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Disaster Behavioral Health and 
People With Access and Functional Needs: Resources from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) 
Thursday – August 11th 2016

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Webinar Agenda

•	Disaster Behavioral Health (DBH) Overview
•	SAMHSA’s DBH Information Series
•	SAMHSA’s Disaster Distress Helpline 
•	DBH & FEMA’s ESF/NDRF
•	Local & State DBH Resources
•	Incorporating DBH into Planning & Preparedness
•	Discussion / Q&A

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Disaster Behavioral Health (DBH)
Behavioral Health Concerns [meet]
Disaster
•	Pre-existing behavioral health concerns aggravated, triggered by disaster event
•	New behavioral health concerns emerge after event
•	Access to care affected by event

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Disaster Behavioral Health (DBH)
Distress Risk Factors

Who is most at risk for distress?
•	Survivors living or working in impacted areas
•	Loved ones of victims 
•	First responders, rescue & recovery workers

Other considerations:
•	Pre-disaster level of functioning
•	History of challenging or difficult recovery from past disasters
•	Degree of exposure during event
•	Media exposure 
•	Access & functional needs

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Distress Reactions
Possible Distress Reactions Include:
Mild to Moderate  Severe to Very Severe
•	Trouble sleeping
•	Difficulty concentrating and performing daily tasks
•	Irritability; increased feelings of worry and anger
•	Withdrawal and isolation
•	Feelings of hopelessness
•	Setbacks during anniversaries, other event reminders
•	Increased substance use; risk for abuse or addiction
•	Persistent anxiety
•	Depression; suicidal thoughts, ideation, attempt
Also: Post-Traumatic Growth

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Individuals & Families with      Access and Functional Needs
Unique Risk Factors for Distress May Include:
•	Multiple access & functional needs
•	Disruptions in transportation and/or communications systems; impaired or limited mobility
•	Heightened medical health concerns related to medication supply, power outages, etc.
•	Marginalization from health & social services before, during, after disaster events
•	Services slow to catch up with advancements in assistive technologies
•	Lack of inclusion in preparedness plans, exercises, outreach & educational resources

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Individuals & Families with      Access and Functional Needs
Possible Heightened Distress Impacts May Include:
•	Withdrawal & isolation
•	Overwhelming anxiety, fear, confusion
•	Setbacks in treatments/therapies
•	Distress impacts on physical health
•	Delayed recovery
Also:
Resilience + Increasing Awareness & Accountability

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SAMHSA’s Disaster Behavioral Health Information Series (DBHIS)
•	Contains resource collections and toolkits pertinent to disaster behavioral health 

•	Targets specific populations, specific types of disasters, and other topics related to all-hazards disaster behavioral health preparedness and response

•	All resources are in the public domain or have been authorized for noncommercial use  

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DBHIS Installments:
Acute Interventions
Animals and Disasters
Chemical & Biological Events
Children and Youth
Disaster Responders
Languages Other than English
Older Adults
Pandemic Influenza
People with Disabilities
Resilience & Stress Mgmt 
Rural Populations
Substance Use Disorders 
Suicide & Disasters
Women & Disasters    Zika Virus Resources

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DBHIS Installments: 
DBHIS 
Today we will be focusing on the DBHIS installments of:

 People With Disabilities and Other Functional and Access Needs
&
Disaster Response Template Toolkit

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People With Disabilities &                                           Other Access and Functional Needs

DBHIS installment covers:

•	Ways that emergency management, government agencies, nonprofits, first responders, and disaster responders can make sure to include people with disabilities in disaster plans, communications, and response

•	Information for people with disabilities and other access and functional needs about preparing for and recovering from disaster

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Examples of DBHIS   Disability Resources (1)
An ADA guide for local governments: Making community emergency preparedness and response programs accessible to people with disabilities  
U.S. Department of Justice (DOJ)

Provides recommendations for local governments and agencies to help them create disaster preparedness and response programs that account for the needs of people with disabilities, which will bring these programs into compliance with the Americans with Disabilities Act (ADA). 

http://www.ada.gov/emergencyprepguide.htm 

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Examples of DBHIS   Disability Resources (2) 
Disability and health: Emergency preparedness                  
U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (HHS, CDC)

This web page provides information to help people with disabilities and their families to prepare for disasters and other emergencies, as well as information for emergency management professionals and disaster responders. 

http://www.cdc.gov/ncbddd/disabilityandhealth/emergency preparedness.html 
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SAMHSA Disaster Response 
Template Toolkit
Template Toolkit Features:

•	Program Administration section

•	Public Education Materials

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Disaster Response Template Toolkit: Program Administration

•	Outlines responsibilities for program administrators in a management plan

•	Can be adjusted according to the program’s ongoing needs assessment  

Goal of the management plan:

•	Ensure that all of the interrelated components of the disaster response plan work together 

•	Assign accountability so that each department and staff member is clear on their roles and responsibilities

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Program Administrative Components                   Within The Management Plan 

•	Needs Assessment 

•	Communications

•	Outreach Strategy

•	Staffing

•	Training 

•	Fiscal Management

•	Quality Assurance

•	Evaluation and Data Collection

•	Organizational & Individual Stress Management

•	Disaster Responder Stress Management 
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Disaster Response Template Toolkit 
Public Education Materials:                        Printed Materials
Templates for Printed Materials in the Toolkit include: 
•	Brochures, Wallet Cards
•	Door Hangers, Flyers, Postcards
•	Tip Sheets
•	Newsletters

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Disaster Response Template Toolkit 
Additional Resources:                           “Messaging through Other Media”
Included in this section are tips & resources for: 
•	Blogs
•	Public Service Announcements
•	Program Websites
•	Social Networking Web Pages

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SAMHSA DBHIS WEBLINKS
•	SAMHSA DBHIS COLLECTION:
http://www.samhsa.gov/dtac/dbhis-collections

•	DBHIS DISABILITIES & OTHER FUNCTIONAL AND ACCESS NEEDS COLLECTION:
http://www.samhsa.gov/dbhis-collections/persons-with-disabilities?term=People-with-Disabilities-DBHIS

•	DBHIS DISASTER RESPONSE TOOLKIT:
http://archive.samhsa.gov/dtac/dbhis/toolkit/

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SAMHSA: Additional Resources
SAMHSA Disaster Technical Assistance Center (DTAC)
http://www.samhsa.gov/dtac

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SAMHSA: Additional Resources
SAMHSA Emergency Behavioral Health Disaster Response App
•	“Going digital” allows greater access to content, reduces printing and shipping costs, and literally lightens responders’ load.
•	Be ready
•	Be prepared
•	Be confident
•	Share resources easily

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SAMHSA’s Disaster Distress Helpline (DDH)
The psychological impact disasters have on a significant proportion of people who experience them demonstrates the need for a hotline network with the capacity to provide crisis counseling and emotional support in any part of the country with immediacy. 

Five intervention principles following disasters to promote among those affected:
	1) Sense of safety 
	2) Calming
	3) Sense of self– and collective efficacy 
	4) Connectedness 
	5) Hope

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SAMHSA’s Disaster Distress Helpline (DDH)
DDH: Overview of Services
•	National hotline (1-800-985-5990) and SMS (text ‘TalkWithUs’ to 66746) service available to anyone in U.S. experiencing distress or other behavioral health concerns related to disaster, in order to help them move forward on the path of recovery
Also: 
•	Complements local, state and national I&R / crisis hotlines
•	Multi-lingual 
•	Hotline & texting available to all U.S. territories
•	People who are deaf or hard of hearing can use 711 or preferred relay provider to connect with hotline                                          and/or utilize the texting option

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DDH: When Someone Calls or Texts…

Disaster Crisis Counseling for Crisis Contact Centers:
•	Engage, Explore, Connect & Conclude
•	Using: Active Listening, Normalization, Validation, Psycho-Education

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DDH: Additional Resources
Program Literature
-	DDH outreach resources (brochures, wallet cards) geared towards disaster distress risk groups and available for free to stakeholders for distribution; in English & Spanish:

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DDH: Additional Resources
Disaster Distress Helpline Website 
-	http://disasterdistress.samhsa.gov 
8	Resources for providers,
	risk groups, general public
8	Education & Information
8	Disaster-specific resource pages

Social Media 
-	http://www.facebook.com/distresshelpline  
-	http://twitter.com/distressline

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Disaster Behavioral Health (DBH) & FEMA’s ESF/NRDF
Disaster Distress Helpline & FEMA ESF / RSF:

U.S. Department of Health and Human Services
•	Support Agency for ESF 6
•	Coordinator / Primary Agency for ESF 8
•	Coordinating Agency for RSF Health and Social Services
•	HHS Disaster Behavioral Health Concept of Operations http://www.phe.gov/preparedness/planning/abc  

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Additional Local, State, and National DBH Resources
•	State Disaster Mental Health Coordinators
•	SAMHSA Regional Administrators
•	FEMA Office of Disability Integration Coordination
•	Medical Reserve Corps
•	Voluntary Organizations Active in Disaster (VOAD)/COAD Emotional & Spiritual Care; Private/Non-profit Medical / Mental Health /           Public Health Care Providers
•	Crisis Contact Centers

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Additional Local, State, and National DBH Resources
•	National Library of Medicine, 
     Disaster Information Management Research Center
     https://sis.nlm.nih.gov/dimrc.html 

Sample Resource shared from DIMRC email list-serv: NACCHO Behavioral Health Videos in ASL http://bit.ly/2aGl7CP 

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Incorporating Disaster Behavioral Health (DBH) into Planning & Preparedness
•	Identify key local, state, regional, national DBH stakeholders & establish points-of-contact
•	Include DBH stakeholders in preparedness, response & recovery planning and preparedness
•	Promote DBH resources to individuals, families & communities served + as resource for self –care
•	Connect with DBH providers on social media & through other communications before, during and after disasters  
 
Communication – Coordination –                                             – Collaboration – Cooperation (National VOAD)

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Discussion / Q&A

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For More Information
CDR Jamie Seligman
Jamie.seligman@samhsa.hhs.gov 
202-384-3204

Christian Burgess
cburgess@mhaofnyc.org
212-614-6346