National Commission on Children and Disasters. 2010 Report to the ...

As previously noted, children often go without needed mental health services on a daily
basis due to a chronic shortage of pediatric mental health professionals 90 and limited
insurance reimbursement for these services. 91 This gap worsens following disasters because
of increased demand, limited surge capacity among providers, limited transportation, and
other competing family recovery needs. 92,93 Resources must be provided to ensure that
children have access to immediate and long-term mental health interventions following
disasters in order to address disaster-caused mental health issues, as well as pre-existing
mental health conditions exacerbated by the disaster.
The <strong>Commission</strong> recommends that Congress authorize and provide appropriations to
support a single, flexible grant funding mechanism with the specific purpose of addressing
barriers to mental health treatment services for children following disasters. Congress may
choose to modify and adequately appropriate funds through an existing grant program such
as SAMHSA Emergency Response Grants or authorize a new grant program for use after
Presidentially declared disasters. 94
Adequate funding should be targeted to States and communities in need, for the specific
purpose of supporting disaster mental health treatment services immediately following a
Presidentially declared disaster and throughout long-term recovery efforts. After catastrophic
disasters such as Hurricane Katrina and 9/11, a variety of different established programs,
such as block grants and other ad hoc grants, have provided pools of funding to States from
which funds could be used to support mental health services. However, States recovering
from disasters face many competing priorities and may not choose to expend funds on
mental health services, which often do not receive attention equivalent to that given to
other health needs.
Funding should be used to support the full range of mental health and substance abuse
treatment services that are not covered by the CCP, including the treatment of disaster-
90 Jane Koppelman, The Provider System for Children’s Mental Health: Workforce Capacity and Effective
Treatment, ed. <strong>National</strong> Health Policy Forum (Washington, DC: NHPF, 2004), 3-5,
http://www.nhpf.org/library/issue-briefs/IB801_ChildMHProvider_10-26-04.pdf.
91 American Academy of Pediatrics, Improving Mental Health Services in Primary Care: Reducing Administrative
and Financial Barriers to Access and Collaboration, (Elk Grove Village, IL: AAP, 2009), 2-5,
http://practice.aap.org/content.aspx?aid=2775.
92 David Schonfeld, “Are We Ready and Willing to Address the Mental Health Needs of Children?: Implications
From September 11th,” 1400.
93 U.S. Government Accountability Office, Hurricane Katrina: Barriers to Mental Health Services for Children
Persist in Greater New Orleans, Although Federal Grants Are Helping to Address Them, 12.
94 Under SERG, SAMHSA has authority to award noncompetitive grants from its discretionary funding to fund
emergency mental health and substance abuse treatment services not permitted under CCP, whether or not there
has been a major disaster declaration. Although Congress provided funding for the response to Hurricanes Katrina
and Rita through several supplemental appropriations, SAMHSA did not receive any supplemental funding.
Accordingly, SERG grants totaling only $600,000 were split among Alabama, Louisiana, Mississippi, and Texas.
Ramya Sundararaman, Sarah A. Lister, and Erin D. Williams, Gulf Coast Hurricanes: Addressing Survivors’ Mental
Health and Substance Abuse Treatment Needs, 6.
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NATIONAL COMMISSION ON CHILDREN AND DISASTERS: 2010 REPORT