know the whats and whys of these changes.  Retail consumers will only be able to purchase first generation rodenticides and they will only be available in bait station formulations.  This should improve child safety and could have the effect of making professional rodent control help more attractive to the average consumer.  For EPA's take on the changes, click here.

    Thursday, December 2, 2010

    TIPMAPS 2.0

    Keynote speaker, TDA Assistant Commissioner Jimmy Bush, connected
    with the crowd on Day One.
    In case you're new to this blog, you may not have heard me talk about our state association for school IPM coordinators, TIPMAPS.  Short for Texas IPM Affiliates for Public Schools, the group is an affiliate of the Texas Association of School Business Officials (TASBO), a well-respected professional organization for school professional in our state. 

    The TIPMAPS group recently held its second annual meeting.  According to TASBO, the conference was attended by over 220 attendees and vendors, representing 108 school districts.  The business meeting on the second day of the conference held over 90 participants, significantly more than 2009.  This is wonderful growth for this new group, and seems to indicate that school IPM coordinators are beginning to take ownership of their relatively new profession.

    For me the highlights of the meeting were hearing coordinators and school administrators present their own take on how IPM works in Texas schools.  Jim Olenski, Greenville ISD, gave an excellent presentation on how to get staff on your side in a school IPM program.  "Don't be a battleship [trying to bend people to will]," Jim said.  Instead, "be a cheerleader." Encourage folks in the positive things they do, and respect the contributions everyone makes to the district.

    Martha Buckner, Humble ISD, shared her insights as to how to work with school boards.  Knowing your board members as individuals, knowing what makes them tick, their special interests and their connections in the district is key to developing a working relationship there.

    Charles Adams, Sherman ISD, shared his extensive experience with trapping wildlife with two classes.  The highlight of his talk was watching him do an outdoor inspection of the hotel and find rat activity (one jumped out of a burrow in front of the class) and raccoon scat a few feet from the elegant outdoor dining area.  Everyone in the training was also treated to a whiff of several baits guaranteed to drive critters wild.

    This year's keynote speaker was Mr. Jimmy Bush, Assistant Commissioner of the Texas Department of Agriculture, over all pesticide programs including school IPM.  Many people cited Bush as one of the highlights of the conference, as he gave an understandable overview of how pesticides are regulated in the state.  In addition to Bush, Randy Rivera gave an informative session on IPM and ag science programs; and inspector Perry Cervantes explained the licensing process and how to get the necessary training for unlicensed employees.

    Comments from participants included:
    • Appreciated the fact that unlike some CEU programs, speakers were not spokesmen for particular products
    • Enjoyed the opportunity to network and see what other schools are doing
    • It was nice to meet and greet the vendors
    • Hearing from people from different fields [of expertise] helps
    • Well prepared and knowlegable speakers.  I appreciate the in-depth information
    • Wish I had come last year!
    • Can't wait till next year...
    To see more photos from this year's conference, click here.  And if you couldn't make this year's event, don't miss it in 2011.  The hotel is reserved and ready for next time.

    Wednesday, December 1, 2010

    Bed bugs go to school

    Treating school classrooms for bed bugs should be
    a last resort, and only if the pests are known to be present.
    A recent incident in a New Jersey public school made headlines, and got me thinking about right and wrong ways to deal with bed bugs in schools.  In the story, two bedbugs were found on the book bag of a student on a school bus, resulting in an immediate inspection of the school and "fumigation" of the bus.

    Without actually detecting bed bugs in the classroom, the story says that a "specialized exterminator" (I wish we could lose that name) was called in to treat the surfaces where bed bugs could take refuge in the affected class. Later, a bed bug sniffing dog was called in to clear the classroom. Similar incidents with similar aggressive responses are being reported throughout the country.

    If you read the story you can see the incident from the perspective of a school superintendent. The superintendent wants to be able to get up in front of the media and confidently say, “We’ve taken care of the problem.” To this superintendent, this meant that they had involved the highest authority to affirm that the school viewed the problem seriously (State Board of Health—who likely didn't really want to get involved) and gotten professionals to identify the pest and deal with it quickly (by “fumigation”).

    This may be good PR, but it's not the ideal IPM response. Eventually schools, I think, will find this sort of approach unsustainable. This will occur when bed bugs start showing up more routinely in schools. State Boards of Health will no longer accept calls about bed bugs, the maintenance department’s pest control budget will become strained from all the extra, premium-priced service calls, teachers will get tired of having their classrooms “sealed off” unnecessarily, and those dogs will get doggone'd expensive. And inevitably, parents will soon begin to worry about their kids' exposure to pesticides.

    The main problem with the approach reported in story is that some schools are over-reacting to what will certainly become a relatively routine pest problem. Schools want a guarantee that they are bed bug-free, something that is very difficult in real life.  Professionals know that if they really treated every surface where bed bugs could hide, it would require a major investment of labor and time (one I hope you would be charging for). Such efforts would certainly not be warranted without first determining that there was an actual infestation.

    By the way, this brings up our use of the terms infested and infestation. I think it’s better, when it comes to bed bugs, if we reserve use of these terms to situations where bed bugs have settled in and are reproducing as a result of a consistent and available nighttime food supply—something that will probably not be very common in the average public school. I recommend that we start referring to isolated bed bug sightings as detections, not infestations.

    We aren’t told what “fumigation” referred to in this story, though it was certainly not a real fumigation job involving fumigant gases. At its most harmless level, the treatment was likely an application of a non-residual, contact insecticides to cracks and crevices around the backpack areas and the student's desk. It might have been an aerosol ULV application to the bus (not very effective against bed bugs in good harborage). At it's worst, the treatment may have been haphazard spot treatments with residual pyrethroids, which could easily result in contamination of surfaces where kids might have contact.  None of these treatments, as they are commonly applied, provide an absolute guarantee of no more bed bugs. 

    A school district in Texas recently went through a similar incident in several of its classrooms. The response of this district, well trained in IPM, was to do a visual inspection of the room, alert the parents of the child, and have their pest management contractor put out two carbon dioxide bed bug monitors over the weekend to confirm that bed bugs were not present. Monitoring, not pesticide application, is probably the best first response to reports of “hitchhiking” bed bugs on a school backpack.

    This same school district has determined that in cases where the children are likely to continue to come to school with bed bugs, their backpacks will be zip-loc™ bagged during the day as a precaution. This district recently held a district-wide training for its school nurses about bed bugs, and also sends informational letters out to parents in classrooms where bed bugs have been detected.

    We're still learning about the best ways to deal with bed bugs in schools, and doubtless we will come up with better protocols. In the meantime, we should avoid over-reacting to what will become an increasingly routine problem.  And this means educating superintendents and school principals about the facts of life when it comes to bed bugs.