The April/May/June 2012 print issue of PA TIMES published a series of articles on the topic of Emergency Preparedness and Disaster Recovery. The piece below is part of a Student Symposia from that issue.
In 2011 alone, President Obama made 97 major disaster declarations. Naturally, disasters produce devastation, and witnessing a disaster can also have harmful effects. If left untreated, emotional impairment may lead to long-term consequences, like post-traumatic stress disorder (PTSD), chronic anxiety, depression, substance abuse, suicide and conduct problems. Fortunately, the federal government has implemented a program that helps states and local authorities provide hope by addressing counseling issues for citizens within disaster-stricken communities. However, this program has experienced some noted administrative issues.
While natural disasters such as the Joplin tornado are out of our control, helping those affected by these disasters is not.
Crisis Counseling Program (CCP) Defined
In 1974, the federal government realized the need to establish a program that would provide mental health services to those exposed to disaster; consequently, the Disaster Relief Act authorized the creation of the CCP, which was re-codified in Section 416 of the Robert T. Stafford Disaster and Emergency Assistance Act. Today, the CCP is federally funded by FEMA and is administered via inter-agency collaboration and effort between FEMA and the Emergency Mental and Traumatic Stress Services Branch of the Center for Mental Health Services, within the Substance Abuse and Mental Health Services Administration (SAMHSA).
FEMA notes that the CCP provides short-term support to states, U.S. territories and federally-recognized tribes following presidential disaster declarations. According to the Office of the Inspector General, “The scope of the Crisis Counseling Program is immediate, short-term, incident- specific, intervention-style crisis counseling services and support for emotional recovery to individuals adversely affected by major disasters.” The CCP aims to supplement state and local resources and response efforts.
After a disaster has occurred, an approved entity may apply for the Immediate Service Program (ISP) or the Regular Service Program (RSP). The ISP grants assistance to state or local agencies in the form of funds and resources to respond to the immediate needs of people exposed to disaster and lasts for up to 60 days from the time of allowance. Unfortunately, the effects of disaster may have long-term effects. For this reason, the RSP follows the ISP and is intended for continuous counseling and expanded services, and this program provides funding for up to nine months for such activities as crisis counseling and outreach.
Shortly after Hurricane Katrina, SAMHSA awarded approximately $59 million to 14 states for crisis counseling assistance. Many states have established specific project names in order to emphasize hope for those affected by disaster. For example, the state of Mississippi instated ‘Project Recovery’ and was approved for $20 million in 2005.
Noted Problems Associated with CCP
CCP has undoubtedly helped states respond to the psychological needs of citizens affected by disaster; however, problems associated with the CCP have been noted. In 2008, the GAO examined the effectiveness of the CCP. According to GAO data, state officials argued that states “experienced difficulties in applying for CCP funding and implementing their programs following catastrophic disasters.” Results show that state officials thought the application process for RSP applications were lengthy and the information for the application, especially for ISP, was difficult to obtain in time for the prescribed deadline.
The officials noted that the difficulty in obtaining the information was directly related to the extent of the disasters and the need to respond to other aspects of response, such as securing the safety of mentally-ill patients and faculty at state-run institutions. Texas officials reported having to collect information for more than 250 counties in order to be able to estimate how many individuals needed crisis counseling services.
The GAO study in 2008 revealed that officials experienced arduous efforts with assisting individuals who needed intensive, comprehensive crisis counseling services. It was apparent the services traditionally provided through state CCPs fell short of meeting the needs of chronic illness. In fact, some experts argue that CCP is short term and specific to crisis situations. They argue that this sort of program does not address chronic mental health issues, like PTSD.
An additional problem associated with the administration of CCP pertains to a lack of federal oversight. In 2005, the GAO conducted a study of Project Liberty’s efforts post 9/11. The GAO made a number of different conclusions pertaining to financial reimbursement. State officials stated, “Project Liberty had not been fully reimbursed for the expenses incurred throughout the program.”
This problem stemmed from the fact that NYC Department of Education had not been able to provide support information for some of the expenses. In addition, the GAO noted “While SAMHSA did have procedures in place to monitor Project Liberty’s delivery of services, it did not have procedures in place to effectively monitor financial information reported by Project Liberty about the cost of services.” Thus, a general lack of federal oversight of financial information occurred; as a result, increased oversight and improvement to the process for determining federal funding is warranted.
Lastly, a study performed by the Office of Inspector General (OIG) examined the CCP in relation to Florida’s Project HOPE. The report found five areas needing improvement, which included the following:
These managerial aspects of CCP are potential roadblocks to effectively implementing the CCP.
People exposed to disaster are vulnerable to psychological consequences and impairment; thus, being able to address these issues is a priority for governments at all levels. The CCP is a federally-funded program that has experienced some administrative issues in times past. In order to assist citizens, the issues noted above must be resolved. While natural disasters such as the Joplin tornado are out of our control, helping those affected by these disasters is not.
Brooks Wiley is a graduate student in the Department of Emergency Management at Jacksonville State University.
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