How to Create a Disaster Behavioral Health Plan

Disasters happen. Whether they are natural or man-made disasters, human services professionals must prepare accordingly. While the steps your organization takes to prepare for a disaster may vary based on its location, there are certain best practices everyone can follow. To help your organization provide the best response possible, we’ve put together this resource on disaster behavioral health.

In this article, we cover what disaster behavioral health is, why it’s important, and how to formulate a disaster behavioral health response plan.

What is disaster behavioral health?

Disaster behavioral health is a field of disaster response that focuses on the mental and behavioral health of those affected by a disaster. According to the Department of Health and Human Services:

“Disaster behavioral health… includes the interconnected psychological, emotional, cognitive, developmental, and social influences on behavior, mental health, and substance abuse, and the effect of these influences on preparedness, response, and recovery from disasters or traumatic events.”

Often, when we think of disasters, we think of catastrophic natural events. These can include hurricanes, tornados, earthquakes, and others. However, man-made disasters have become an all-too-real possibility as well. Situations such as mass shootings, terrorist attacks, and other forms of large-scale directed violence fall under the umbrella of disaster behavioral health.

While these disasters can inflict significant damage, they also leave manifold crises in their wake. Scenarios that commonly arise from disasters include homelessness and financial instability, personal injury or loss of a loved one, and lack of access to necessities such as clean water.

All of these effects of disasters can lead to mental and behavioral issues that further compound the trauma.

How disasters can affect behavioral and mental health

The impact of disasters is often felt long after the disaster itself. While some disaster survivors can resume normal life after the end of the event, many others encounter adverse behavioral and mental health effects. These can include anxiety, depression, post-traumatic stress disorder (PTSD), and more.

In fact, 15% of individuals who have lived through a natural disaster are diagnosed with depression or anxiety. These adverse effects can arise for a variety of reasons, such as:

• Individuals who lose their home — this can result both in displacement, as they must live in temporary housing/emergency shelters, and potential loss of support networks, as they may become separated from family and friends.
• Difficulty contacting family and friends — the stress of not knowing if loved ones are safe can cause large amounts of anxiety that can be retriggered during another disaster or threat of a disaster.
• Danger and trauma to those responding to a disaster — it is difficult for first responders and aid workers who witness the destruction that these events can bring. This group also experiences an increased risk of injury and exposure to harmful or hazardous materials.

The resultant mental and behavioral health effects may cause wide ranging issues among the affected populations. Those who continue to cope with anxiety, depression, or stress-related mental health issues will most likely show symptoms such as irritability, trouble sleeping, tremors in their hands or other extremities, and/or fatigue just to name a few.

Those experiencing PTSD following a disaster will exhibit different symptoms. Some common signs and symptoms of PTSD include:

• Finding themselves reliving the event through flashbacks, nightmares, or uncomfortable, distressing memories of the event itself
• Having feelings of numbness and avoiding social situations, especially people or places that remind them of the trauma
• Experiencing feelings of being on edge or jumpy, which can make it difficult to sleep and cause irritability or anger

The link between trauma and healthcare needs

In recent years, researchers have taken a more holistic approach to understanding human health. As a result, we now know that mental health issues, such as trauma resulting from a disaster, can have profound effects on every part of one’s health. When performing disaster behavioral health, it is important to understand the physical manifestations of trauma.

Such manifestations can occur in a variety of ways. They can appear as benign as a headache or stomach pain or as severe as breathing difficulty and accelerated heart rates. Additionally, it’s important to understand the link between trauma and substance use.

If left unchecked, the mental and behavioral health consequences of disasters can begin to affect other parts of the body. These effects can present in the weeks, months, or even years following the disaster. Multiple studies, in fact, have found a connection between trauma and neurological illness, cardiovascular issues, and musculoskeletal disease.

Disaster behavioral health and recovery

There are many ways to practice disaster behavioral health to help those in crisis. Here, however, we’ll concentrate on the most proven methods on both the individual and community level. All of these practices have the same end goal in mind: to help those affected by disaster recover from the stress and trauma of the event.

Provide Psychological First Aid

Much in the way traditional first aid is designed to relieve the patient of physical pain, Psychological First Aid (PFA) is a program that helps to begin the emotional healing process following a traumatic event. As discussed above, myriad behavioral and mental health issues can arise following a disaster. While PFA is not a substitute for therapy or other forms of psychiatric care, agencies can use it to help reduce stress and trauma immediately following a disaster.

The goal of PFA is to assist individuals in finding safety and stability while also connecting them with appropriate resources for further help. Since no two disasters are the same, and everyone reacts to disasters differently, PFA functions more as a set of guidelines to organizations offering this help. When formulating a PFA plan, your agency should train its responders to do the following:

• Look for and identify those individuals with urgent needs following the disaster.
• Help affected individuals find food, potable water, shelter, and medical care.
• Assist individuals in finding family and/or friends.
• Listen to survivors, offer them reassurance, and remind them that more help is on the way.

By performing these actions, those responding to disaster can have a profound effect on individual survivors. But, for human services organizations it is also key to consider larger, community-level responses to disaster.

Engage in partnerships

Partnerships are a key component of disaster behavioral health. They help organizations provide more services to affected populations by making a wider range of resources available. When coordinating your disaster response plan, it’s important to understand which governmental agencies (federal, state, or local) as well as private organizations you can partner with.

When seeking partners to work with, make sure to identify shared values, objectives, and goals regarding your response plan. This will help you and your partners be on the same page from day one. Additionally, work to identify each agency’s roles in the disaster behavioral health plan. This will help ensure there’s no duplication of effort so that the affected communities get the most help possible. Additionally, it’s helpful to create boundaries for the partnership. This can include:

• How long the partnership will remain active
• Which organization will function as the leader and which will fill a support role
• Goals for your partnership’s response and when to demobilize your response

After these parameters are in place, you’ll need to finalize your partnership through a memorandum of understanding (MOU).

The final step to engaging in effective partnerships is to keep them going through consistent and effective meetings, exercises, and training sessions.

Providing information to affected communities

It’s not uncommon for misinformation to spread following a disaster. As such, a crucial component to any disaster behavioral health response is providing accurate, timely information. You should seek to provide this information through your organization’s own outward facing communication channels, as well as partnerships with local media outlets.

According to guidelines developed by SAMHSA, public messaging after a disaster should do the following:

• Use simple, easy to understand messages that provide regular and accurate updates.
• Make sure information is released in a timely manner, as delays in crucial information could cause further harm and/or mistrust among the affected communities.
• Demonstrate your expertise. This will lend credibility to the information you present, making it easier for your organization to help ease tension and fears following a disaster.
• Build trust with the affected communities via your messaging. A great way to do this is through a respectful display of empathy.
• Address rumors in an open and honest fashion.

Through these steps, your organization’s disaster behavioral health plan can disseminate helpful information while combating the spread of misinformation among communities in distress.