Public Health Practices: Enhancing Emergency Preparedness & Response
Public Health Practices
Enhancing Emergency Preparedness & Response
ASTHO - The Association of State and Territorial Health Officials

Disaster Mental Health Intervention Field Guide (IN)

Indiana Division of Mental Health and Addiction
Practice Description: 

Updated August 2010

The Field Guide is a compendium of mental health tools that describes the range of behavioral health responses to disaster and offers suggestions on how to interact with and respond to victims. It provides a strong overview both for mental health professionals and for disaster responders who may lack a background or training in behavioral health. The guide also describes an exposure hierarchy that lists several specific at-risk groups for behavioral health problems and prioritizes groups for intervention.

The guidance takes the stance that behavioral health interventions during a disaster will focus solely on basic needs, while referral for support or further services will occur following the disaster. Information is presented in bullet points that do not allow great depth or detail. The benefit to the format is that they contribute to this guide's ease of use as a quick reference document. State and local organizations should note that some recommendations in this guide (e.g., contacting a public information officer or advising victims before speaking to the media) may need to be revised or adapted to the specific policies in a jurisdiction. This practice is noteworthy, because the field guide distills and presents material from a variety of behavioral health sources in a well-organized, extremely thorough, and concise format.

In 2010, the Indiana Family and Social Services Administration (FSSA) updated the guide based on knowledge of how it had been used in disaster response during the past several years.

During 2009-2010, the field guide was revised to include several topics deemed relevant to responders' experiences. An FSSA committee felt that it was important to add more information about substance abuse, so the topic was included in guidelines for behavioral health response. One of the most significant revisions was the addition of a section on self-care, which had been a topic of active discussion during deployments. Smaller changes included clarifying some points about speaking with the media and communicating a message, along with making the overall language more precise and clear. FSSA is working with the Indiana University Haitian Creole Institute to have the field guide translated into Haitian Creole, and the guide also will soon be available in Spanish.

The field guide has been used widely both for training and for a variety of response efforts. Mississippi and Nebraska adopted the guide as part of their regional disaster mental health teams' training program. Indiana's 10 district mental health response teams have used the guide during five presidentially declared disasters since its development. A team of Indiana mental health responders used the guide extensively while in Haiti helping survivors of the January 2010 earthquake. The guide's recommendations were also incorporated into mental health trauma workshops convened for Haitian people by the Episcopal Church in Dominican Republic. This year in Indiana, FSSA distributed the guide to local health departments whose staff held clinics during the H1N1 response.

Indiana's mental health response teams found the guide both helpful and valuable, said Andrew Klatte, Assistant Deputy Director of the Office of Addiction Services and Disaster Management at FSSA. The guide particularly helped Indiana's teams address the needs of groups with which they might have had little prior experience (e.g., children and adolescents). The guide was especially helpful in Haiti, because responders often did not know who their audience would be before they arrived in a town or tent city. In one instance, responders were told their audience would be teachers working with middle-school children. The teams then consulted the guide and gave the teachers appropriate information for working with the needs of that age group.

Originially posted September 2007

State / Territory: 
Field Guide