HLTH 6740 Week 8 Post-Disaster Support Plan Example

Support Plan for Displaced Low-Income Renters After the April Flood: What Help, When, From Whom, and the Evidence for Each Element

Student Name

Walden University

HLTH 6740: Disaster, Crisis, and Trauma

Instructor Name

Month Day, Year

Support Plan for Displaced Low-Income Renters After the April Flood: What Help, When, From Whom, and the Evidence for Each Element

Purpose and Population

This plan sets out the support that displaced low-income renters would receive after the April flood in the composite county, about 390 households, at what point after the event, delivered by whom. Each element is attached to evidence. The plan follows directly from the population profile, which attributed this group's heavier burden largely to displacement, secondary stressors and lost resources after the event, and from research showing that most survivors recover while a minority follow chronic or delayed courses (Bonanno et al., 2010).

Phase 1: The First Weeks

What: Psychological first aid delivered at shelters, the recovery center and door to door, focused on safety, calm, practical needs, connection to family and services and realistic hope. Who: Trained crisis counselors and Red Cross mental health volunteers, with interpreters for Spanish- and Vietnamese-speaking households. Evidence: An expert review identified safety, calming, self- and community efficacy, connectedness and hope as principles with empirical support for this period (Hobfoll et al., 2007). Excluded: Single-session psychological debriefing will not be offered or required, because a systematic review found it did not prevent PTSD and may raise risk for some (Rose et al., 2002).

Phase 2: Weeks 2 to 12

What: Crisis counseling through the federally funded crisis counseling program, combined with case management for housing, documentation of losses and income. Who: Crisis counselors working alongside case managers from the long-term recovery group, meeting households where they are staying. Evidence: Federal law authorizes crisis counseling assistance and training after declared disasters (42 U.S.C. § 5183). A cross-site evaluation of these programs after the 2005 hurricanes found that participants' perceived benefits improved as service intensity, service intimacy and psychological referrals increased (Norris et al., 2009). Pairing counseling with practical help addresses secondary stressors, which reviews identify as among the strongest predictors of poor outcomes (Norris et al., 2002).

Phase 3: Months 3 to 12

What: Structured screening for PTSD, depression and suicidal thoughts at about three, six and twelve months, with referral to evidence-based treatment for those with persistent symptoms. Who: The community health center's behavioral health team, which already serves many of these households and has staff who speak Spanish, with telehealth for those displaced farther away. Evidence: Research on responses over time shows that early symptoms do not reliably distinguish people who will recover from those who will not, and that some problems emerge later (Bonanno et al., 2010). In the Katrina panel, mental illness rose over the first year and a half where hurricane-related stresses remained unresolved (Kessler et al., 2008). Repeated screening is the way to find the people who need treatment.

Cross-Cutting Element: Keeping Networks Together

What: Coordination with housing programs to place displaced households from the same building or neighborhood near one another, near work and schools, and to support groups that renters organize themselves. Who: The county recovery manager, housing case managers and community organizations. Evidence: Eroding social support is one of the risk factors the survivor review flagged most often (Norris et al., 2002), and keeping networks intact is a direct way to slow that deterioration.

Who Coordinates the Plan

A plan with four providers across a year needs one point of coordination, or households will fall between phases. The county's long-term recovery group will designate a behavioral health coordinator who keeps a shared list of displaced renter households, tracks which phase each household is in and makes sure that households leaving crisis counseling are scheduled for the three-month screening. The coordinator will also make sure households who move outside the county are offered telehealth follow-up rather than being dropped. Without this role, the strongest element of the plan, repeated contact over a year, would depend on each provider remembering to hand households on, which experience suggests they will not reliably do.

How Households Will Be Found

Displaced renters are hard to find because they move. The plan relies on three sources: shelter registration lists, the recovery center's case files and the lists of households receiving rental assistance. Crisis counselors will ask each household for two contact methods and permission to share contact details with the community health center for the later screenings. Outreach materials will be produced in English, Spanish and Vietnamese, and counselors will visit motels and apartment complexes where displaced households are known to be staying. The aim is that no household in the target group goes more than a month without contact during the first year.

The Plan at a Glance

Table 1 summarizes the plan.

Table 1

Support Plan Components for Displaced Low-Income Renters (Composite County)

What the Plan Cannot Promise

The evidence behind this plan is uneven. The principles for early support rest on expert synthesis of indirect evidence rather than on trials in this population. The crisis counseling evaluation measured participants' perceived benefits rather than symptom change. And no study has tested this combination of elements for displaced renters. The plan therefore includes its own measurement: tracking how many households are reached in each phase, how many screen positive at each interval and how many referred households begin treatment. Those figures will show whether the plan reaches the people it was designed for, even before anyone can say whether it improved their outcomes. A brief report at six and twelve months would let the county decide whether to keep, change or expand the plan for the next disaster.

References

Bonanno, G. A., Brewin, C. R., Kaniasty, K., & La Greca, A. M. (2010). Weighing the costs of disaster: Consequences, risks, and resilience in individuals, families, and communities. Psychological Science in the Public Interest, 11(1), 1-49. https://doi.org/10.1177/1529100610387086

Crisis counseling assistance and training, 42 U.S.C. § 5183 (2023).

Hobfoll, S. E., Watson, P., Bell, C. C., Bryant, R. A., Brymer, M. J., Friedman, M. J., Friedman, M., Gersons, B. P. R., de Jong, J. T. V. M., Layne, C. M., Maguen, S., Neria, Y., Norwood, A. E., Pynoos, R. S., Reissman, D., Ruzek, J. I., Shalev, A. Y., Solomon, Z., Steinberg, A. M., & Ursano, R. J. (2007). Five essential elements of immediate and mid-term mass trauma intervention: Empirical evidence. Psychiatry, 70(4), 283-315. https://doi.org/10.1521/psyc.2007.70.4.283

Kessler, R. C., Galea, S., Gruber, M. J., Sampson, N. A., Ursano, R. J., & Wessely, S. (2008). Trends in mental illness and suicidality after Hurricane Katrina. Molecular Psychiatry, 13(4), 374-384. https://doi.org/10.1038/sj.mp.4002119

Norris, F. H., Friedman, M. J., Watson, P. J., Byrne, C. M., Diaz, E., & Kaniasty, K. (2002). 60,000 disaster victims speak: Part I. An empirical review of the empirical literature, 1981-2001. Psychiatry, 65(3), 207-239. https://doi.org/10.1521/psyc.65.3.207.20173

Norris, F. H., Hamblen, J. L., & Rosen, C. S. (2009). Service characteristics and counseling outcomes: Lessons from a cross-site evaluation of crisis counseling after Hurricanes Katrina, Rita and Wilma. Administration and Policy in Mental Health and Mental Health Services Research, 36(3), 176-185. https://doi.org/10.1007/s10488-009-0215-1

Rose, S., Bisson, J., Churchill, R., & Wessely, S. (2002). Psychological debriefing for preventing post traumatic stress disorder (PTSD). Cochrane Database of Systematic Reviews, 2002(2), Article CD000560. https://doi.org/10.1002/14651858.CD000560