Author: Rachel E. Kaul, LCSW, CTS, Senior Public Health Advisor, Division for At-Risk, Behavioral Health & Community Resilience, Office of the Assistant Secretary for Preparedness and Response
Psychologically, people respond differently to disasters. Planning for those different reactions can help individuals and their communities become more resilient in the face of a disaster.
During and after an emergency, people affected by the event—including response workers—may feel distressed or anxious about their safety, health, and recovery. People may experience grief and a sense of loss.
Most survivors recover psychologically from a disaster without formal behavioral health intervention. They have pre-existing support systems that contribute to their resilience. Some people may have more severe behavioral health reactions that hinder their recovery; they may develop psychological conditions or begin substance use or abuse or these behaviors may get worse if their needs are not addressed.
Disaster behavioral health services can help people who need it after an event through communication, education, basic support, access to clinical behavioral health services, and other tools. Disaster behavioral health seeks to increase health resilience and improve the success of emergency response and recovery.
In preparing for disasters, behavioral health activities primarily focus on planning, training, and exercising public health capabilities that mitigate the behavioral health impacts of disaster. Plans that strengthen pre-existing systems, build on the daily delivery of health and behavioral health care, and address reimbursement requirements are essential to effective disaster response.
During a response, disaster behavioral health actions often focus on supportive, strengths-based interventions such as psychological first aid, crisis counseling, risk communication, and response worker support. These interventions may be provided by behavioral health professionals, but are often also provided by paraprofessionals, other health workers, volunteers, and laypeople who have received training in basic disaster behavioral health support.
Federal disaster behavioral health officials collaborate with these entities to promote preparedness and to respond in ways that integrate behavioral health into larger public health and medical response and recovery efforts. Federal experts supplement local responders based on behavioral health needs defined by state, territorial, tribal and local agencies, and they partner in longer-term recovery efforts to promote individual and community resilience.
The latest HHS Disaster Behavioral Health Concept of Operations (CONOPS) reflects this intricately woven whole community approach to resilience that includes voluntary organizations, government, academia, and behavioral health care and professional organizations. The CONOPS goes beyond a traditional CONOPS.
The CONOPS aims to improve coordination of federal preparedness, response, and recovery efforts concerning behavioral health in a manner consistent with—and supportive of— state, territorial, tribal and local efforts.
The CONOPS is meant to be easy for agencies and organizations outside HHS to use. For these partners and for response agencies less familiar with the overall field of behavioral health, the CONOPS includes conceptual language to frame disaster behavioral health, in addition to discussing federal disaster behavioral health operational response and recovery.
The newest CONOPS adds a checklist of key disaster behavioral health activities and indicates the definitive action to be taken. New sections describe disaster behavioral health considerations and roles through each phase of the emergency, from readiness to long-term recovery. This CONOPS builds on past versions and leverages experience with the most recent emergency response and recovery operations.
Have your agency or community found ways to incorporate behavioral health into emergency preparedness, response, and recovery? Share your experiences in a comment to this blog.
