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efforts should create mutual aid agreements between healthcare providers to facilitate cooperation. This will allow for both the evacuation and hosting of the special needs population. Planning efforts should identify secondary means of transportation including taxis, school buses, charter buses, and so on. Planning strategies must use realistic and tested or theoretically sound assumptions. Unfortunately, most plans do not address psychological considerations. Recent events have demonstrated that psychological impacts to large numbers of people are just as profound as the physical trauma they suffer. People may overreact due to a lack of knowledge or fear of hazardous materials or radiation and the effects of exposure to them. Some people who are not actually exposed will believe that they are. The idea that perception is reality holds true, so people's perceptions should not be casually dismissed. Road rage due to traffic congestion and unreasonable behavior is very likely, as it happens on a daily basis in normal times. It is conceivable that it could become widespread and violent during evacuations. It is also possible that assaults, suicides, and homicides would increase and that fanatical religious and extremists groups would take advantage of the situation of unrest. Our multi-hazard plan does not fully incorporate all psychological considerations and is therefore based on unsound assumptions. Our plan assumes that evacuation will be orderly, when in fact it will not. Our plan assumes that civil disturbances will be very limited, when in fact they may become widespread. Our plan assumes that individuals will follow directions, when history shows that they are more apt to act on their own initiative. Our plan assumes that only those told to leave will evacuate. In reality, many people evacuate because of their own perceptions and fears, not because they are at direct risk or told to do so. Our plan assumes that all available personnel will come to work, when some, perhaps many, will not be able to for a variety of reasons. Does your plan consider psychological factors such as heightened anxiety, overreaction, anger, a sense of loss of control among your citizens, and other feelings that may lead to unreasonable actions? Does your plan consider the limited public safety resources on duty at any time and how to augment them to achieve your objectives? Does it also provide for volunteer management for those who show up to help? Does your plan address the need to maintain order in a panicked society and the actions, which may be necessary to restore order if it is lost? Does your plan include provisions for providing initial and ongoing mental health care for the citizens and emergency workers? Regional planning efforts should identify procedures for calming citizens and maintaining order, including public information, special notification, establishment of hotlines, and so forth. Regional efforts should establish agreements and procedures to facilitate mutual aid and common disaster operation protocols. These protocols may establish a standard incident command structure, standard radio codes, and specify inter-agency communication channels. Planning efforts must consider mental health needs both during and after a large- scale incident. Some psychological effects may not be apparent for days or weeks after the event. Regional planning should identify all area mental health resources and their capabilities and create a network for disaster operation. Planning strategies must use realistic and tested or theoretically sound assumptions. Now let's look at a few additional planning considerations. Radio systems across the region are not currently compatible with each other. A uniform regional incident command system is needed. Now, different agencies use different systems or their own different variations of systems. A uniform common terminology or code system is needed. Currently, the same codes have different meaning for different agencies. For example, 1081 means a disabled vehicle for one agency, a warrant service for another, and careless and reckless driving for yet another. Regional resource typing must be developed to ensure that everyone throughout the region calls the same resource by the same name. For example, is a rescue unit an ambulance, a fire department crew, an extrication squad, the Red Cross, the Animal Protection Society? Across the region, all of those are called rescue units. Accurate and rapid