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Building an Evidence-Based Response to Disaster and Mass Trauma Events

NAMHC Concept Clearance

Presenter

Farris Tuma, Sc.D.
Division of Adult Translational Research and Treatment Development (DATR)

Goal

This initiative seeks to leverage the existing disaster response infrastructure and workforce to integrate evidence-based and promising interventions into current mental health response. Partnership between researchers and disaster response providers will enable the field to plan, in advance of large scale emergencies, rigorous intervention and services research studies to improve care for new and complex mental health needs in the wake of disasters.

Rationale

After disasters or emergency events, substantial federal and non-federal mental health resources are made available. Current practice primarily consists of brief contact and needs identification with impacted community members, teaching outreach workers how to calm, support and listen to the needs of affected individuals. Distribution of tip sheets on coping skills and referrals to specialty care may also be provided. Although many people may benefit from these efforts, there is little empirical evidence of the individual and societal benefits derived. These efforts are also insufficient to meet the needs of a significant minority of impacted individuals who will experience more severe and chronic mental health problems.

Programs at NIMH have been encouraging mental health investigators to move from studies to confirm and reconfirm what we know from prior epidemiological efforts, to establishing the feasibility and research base needed to address identified needs after disasters and other large-scale emergencies have occurred. However, there are no existing grant mechanisms designed to enable the translation of standard evidence-based treatments, or translation of emerging and promising early-intervention models and technology-based approaches into service programs within the first few months of a disaster.

Leadership from the majority of federal and non-federal emergency response resources deployed following disasters have partnered to establish a work group to address this issue. The work group includes the U.S. Department of Health and Human Services’ Assistant Secretary for Preparedness Response, the Office of the Assistant Secretary for Health/Division of the Civilian Volunteer Medical Reserve Corps, the National Institutes of Health, the Federal Emergency Management Agency, the Administration for Children & Families, the Substance Abuse and Mental Health Administration, and the American Red Cross. Cooperation among the partner organizations provides an opportunity to learn about the utility of existing disaster mental health response programs in comparison to promising newer strategies for identifying and intervening with high risk survivors, and integrating standard evidence-based services into programs that currently fail to address clinical needs in the first few months after a disaster.

Major research and public health questions to be addressed by this initiative include: (1) whether a broader range of services can reduce severity and/or duration of common adjustment problems and better address needs of those with pre-existing conditions; and, (2) whether there are long-term benefits (health/mental health co-morbidity, occupational/economic functioning, family/parenting, etc.) of early assistance programs.

NIMH and its partners are exploring how to leverage response infrastructure and workforce in partnership with disaster mental health researchers. The work group is seeking to establish a data-driven foundation for a range of services, beyond current practice, to reduce severity and duration of mental health problems and better address the needs of those with serious mental illness in the wake of disasters. The goal of this partnership would be to plan for and then systematically examine screening, counseling, referral, and care as usual as well as standard evidence-based treatments, emerging and promising early-intervention models and technology-based approaches to screening, referral, and treatment.

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