Crisis Counseling

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Crisis Counseling

Crisis Counseling

Overview of the issue

Since the Crisis Counseling Assistance and Training Program (CCP) was authorized in 1974 by the Robert T. Stafford Disaster Relief and Emergency Assistance Act (Public Law 93-288, amended by Public Law 100-707), the Federal Emergency Management Agency (FEMA) has funded dozens of CCPs across the United States and its territories. The CCP provides supplemental funding to states, US territories, and federally recognized tribes after a Presidential disaster declaration. Through an interagency agreement with FEMA, the Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Mental Health Services (CMHS) provides grant administration and program oversight for the CCP, as well as training and technical assistance for mental and behavioral health personnel.

CCPs incorporate a strengths-based approach to help disaster survivors access and identify personal and community resources that will aid in the recovery process. These programs assume that most disaster survivors can be naturally resilient when empowered by support, education, and linkages to community resources. CCPs aim to reach disaster affected communities by bringing services to where people are in their day-to-day lives—in their homes, neighborhoods, schools, churches, and places of work—a model of service delivery commonly referred to as outreach (Elrod et al. 2006; Felton et al. 2006; Flynn 1994; Naturale 2006; Young et al. 2006).

What is the issue?

With the possible exception of the September 11th terrorist attacks, no disaster on US soil has raised more immediate or immense concerns regarding its potential mental health impacts than Disaster (see Norris and Rosen 2009). On August 29, 2005, Disaster caused catastrophic damage on the Mississippi Gulf Coast, and the subsequent levee failures in New Orleans caused extensive loss of life and massive displacement. In light of the severity of this disaster, it was not surprising that the disaster-declared states of Louisiana, Mississippi, and Alabama moved swiftly to apply for CCP grants.

Why is it important?

What was surprising was the unprecedented decision of the federal government to open up CCP eligibility to all states hosting “Disaster evacuees,” as persons displaced by the hurricane came to be known. Over 30 states applied for the CCP and received Immediate Service Program grants, which are funded up to 60 days after the date of the disaster declaration, and 18 states subsequently applied for and received Regular Service Program (RSP) grants, which typically operate for nine additional months (although extensions are common). The degree to which this single program innovation was effective in reaching Disaster survivors and evacuees is important to examine because a number of hypothetical disaster scenarios could cause substantial displacement.

Interested tool

Such an examination is possible because of a second, concurrent program innovation. Shortly after Disaster, CMHS introduced a standardized data collection system for cross-site evaluation. Prior to this policy change, the quality of any evaluation was vastly determined by the grantee; some programs, like Project Liberty (New York's CCP after 9/11), conducted extensive evaluation, whereas others did little more than tally services, according to varying definitions. The Disaster cross-site evaluation was designed to document ...
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