Center for the Study of Traumatic Stress
CSTS | Department of Psychiatry | Uniformed Services University | 4301 Jones Bridge Road, Bethesda, MD 20814-4799 | www.CSTSonline.org

Center for the Study of TraumaticStress Identifies Factors of Interest
for Behavioral Health Providers in theInstitute of Medicine (IOM) Report“Healthy, Resilient, and Sustainable Communities
After Disasters: Strategies, Opportunities, andPlanning for Recovery”
A driving goal of the Center2015 IOM report.
The
reportmodelsamultidisciplinary,for the Study of Traumatic Stress
As with all IOM reports, this(CSTS) is to promote understanding
wasdeveloped through a lengthy
multidimensional approach toof traumatic stress from the cellularand considered process involving
understanding and promoting resilience inlevel to the community level. That is
a wide diversity of experts on thecommunities following disasters.
accomplished through direct work
topic. The draft report was thenby CSTS, collaboration with otherreviewed by other content experts,
including CSTS, representing aorganizations, and the dissemination
range of perspectives. The draft wasof quality information from other reputable sources. In
revised and the final report published in 2015.
service of the latter, we recommend that leaders in thebehavioral health community consider the content of thisThis report will be of interest to behavioral healthprofessionals for a variety of reasons:■ It models a multidisciplinary, multidimensional
approach to understanding and promoting resilience incommunities following disasters.
■ It firmly reinforces behavioral health as an essential
component of all health.
■ It describes a strategic planning process forcommunities to consider. This includes establishing ashared vision of a healthy community, assessment ofhealth and hazard vulnerabilities, planning across all
sectors, and implementation guidance.
■ It documents that there are health components to allpolicies involved in disaster recovery and speaks tointegrating health into other recovery activities andpriorities.
■ It examines factors sometimes neglected when

considering healthy communities such as housing andsocial services.
■ It provides specific and actionable recommendations
that apply to leaders and stakeholders at all levelsof government and within diverse stakeholder
organizations and groups.
While the report speaks to behavioral health elements
within sections related to public health, healthcare, social
services, and housing, notably, there is a lengthy section
exclusively devoted to behavioral health. That in itself
is noteworthy. It reflects the growing and widespread
understanding that behavioral health is an essential elementof all health and that it should be included in disaster
preparedness, response, and recovery.
Behavioral health professionals will find a large amountof material in this section that not only identifies behavioral
health factors, but also provides a framework for addressing
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these factors, offers examples of programs and approaches,and offers specific recommendations. Interested behavioral
health professionals will have no difficulty finding content
relevant to their particular interest(s).
The report recommends that behavioral healthstrategies should cut across all disaster phases and should:■ Integrate behavioral health into other recovery sectors.
■ Assure a variety of services.
■ Maximize participation of impacted populations in thepreparedness and recovery efforts.
■ Promote a sense of safety, connectedness, calming,
hope, and efficacy at all levels.
The report provides a concise and readable summary of
key elements in understanding disaster behavioral health.
This material will be of interest to those already well-versedin this aspect of behavioral health as well as those newer tothis special area. This report includes:■ Provision of a comprehensive list of ways inwhich disasters affect physical, psychological, andsociocultural well-being of community members.
■ Impact on subgroups within communities (e.g.,children, individuals with preexisting mental illness,
responders and recovery workers, etc.).
■ Government and NGO roles and programs related todisaster behavioral health.
■ Understanding disaster behavioral health factors in thecontext of the pre-disaster behavioral health priorities.
■ Identification of ways behavioral health professionals
can become involved in preparedness, response, andrecovery.
■ A comprehensive summary of the continuum (fromuniversal interventions to specific intensive treatmentof disorders) of behavioral health interventions
following disasters.
■ Issues involved in strengthening resilience in thebehavioral health sector.
■ Identification of research needs and gaps.
■ Recommendation that a National Disaster Behavioral
Health Strategy be developed and discussion of boththe rationale and content.
This report is rich in both the process of its
development and in the scope and depth of its content. It
is highly recommended for behavioral health professionals
who are involved in, or who might wish to become

involved with disaster preparedness, response, andrecovery.
Additional Resources:
Center for the Study of Traumatic Stress. Addressing theNeeds of the Seriously Mentally Ill Following Disasters.
https://www.cstsonline.org/assets/media/documents/
CSTS_FS_Addressing_Needs_of_Mentally_Ill_in_Disasters.pdf
Center for the Study of Traumatic Stress. PsychologicalFirst Aid. https://www.cstsonline.org/assets/media/documents/CSTS_FS_Psychological%20First%20Aid_
Support_Well_Being_of_%20Disaster_Victims.pdf
Fullerton, C.S., Mash, H.B.H., Benevides, K.N.,
Morganstein, J.C., & Ursano, R.J. (In Press). Distress ofRoutine Activities and Perceived Safety Associated withPTSD, Depression and Alcohol Use: 2002 Washington,
DC Sniper Attacks. Disaster Medicine & Public HealthPreparedness.
Fullerton, C.S., Ursano R.J., Liu X, McKibben J.B.A., Wang
L., Reissman D.B. (in press). Depressive symptom
severity and community collective efficacy following
the 2004 Florida Hurricanes. PLoS ONE.
Heberman Mash, H.B., Fullerton, C.S., Kowalski-Trakofler,K., Reissman, D.B., Scharf, T., Ursano, R.J. (2013).
Florida department of health workers’ response to 2004
hurricanes: a qualitative analysis. Disaster Med Public
Health Prep, 7(2):153-159.
Ursano, R.J., McKibben, J.B.A., Reissman, D.B., Liu,X., Wang, L., Sampson, R.J., Fullerton, C.S. (2014).
Posttraumatic stress disorder and community collective
efficacy following the 2004 Florida Hurricanes. PLoSONE, 9(2):p.e88467.
The report provides a concise and readable
summary of key elements in understanding
disaster behavioral health.
Citation: Institute of Medicine. 2015. Healthy,
Resilient, and Sustainable Communities After
Disasters: Strategies, Opportunities, andPlanning for Recovery. Washington, DC: The
National Academies Press.
https://doi.org/10.17226/18996.
Website: https://www.nap.edu/catalog/18996/
healthy-resilient-and-sustainablecommunities-after-disasters-strategiesopportunities-andCenter for the Study of Traumatic Stress
Department of Psychiatry
Uniformed Services University
4301 Jones Bridge Road, Bethesda, MD 20814-4799
www.CSTSonline.org