This Web site is a component of the SAMHSA Health Information Network
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This Web site is a component of the SAMHSA Health Information Network. |
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Responding to the Needs of People with Serious and Persistent Mental Illness in Times of Major DisasterYou may order a courtesy copy by using the online order form, or click below to download it to your computer via FTP This document is available as zip-compressed archives, in the following formats: Zip-compressed files must be extracted before use. Utilities for this are available here for the PC and the Macintosh.
Introduction to Crisis Counseling Programs and Services to Persons With Serious and Persistent Mental Illness Tony Speier, Ph.D. This document provides a brief guide for State and local mental health agency administrators and five detailed chapters for program planners and providers of direct services. The intent is not to suggest that persons with serious and persistent mental illness require separate disaster recovery programs, but that within the scope of such programs people with mental illness may require specialized strategies for accessing the services they need on the journey to recovery. Our goals are:
Chapter Summaries These summaries offer a quick reference to the information in the full document. Chapter 2: This chapter gives State mental health program directors an overview of the role of the public mental health system in disaster response operations, with special emphasis on preplanning activities essential to mobilizing agency resources. State and local mental health program agencies typically function along parallel lines of authority and responsibility. Emergency situations require rapid and integrated agency responses. SMHAs must plan and organize their disaster response operations before the disaster. Administrative policy development occurring concurrently with direct service responses are ill-advised and often confuse--rather than simplify--the response effort. Disaster response planning requires the SMHA to understand the structure of State government, the mission and function of social and human agencies, and the responsibilities of local governments. State emergency operations plans and the mental health response should be organizationally integrated, and direct responses must be well coordinated. The SMHA must assist responders and survivors during all phases of the disaster event and its aftermath. The rapidly evolving nature of disaster events require a flexible mental health response. Quick implementation of preplanned administrative procedures assures availability of crisis counselors and crisis counseling services. Chapter 3: Local mental health authorities, whose missions include providing services and resources to people with serious and persistent mental illnesses and providing mental health assistance to survivors and disaster, will find this chapter useful in assuring that the special needs of those with mental illness are met after a major disaster. People with mental illness have the same basic needs as the general population following a major disaster--safety, shelter, food, social support--but they may have other special needs. Programs designed to meet these special needs should not be anymore stigmatized than programs for other special populations, such as children, the frail elderly, or people with special language or cultural needs. People with mental illness have the same capacity to "rise to the occasion" and perform heroically in the aftermath of a disaster as the general population. Many demonstrate an increased ability to handle this stress without decompensation from their primary illness. Though the local mental health authority is responsible for reestablishing general mental health services to this population, it is also important to provide special disaster services and interventions for those with special needs, either through crisis counseling services for the general population or those specifically provided at mental health service sites. Disaster mental health training should be provided to therapists, case managers, and care coordinators as well as to consumers, families, board-and-care home operators, single-room-occupancy hotel managers and consumers who operate satellite housing programs. Preparedness training should be provided to consumers. Recognition should be given to staff members who continue to provide routine clinical services to people with mental illness as well as to those staff who provide disaster response services. Chapter 4: This chapter will help CMHC managers, program directors, clinical staff, and consumers prepare for, and recover from, a disaster experience. Making disaster planning as a part of an ongoing psychiatric rehabilitation program is a way to educate staff and consumers about preparedness, response, and recovery. Consumers can develop the curriculum and train their peers. Staff must address disaster-related needs of consumers, provide opportunities for group work to share experiences and resolve the painful aspects of the experience, and provide opportunities for consumers to serve the larger community in its recovery. Chapter 5: This chapter is written for those who design, administer, or work in crisis counseling programs. It describes the crisis counseling programs funded by FEMA and monitored by CMHS. It also addresses how these programs may, within the scope of their intent, respond to the needs of this population. Establish predisaster plans, agreements, and relationships among State Mental Health Authority, local mental health provider agencies, State emergency management agencies, and FEMA will help ensure rapid, effective disaster mental health response and timely implementation of the Crisis Counseling Program. CMHS staff may be contacted for help with developing the Crisis Counseling Program and negotiating the bureaucratic maze of State and Federal agencies. States that have recently implemented successful Crisis Counseling Program also can be consulted. The disaster mental health needs of people with mental illness will be similar to those of the general population; it must be assumed that these needs cannot be met by traditional mental health and psychiatric programs. The service concepts of "the three A's"--availability, accessibility, and acceptability--should be incorporated into all crisis counseling services. Adjustments may need to be made for survivors with mental illness. The Crisis Counseling Program function should be broadly applied. It must provide direct services for survivors; training and consultation for disaster workers, CMHC staff, and other providers of services; and crisis counseling and support with CMHC and other staff who are also disaster survivors. Chapter 6: Psychosocial Rehabilitation Programs and Consumer EmpowermentThis chapter is for providers of mental health services, consumers of those services, and their family members. It outlines the experiences of members of Fellowship House, a clubhouse program that experienced Hurricane Andrew. Developing and maintaining a community support network is vital to the ability to access needed resources during a disaster. Using social group work as a methodology prepares consumers and staff for the teamwork needed to weather an emergency. The sense of community and ownership of the clubhouse by consumers and staff plays a major role in recovery from a disaster. Involving consumers in preparing for and recovering from a disaster provides needed human resources and makes good rehabilitative sense. Principles of psychiatric rehabilitation are as effective in a disaster as in normal times. SMA96-3077 |
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