Disaster Relief & Mental Health

“The Federal Emergency Management Agency (FEMA) coordinates the federal government’s role in preparing for, preventing, mitigating the effects of, responding to, and recovering from all domestic disasters, whether natural or man-made, including acts of terror.”

“Section 416 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act of 1974 authorizes FEMA to fund mental health assistance and training activities in Presidentially declared major disaster areas through the Crisis Counseling Assistance and Training Program.”

Some views hold that disaster relief should be at the state level or even in the private sector rather than at the federal level. Having witnessed the destructive path of Hurricane Sandy, how would shifting disaster relief funding from the federal level to the state level or private sector affect mental health disaster relief efforts?

Megan Douglas, JD says…

Although the federal government has its own set of problems coordinating disaster relief, leaving this to the states would be a catastrophe. With already tight state budgets, disaster relief at the state level would result in 50 very different plans. As we see with Medicaid funding, the need does not impact the allocated funding. Therefore, states that do not prioritize disaster relief would be poorly equipped to support their citizens, while states that do would be fine. The state to state disparities that would result could be disastrous. Furthermore, natural disasters do not see state lines, so two states impacted by the same incident could have two very different outcomes. The focus should be on how to better equip and coordinate the federal government’s disaster response, not to leave it to the states.

Dan VanderEnde, MD, MPH says…

Some may argue that ideally, mental health issues that arise after a disaster like Hurricane Sandy are best handled by the state or private companies. The reality is they lack common standards of care, the capacity, and are financially disincentivized to provide timely, accessible, and affordable treatment to everyone. Unreimbursible costs are overwhelming, and mustering short-term services logistically daunting. Shifting of funding to states or private entities puts the politically poor at greatest risk at a time of greatest need. This disparity is negated when an impartial government directs resources to devastated areas in a coordinated effort with affected states.

[ These comments appear courtesy the Health Policy Leadership Fellows at the Satcher Health Leadership Institute at the Morehouse School of Medicine. , a Policy Prescriptions ® contributor, currently serves as interim associate director of the Fellowship and has encouraged her Fellows to engage in discussions on current health policy topics. The best discussion points put forth will be featured on our site. ]