It is estimated that up to 25 to 30 percent of people—in severely exposed communities — experience new mental health and addictions problems in the wake of disasters. Such persons, who are traumatized by disaster but do not have pre-existing behavioral health disorders, need professional crisis counseling and help in formulating practical plans to regain normalcy.

Consumers with pre-existing serious mental illnesses are very vulnerable to stress. In addition, separation from home, family, and their normal living situation adds to the vulnerability of an already vulnerable population. Their immediate needs are therefore for access to the medications they normally take and for ongoing psychological support. They also need support to integrate into their new communities and to find and use local resources, given that disaster has caused them to be displaced and relocated, for indefinite periods or even permanently.

While community behavioral health providers are ideally equipped to serve both groups requiring mental health treatment in the wake of a disaster, they are faced with additional burden on already limited resources and consequently with many challenges such as

• Addressing the needs of staff. As first responders, members of staff often struggle with their own trauma and reactions when they confront disaster. Providers typically face significant temporary or permanent loss of staff in the wake of disaster, due to dislocation and inability to offer competitive salaries. This compounds what is an already serious problem — the shortage of a skilled behavioral healthcare workforce. Further, providers need additional staff because they have to care for new disaster victims, in addition to their existing caseloads.
• The need for increased infrastructure and resources from cell phones to computers to transportation — often, the providers must continue to provide services, despite significant damage to their own facilities and equipment.
• Lack of direction on how to handle new patients, many of whom have no medical records or history to provide in the wake of the disaster.
• The struggle to cover the costs of treating hundreds of new patients without quite knowing how and when they will be compensated. Financial support is usually slow in coming through and when it does, access to funds is complicated. Providers responding to disaster thus have the dual challenge of short-term cash flow problems and longer-term access to special funding.
• Shortage of psychotropic medications to meet the increased need.
• Support of disaster victims with serious mental illness who lose the supported housing they live in while transitioning to community living.
• Patients who lose this 24-7 support would be devastated and might have to be re-hospitalized — a horrible and expensive consequence.

Community providers responding to disasters have also expressed to the National Council the need for technical assistance, state-of-the-science information and educational tools and resources to help in accurate diagnosis and treatment of trauma victims. Providers also need forums to share with one another knowledge, experience, and best practices on all aspects of dealing with the aftermath of disaster.

Despite the many challenges, we’ve seen that in the face of disaster, community behavioral health providers keep their doors open and continue to serve all in need. The National Council is committed to helping to meet this need through Project Helping Hands.