Updates

What’s in Your State’s Disaster Management Plan? 4 Ways to Incorporate Mental and Behavioral Health Into Disaster Planning

By Caroline Willemin

(Released 9 May 2018) Last year was one for the record books: hurricanes, floods, severe cold, drought, and wildfires – totaling over $1 billion in climate- and weather-related damages. Hurricane Preparedness Week is a perfect time for states, tribal nations, and territories to start reviewing state and local disaster preparedness plans to ensure they are up-to-date and address all aspects of planning, response, and recovery.  

A recent analysis by the U.S. Department of Health and Human Services found that 64% of the state emergency response plans that are available online do not adequately plan for behavioral health needs. Behavioral health services - the provision of mental health, substance abuse, and stress management services to disaster survivors and responders – is a critical component of disaster response.  

To help states build psychological resilience for both victims and responders of a disaster, recovery specialists from HHS’ Office of the Assistant Secretary for Preparedness and Response (ASPR) reviewed each of the 16 behavioral health plans to identify programs and methods that promoted successful outcomes. 

  • Crisis Counseling Assistance and Training Program (CCP) Implementation 
  • Continuity of Medications Implementation Plan
  • Spontaneous Volunteer Supervision Implementation Plan
  • Training Inclusion Implementation Plan

States are encouraged to use this information as a starting point to help integrate mental and behavioral health needs into preparedness, response, and recovery activities.

The following examples illustrate some ways states have successfully incorporated and utilized these components in their state preparedness plans.

SAMHSA CCP  

In the event of a Presidential disaster declaration, the Federal Emergency Management Agency has the authority to activate supplemental assistance to help states address behavioral health needs utilizing the Crisis Counseling Assistance and Training Program. States interested in applying for this assistance, which is managed by the Substance Abuse and Mental Health Services Administration (SAMSHA), must adhere to strict deadlines for submission.  Preparing prior to a disaster will allow for more efficient grant submission and implementation.   

California addresses CCP in its Mental/Behavioral Health Disaster Response Plan by providing a brief program description along with recommended actions for implementation, and appendices that provide more detailed information.  Some key features of California’s plan are:

  • Familiarizing yourself and your behavioral health staff with the CCP application and other available federal resources in advance of a disaster. 
  • Educating state and local stakeholder groups on federal resources available and how to incorporate them locally.  
  • Pre-identifying local providers for CCP services and having a system in place for documenting the behavioral health efforts expended. 

Texas utilized the CCP program following Hurricane Harvey. FEMA provided $13.9 million in disaster crisis counseling, most of which the Texas Health and Human Services Commission put toward the Texans Recovering Together program.  This program helped people recover by providing extended crisis counseling services that allowed local providers to travel to clients’ homes and community centers to offer counseling, education, resources, and referral services to survivors of Hurricane Harvey. 

Continuity of Medications 

Following a disaster, continuity of care poses a major challenge as many individuals are forced to evacuate their homes and leave medications behind.  Interruption of routine medication schedules poses health risks, and can add to individual distress during disasters.  Integrating medication availability, stockpile location, transportation, and administration into state disaster response plans promotes a coordinated approach to continuity of care during and following disasters. 

Mississippi’s Disaster Preparedness and Response Plan specifies that each Department of Mental Health facility have a limited supply of medications available in the event of an emergency.  Each facility director is responsible for providing wholesaler and/or vendor information to the Mississippi Mental Health Disaster Coordinator (MHDC) who can then reach out to wholesalers if additional supplies are needed.  The MHDC also coordinates medication delivery if regular procedures are unavailable or not accessible.  Lastly, Mississippi’s plan includes information on how to access and distribute resources from the Strategic National Stockpile.  

Managing Spontaneous Volunteers

Spontaneous and unaffiliated volunteers sometimes converge on the disaster site.  Although these volunteers arrive with good intentions, they are usually not associated with any existing emergency management response system, which can present challenges.  FEMA has a guide, Managing Spontaneous Volunteers in Times of Disasters: The Synergy of Structure and Good Intentions, to help communities plan for and manage spontaneous volunteers. 

The Arizona Department of Health and Human Services has developed a Volunteer Management Plan and pre-identified a health volunteer coordinator to use in conjunction with the state Emergency Response Plan.  This plan ensures statewide coordination of all volunteers, including spontaneous ones who have not undergone credentialing or enrolled in the Arizona Disaster Healthcare Volunteer database.  

Training before a Disaster

Crisis responders, including disaster behavioral health professionals, may experience psychological effects after responding to a disaster.  It is important for these responders to receive training prior to a disaster to prepare for and respond to such events.  Suggested trainings include: National Association of County and City Health Officials’ Building Workforce Resilience through the Practice of Psychological First Aid and FEMA’s Incident Command trainings 100-800. 

Colorado has developed a Crisis Education and Response Network (CoCERN) that suggests trainings for individuals at several different levels of disaster behavioral health response.  CoCERN also has a trainee position where individuals new to the field can gain experience working closely with the incident management and response teams. 

During Hurricane Preparedness Week, take some time to get ready for the upcoming hurricane season. ASPR’s Division for At-Risk Individuals, Behavioral Health & Community Resilience (ABC) has identified numerous behavioral health and at-risk planning resources. Also available for download is SAMSHA’s Mental Health All-Hazards Disaster Planning Guidance. 

Released by U.S. Department of Health and Human Services Assistant Secretary for Preparedness and Response (ASPR). Click here for source.