Geriatric Mental Health Disaster and Emergency Preparedness

Chapter 7 Making the Community Plan 131
paredness and response and how these organizations will operate within
the National Incident Management System.
Recognize the Role of Community and Community
Organizations in Preparedness and Recovery
The experience of September 11, 2001, taught us that 90% of those experiencing
stress after the World Trade Center attacks sought support from
religious and community activities (Schuster, et al., 2001). Community caregivers,
including teachers, clergy, and community leaders, are considered
gatekeepers who serve as a first line of assistance to communities at all times
and especially during times of crisis (Neighbors, Musick, & Williams, 1998).
For groups who traditionally underutilize mental health services—such
as older adults, Black Americans, and those of low socioeconomic status—community
outreach is necessary to improve access to care following
a disaster (Kaniasty & Norris, 1995; Neighbors, et al.; Van Citters &
Bartels, 2004). Recognizing the essential role of community caregiving—
such as religious coping and spiritual care—as a first line of mental health
response (Roberts, Flannelly, Weaver, & Figley, 2003), and more broadly
as a positive element of disaster response (Meisenhelder, 2002), could improve
communication between traditional mental health providers and
community-recognized mental health providers, thus improving services
for entire communities. Additionally, since long-term disaster recovery occurs
in the community, recognizing community organizations for their efforts
would be a step toward improving group relations with the public
health community and the government.
Develop Community Mental Health Programs
in Partnership With Community Organizations
Following the 1995 Oklahoma City bombing, an innovative community
mental health program was developed to intervene in the short-to-medium
term with survivors of this major terrorist event (Call & Pfefferbaum,
1999). Funded by FEMA and the Federal Center for Mental Health Services,
which together form the Crisis Counseling Assistance and Training
Program (CCP), Project Heartland provided crisis counseling, support
groups, outreach, and education for individuals affected by the bombing
(Call & Pfefferbaum). While the program was successful, it did encounter
some major problems: repeated exposure to trauma and secondary