A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

The Dialogue 

2024 | VOLUME 19 | ISSUE 1

Disaster Behavioral Health Planning for the 21st Century
 

 

 

 

 

 

 

CONTENTS 

3 In This Issue 

4 Contributors 

5 Technical Assistance Snapshot 

6 New Perspectives: Disaster Behavioral Health Through a Fresh Lens 

11 Steps to Revising an All-Hazards Disaster Behavioral Health Plan 

14 Resources for Disaster Behavioral Health Planning 

18 Recent Technical Assistance Requests 

COVER Photo by Adobe Stock 

The Dialogue is a quarterly technical assistance journal on disaster behavioral health which 

is produced by the Substance Abuse and Mental Health Services Administration (SAMHSA) 

Disaster Technical Assistance Center (DTAC). Through the pages of The Dialogue, disaster 

behavioral health professionals share information and resources while examining the 

disaster behavioral health preparedness and response issues that are important to the field. 

The Dialogue also provides a comprehensive look at the disaster training and technical 

assistance services SAMHSA DTAC provides to prepare states, territories, tribes, and local 

entities so they can deliver an effective disaster behavioral health response. 

SAMHSA DTAC provides disaster technical assistance, training, consultation, resources, 

information exchange, and knowledge brokering to help disaster behavioral health 

professionals plan for and respond effectively to mental health and substance misuse needs 

following a disaster. 

To learn more or receive The Dialogue, please call 1–800–308–3515, email dtac@samhsa. 

hhs.gov, or visit the SAMHSA DTAC website at https://www.samhsa.gov/dtac. 

The Dialogue is not responsible for the information provided by any web pages, materials, or organizations referenced in this publication. Although 

The Dialogue includes valuable articles and collections of information, SAMHSA does not necessarily endorse any specific products or services 

provided by public or private organizations unless expressly stated. In addition, SAMHSA does not necessarily endorse the views expressed by such 

sites or organizations, nor does SAMHSA warrant the validity of any information or its fitness for any particular purpose.
2024 | VOLUME 19 | ISSUE 1 | PAGE 3 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

 

 

In This Issue 

“If you fail to plan, you are planning to fail!” 

This quote from Benjamin Franklin is often repeated in 

professions that respond to disasters and their effects.

This centuries-old phrase holds true in the disaster

behavioral health (DBH) community to this day for a

reason: if we do not prepare, we are setting ourselves 

up for failure. Conversely, if we do prepare, then we are

setting ourselves up for success.

While planning is a classic element of preparedness,

planning for disasters, and the mental health and 

substance use effects on those impacted by disasters, is

a continually evolving process. Lessons from our own

experiences, successful strategies shared by our peers,

feedback from those with lived experience, and research

from the field continue to inform the way DBH plans are

developed, maintained, and executed.

In this issue of The Dialogue we dive into the DBH 

planning process, exploring challenges, sharing

resources, and examining what DBH planning looks

like today and where it’s heading in the future. We

recognize that much of the knowledge on this topic is

held by those doing the work. Those who have been

in the field for years bring their expertise, their stories,

and their wisdom, and those newer to the field bring

a fresh perspective, creative solutions, and ideas for

the future of DBH planning. In this issue we bring

together a number of practicing DBH professionals,

with various levels of experience, to share their thoughts

and experiences, as well as offering actionable steps and

solutions for DBH planning.

In the first articles of this issue, you will find

perspectives from two professionals who are newer

to DBH; they share what they have experienced and

learned from their first years in the field. Next, Dr.

Denise Bulling of the University of Nebraska Public

Policy Center shares an in-depth strategy for revising

an all-hazards disaster behavioral health plan, with

step-by-step guidance. The final article details a number

of resources that support the DBH planning process,

including printed and online information, tools for needs

assessment, and training opportunities.

If you have experience with DBH planning, other

planners and responders can learn from your efforts and

experience. Please contact us to share your stories and

lessons learned.

CAPT Maryann E. Robinson, Ph.D., RN, Acting

Traumatic Stress Branch Chief, Disaster Behavioral

Health Branch Chief

maryann.robinson@samhsa.hhs.gov

Nikki Bellamy, Ph.D., Public Health Advisor,

Division of Trauma and Disaster Behavioral Health 

nikki.bellamy@samhsa.hhs.gov

Shannon Loomis, M.A., Director, Substance Abuse

and Mental Health Services Administration Disaster

Technical Assistance Center

dtac@samhsa.hhs.gov
2024 | VOLUME 19 | ISSUE 1 | PAGE 4 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

 

Contributors 

Denise Bulling, Ph.D., LIPC, 

CTM, is a Senior Research

Director with the University

of Nebraska Public Policy

Center. She joined the

university in 2003 after an 

over-20-year career as a mental health practitioner.

Her Ph.D. is in human science with her dissertation

focusing on exploration of training needs for disaster

chaplaincy. Bulling uses her extensive field experience

in mental health to create bridges between practitioners,

academicians, and policymakers. She is a leader in

Nebraska’s development of disaster behavioral health

response capacity, consults and speaks about the role

of disaster behavioral health within an integrated 

response and recovery system, and is a national trainer

for the Federal Emergency Management Agency Crisis

Counseling Assistance and Training Program (CCP).

She has served as lead for several CCPs including one

of the first projects in the nation conducted on tribal

land. Bulling is a licensed independent professional

counselor and a certified threat manager through the

Association of Threat Assessment Professionals. She has

numerous publications related to mental health, disaster,

and violence.

Kalie Burke, M.P.H., is the 

Disaster Mental Health 

Coordinator for Georgia at

the Department of Behavioral 

Health and Developmental 

Disabilities. Burke attended

Florida State University for both her undergraduate

degree and master of public health. Prior to joining the

Georgia behavioral health team, Burke worked as a 

public health consultant in Florida and California during

the height of the COVID-19 pandemic. Burke leads the

Georgia Recovery Project, a team of Crisis Counseling

Assistance and Training Program providers located

throughout the state providing information on stress 

management and mental health related to COVID-19.

Additionally, she co-chairs the Georgia Emergency

Preparedness Coalition for Individuals with Disabilities

and Older Adults.

Sofia Cabrera, B.A., is a 

Technical Assistance Specialist

for the Substance Abuse

and Mental Health Services

Administration (SAMHSA)

Disaster Technical Assistance

Center (DTAC). Cabrera attended the University of

Maryland and received a B.A. in English literature and

language. She has worked in the public health field for

2 years. Cabrera provides guidance to state, territory,

and tribal grantees developing behavioral health 

support for disaster-affected communities. She also

provides administrative support and promotes grantee 

development to address growing community needs after

disaster events. Cabrera manages and writes content

for several SAMHSA DTAC resources, including

the SAMHSA DTAC Bulletin and The Dialogue. She

specializes in highlighting culturally competent and

accessible materials and systems for underserved

populations experiencing inequities in access to

behavioral health services.

Heather Phelps, M.A., LPC, 

received her master’s in

human development and 

family relationships from the 

University of Connecticut.

Since returning to Alaska in

1998, she has worked in the behavioral health field
2024 | VOLUME 19 | ISSUE 1 | PAGE 5 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

 

in state government, nonprofit agencies, and the

private sector. Her professional experience ranges

from providing substance use disorder treatment in a

therapeutic community, to behavioral health services for

adolescents at the largest juvenile detention center in

Alaska, to overseeing medication-assisted treatment at

the Department of Corrections. A licensed professional

counselor, she has worked for the Alaska Division of

Behavioral Health specializing in policy, planning, and

regulations. Phelps was the Alaska Disaster Behavioral

Health Mental Health Clinician from March 2022 to

December 2023. In that capacity, she was a member

of the State Emergency Operations Center and worked

closely with the Alaska Division of Public Health’s

Health Emergency Response Operations (HERO) for the

administration of behavioral health disaster response. In

December 2023, she began work for the Alaska Mental

Health Trust Authority as a Program Officer.

TECHNICAL ASSISTANCE SNAPSHOT 

A Look at the Disaster Behavioral Health Workforce: Data 

From the SAMHSA DTAC Customer Feedback Survey 

Each year the SAMHSA Disaster Technical Assistance Center (DTAC) administers the Customer Feedback 

Survey to learn more about customers and their needs. Between 2017 and 2022, the average SAMHSA 

DTAC customer had 8 to 16 years of experience in disaster behavioral health (DBH) and spent 10 to 20 

percent of their time at work on DBH planning. 

Note: Where there are zeroes, there is no data to include. There were few responses in 2019 to the Customer Feedback Survey. 
2024 | VOLUME 19 | ISSUE 1 | PAGE 6 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

 

INTERVIEW 

New Perspectives: Disaster Behavioral Health

Through a Fresh Lens 

By Heather Phelps, M.A., LPC, Alaska Mental Health Trust Authority, State of Alaska; Kalie Burke, M.P.H., 

Georgia Department of Behavioral Health and Developmental Disabilities; and Sofia Cabrera, B.A., SAMHSA

Disaster Technical Assistance Center (DTAC)

Limited resources, lack of time,

and burnout are just some of 

the challenges state disaster

behavioral health coordinators and

other disaster behavioral health 

specialists encounter working in

the field. The Dialogue recently

spoke with Heather Phelps and

Kalie Burke to discuss their

experiences with disaster planning

and response efforts as relatively

new state disaster behavioral health 

coordinators. Phelps and Burke

shared their perspectives on barriers

to disaster planning and priorities to 

provide a fresh outlook on disaster 

behavioral health work in the 21st

century.

How long have you worked 

in disaster behavioral health 

(DBH)? Did you have any DBH 

experience prior to working in 

your current position? 

Heather Phelps: I started working 

in this position in March of 2022, so

I’m relatively new. I wasn’t familiar

with DBH at all. I sometimes filled

in for the person previously in the 

position for some COVID State

Emergency Operations Center

meetings, but that was my only 

previous experience. I used to work

in corrections, so I had experience

with Critical Incident Stress

Management (CISM). I oversaw

statewide CISM teams for the

Department of Corrections. I lend

some of that skill and knowledge to 

my current work.

Kalie Burke: I have officially been

in this position for about a year 

and a half now. That’s my official

DBH experience. Unofficially,

my master’s thesis was on DBH.

It focused on how we can expand

mental health services during a

disaster with or without federal 

funds. When I first started my

thesis, I was working in emergency

management, but not in the DBH 

world. I was doing more work

focused on COVID-19, like getting
2024 | VOLUME 19 | ISSUE 1 | PAGE 7 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

 

vaccines to the public and testing

centers up and running.

What complications or 

challenges have you 

encountered as you focus 

on creating, revising, or 

implementing your state’s 

disaster response plans—or in 

your work in general? 

Heather Phelps: There’s a lot I 

would like to do with the disaster 

behavioral health component of

my position that I just don’t have 

time for right now. My official title

is under policy and regulations.

The bulk of my job is drafting 

regulations and managing the 

regulation projects. We’re going

through regulation changes that

have taken more of my focus. It’s

an interesting mix because policy

regulation is a very slow, lengthy 

process, and disaster behavioral

health is a very immediate process

with high emotional intensity and 

urgency.

I am located in the Division of

Behavioral Health under the 

Department of Health, while 

everything else related to disaster 

response and emergency planning

is under the Division of Public

Health. I’m separated from others in

the Emergency Operations Center.

There’s a lot of mystique about 

behavioral health. There are a lot of

ideas about what behavioral health 

or mental health services should

be in relation to a disaster response 

or a crisis situation. A lot of times

people don’t understand that a 

SAMHSA and the SAMHSA Disaster Technical Assistance 

Center have identified eight promising practices in 

disaster behavioral health planning: 

1 5 

Plan scalability Services assessment 

2 6

Partnerships Logistical support 

3 7 

Financial and Legal and 

administrative regulatory 

preparedness guidance 

4 8

Plan implementation Plan integration 

— From SAMHSA Disaster Technical Assistance Center Promising

Practices in Disaster Behavioral Health Planning: Introduction

video. You can also access the full Promising Practices in Disaster 

Behavioral Health Planning video series. 
2024 | VOLUME 19 | ISSUE 1 | PAGE 8 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

 

person receiving services from a

disaster response is not going to be 

diagnosed or receive a treatment

plan. So there’s an education piece

to this work.

Kalie Burke: We’ve done a good 

job of focusing on population mental

health. We did a lot of great work

with the general population, with 

teachers, and with the healthcare

field. But emergency managers

were, and continue to be, kind of

left out. When a disaster is coming,

we see the news, we see the graphs.

I know a hurricane is coming and I

need to prepare. I, of course, need

to do my job, but also need to help 

my family and friends prepare and 

prepare myself. That can weigh on

you a lot. There’s the impending

doom knowing I’m going to be 

working 12-hour shifts. It’s not to

say we don’t want to do it. But we

would like a bit more support and 

leniency for our mental health.

I know there’s not a lot of room 

for leniency because everything

moves fast during a disaster, but 

it’s important to have people’s best 

interests in mind. When Hurricane

Idalia was coming through, I sent

out an email to my team and said, “I 

know this is a really stressful time.

Just remember to take a deep breath 

and that we can get through this

together.” It’s kind of a “one team,

one fight” type of mentality that I

encourage for my team, because we

are all in it for the same goal.

Our jobs are extremely stressful.

Working in the field for several years

during COVID-19, the burnout we

are experiencing is substantial. I

want to make sure that everyone is 

taken care of. It’s not just the nurses,

doctors, firefighters, and police on

the frontlines. It’s also the people

who may be sitting at a desk all day, 

working from home, who have a toll 

taken on them as well working in 

DBH.

In a field as fast-paced as DBH,

how do you ensure self-care

and wellness for yourself and/ 

or others on your team? 

Heather Phelps: I’m a licensed

professional clinician. My master’s

is in marriage and family therapy, 

so self-care is a practice I’ve been

doing most of my professional and 

personal life. Truthfully, it’s a part

of who I am and not just something 

I do. It’s an everyday component

of my life. I exercise regularly.

I journal. I have an active social

network of friends and family who 

support and care about me, and I

support and care about them. I stain

glass as my hobby. I live in the most

beautiful state. I hike all the time.

Do I get stressed out still? Yes. But

I’ve had my personal journey with 

recovery, and I’m pretty grounded.

Kalie Burke: You should be able

to establish what works best for 

you. I know that I need to go talk to

my therapist once a week and that

works for me. If there’s a disaster

coming, I know I’m going to be

thinking about it and that I’ll be a 

little anxious. I read an interesting

piece once that said, “If you’re

always on call, you’re always in

fight-or-flight response mode.” It’s

important to have everybody on 

the same page of what we want to 

see in terms of work effort, team

meetings, and social supports.

You’re no good to anyone else if you

overwork yourself. You can’t pour

from an empty cup. Know yourself

and know your personal limits. I

did not know mine when I started 
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A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

 

Disaster behavioral 

health is ever 

evolving. Disasters 

are not static events, 

and they’re not 

always the same. 

Every incident has 

its own uniqueness 

that needs to be 

addressed. 

working in emergency management,

and I know a lot of people who don’t 

know theirs because they want to

put everybody else first. This is the

field we got into to help people, but

you’re no good to anyone else if 

you’re not helping yourself.

What recent work have or are 

you pursuing to ensure you 

can best address DBH needs 

in your state? 

Heather Phelps: I stepped into 

the position and there wasn’t an 

active continuity of operations

plan. The disaster behavioral health

response part of the state emergency

preparedness plan was last updated 

in 2019, pre-COVID, and didn’t

reflect resources that are currently

available in our state post-COVID.

It was extremely well written and 

well thought out, but it wasn’t 

practical. Disaster behavioral health

is ever evolving. Disasters are not

static events, and they’re not always

the same. Every incident has its

own uniqueness that needs to be 

addressed.

We successfully updated our

disaster preparedness plan this 

June. I reached out to SAMHSA

DTAC and was connected with Dr.

Denise Bulling, who is amazing.

Unfortunately, there was a change in

leadership here, and regulation work 

took off, so we didn’t take advantage

of her knowledge and expertise as 

much as we could have. I think we

met twice, but just those two times

were extremely motivating and 

encouraging for me.

Something that Denise Bulling

shared with me that I totally 

resonate with is that all disasters 

begin and end locally. Many of our

smaller communities are vitally

connected with Alaska Native

culture, and we may not be aware

of their strengths without asking.

Coming in with a more Western

medical model of behavioral health

may not be appropriate. So we are

considering how we can support

those communities in a culturally

appropriate, respectful, and honoring

way. The community recovers and

rebuilds through support.

Kalie Burke: The Department of 

Public Health has these telemedicine

backpacks that nurses and first

responders can use to conduct a

physical check-in. The backpacks

have a computer with a camera so

users can essentially FaceTime with

a doctor in real time remotely. I have

been working with specialists within

the Department of Public Health to

see if those backpacks are something

we could start using in shelters to get

disaster behavioral health services

out to communities a lot faster.

When a disaster hits, it’s very 

difficult to get people out there and

providing services immediately,

especially when our providers are

short staffed, or are in the affected

area and are also recovering from

the disaster. We may be able to

have something there at the shelters 

where individuals can receive

immediate access to real healthcare
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A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

 

services in a virtual manner. These

locations can offer crisis counselingtype services immediately without

needing someone physically there.

A crisis counselor can be working

at the provider’s office, doing their

normal day-to-day work, and answer

calls as they come in.

It’s a project we have identified as

a way to be able to continuously

provide behavioral health services or

basic public health care in times of

a disaster. We know it usually takes

some time to get services up and

running after a disaster—why not try 

cutting that part out? We’re moving

with the technology and with the

times.

What advice would you give 

to someone starting to work in 

DBH or in your position? 

Heather Phelps: Connect with

SAMHSA DTAC. There’s a lifeline.

When I started in the position, I had 

no clue who to contact regarding

disaster behavioral health response.

So I would do Google searches to

find out what to do. And I found

SAMHSA DTAC and a wealth

of information. And then I was

able to connect with a technical

assistance specialist, and they were

able to connect me with Denise

Bulling. SAMHSA DTAC provides

resources, including fact sheets,

when there’s been a lot of flooding

or wildfires or mass violence events.

SAMHSA has some great resources,

including the TAP 34 Disaster 

Planning Handbook for Behavioral 

Health Service Programs, which

was super instrumental in helping 

me draft our DBH response plan.

I attended the SAMHSA DTAC

Crisis Counseling Assistance and

Training Program Grants Training

and was able to connect with

individuals from other states through 

that training. I connected with an

attendee from Oregon, and we’re

still in contact. Every time a disaster

comes up, she and I are messaging

each other to support each other

however we can.

Kalie Burke: Don’t be afraid to not 

know. That was my biggest thing

when coming into this field. The first

year of having this job, I thought, 

“I am going to ask the stupidest 

questions and they’re going to think 

I am so dumb.” But they didn’t. No

one expects you to be the disaster

behavioral health expert of the world 

because no one is. The individual

that had my job before me was in 

this position for 20 years. She is the

queen of disaster behavioral health, 

and even she doesn’t know things 

sometimes. And she is unashamedly

able to admit she doesn’t know 

something. Even once you feel like

you know everything, there will still 

be more that you can learn.

We’re all moving through this new 

world of disasters and funding, 

so don’t be afraid to reach out for

help. There is a network of disaster

behavioral health coordinators and

individuals in the field across the

county with people who are more

than happy to answer your questions.

No question is too simple to ask.

Honestly, the simplest questions turn 

into great discussions. No one’s here

to scare you or get you. We’re all

here to learn and provide services. ■

Contact SAMHSA DTAC for Planning TA 

SAMHSA DTAC welcomes all requests for technical 

assistance (TA), including requests related to DBH 

planning and preparedness. Staff can provide 

resources, information, and connection with experienced 

professionals in the field that may be helpful for DBH planning. 

You can reach SAMHSA DTAC by email at dtac@iqsolutions.com 

or toll-free phone at 800–308–3515. 
2024 | VOLUME 19 | ISSUE 1 | PAGE 11 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

 

Steps to Revising an All-Hazards Disaster 

Behavioral Health Plan 

By Denise Bulling, Ph.D., LIPC, CTM, University of Nebraska Public Policy Center

All-hazards disaster behavioral

health plans became a priority for

states in the early 2000s. Since

then, we have learned a lot about 

what people need after disasters and 

how to deliver services even when

we can’t be face to face. Plans are

tested by each disaster or large-scale

emergency. Along the way, we face

changes in personnel, availability

of resources, and context—all

impacting how we respond. Most

states have or should have updated 

plans with the lessons they learned 

and the evolving evidence for

effective interventions. The most

tempting way to revise a plan is to 

give it to one person and ask them to 

“update it.” However, this may not

be the best solution.

I am a strong advocate for outlining

the plan revision process to include

timelines and who is responsible for 

each step. The benefits of following

a clear process include increased

transparency and accountability.

There are many ways to approach

the revision process. Below is a

simplified process that can serve

as a starting point for your revision 

or update. Adjust it to meet your

context and resources.

1 Exercise situation manuals are available for viewing 

and download at https://www.disastermh.nebraska.edu/ 

training-education/exercises. These manuals can be 

modified for use in your jurisdiction.

Step 1: Exercise your plan. 

Step 2: Identify the areas of the 

plan that need community 

or organizational 

involvement. 

Step 3: Gather community or 

organizational input. 

Step 4: Draft the plan. 

Step 5: Reconcile with other plans. 

Step 6: Finalize and distribute 

the plan. 

Step 1: Exercise your plan. 

This can be as simple as convening

(virtually or in person) key 

personnel to talk through how your 

plan would be used in a specific

scenario. You could also take a

recent disaster in your jurisdiction

and talk through the strengths and 

weaknesses of the plan. Nebraska

convenes state and local partners

once a year for a tabletop exercise

testing local and state behavioral

health plans.1

 Representatives from 

behavioral health, public health,

emergency management, Nebraska

Voluntary Organizations Active in

Disaster (VOAD), first responders,

and others participate. This results

in an after-action review and report/

implementation plan identifying 

areas of improvement, who is going 

to do it, and when it is expected

to be done. The recommendations

for improvements can be related to

plans, procedures, or even resource

development and acquisition. Doing

an exercise is a great way to enhance

partnerships, foster collaboration

with emergency management, and

tap into their expertise in exercise

design and facilitation. Exercises

help you quickly identify gaps and

outdated assumptions in your plan.
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A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

 

Step 2: Identify the areas of the 

plan that need community or 

organizational involvement. 

Plan gaps or challenges identified

in the exercise may not require

involvement of other entities. For

example, you may find outdated

references or resources in your plan

that are easy to update. However,

you may also find challenges to

your assumptions that impact

stakeholders—for example, the 

way you are organizing your

workforce or assumptions that

are no longer relevant about how 

you plan to implement the federal 

Crisis Counseling Assistance and

Training Program grant when your

jurisdiction is eligible. These and

similar challenges may require input

from stakeholders such as your

leadership, other state agencies,

provider groups, professional 

groups, and so on. This step in

the updating process involves

identifying which parts of the

plan require stakeholder buy-in.

Narrowing the focus of what you

present to stakeholders will help you 

get better feedback.

Step 3: Gather community or 

organizational input. 

Once you know the areas of

the plan you want involvement 

in, determine how you will get 

meaningful input from the various 

groups you identified. Table 1

showcases different methods for

involvement, each with advantages

and disadvantages.

Table 1. Stakeholder Input Methods 

Method Advantages Disadvantages 

Online survey • Easy to deliver.

• Focused questions.

• Easy and quick analysis.

• It may miss key points.

• Not everyone has

online access.

Focus groups or 

interviews 

• Rich data/discussion

points.

• People feel heard.

• Labor intensive.

• Difficult to synthesize.

Virtual meetings • Easy to arrange.

• Amenable to breakout

discussions.

• May reach large groups

of people.

• Must have good

facilitation skills.

• Some may be silent

in a group.

• Scheduling may not

work for all.

Focused input 

during regularly 

scheduled 

meetings/ 

gatherings 

• Integrates with regular

meetings.

• Easier to schedule.

• May involve virtual data

gathering in addition

to discussion.

• May be limited on time.

• Agenda placement may

impact input.

• May miss stakeholders

not attending regular

meetings.

Engagement of • Easier access to some • Data may be filtered.

key stakeholder 

groups to gather 

data from their own 

constituents 

populations.

• Creates buy-in from

the organization.

• May be in person

or virtual.

• Capitalizes on

existing trust.

• Little control over

delivery.

Advisory group 

(ad hoc only for the 

plan update period) 

• Creates high-level buy-in.

• Allows for high-level

review.

• It may be seen as limited

engagement if another

method is not used.

Webinars • May be recorded and

played later.

• Increase awareness.

• May be coupled with

other methods.

• May be issue-focused.

• Not everyone has

online access.

• Recording may not

be accessible.

• It may not stimulate

engagement.
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A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

 

Step 4: Draft the plan. 

Drafting the plan involves 

synthesizing all the input and

making decisions about the

direction the plan will take. Involve

leadership in these decisions before

any changes to the plan are made.

Take time to review and update 

references, resource listings,

statistics, and appendices. Highlight

key areas of change that are based

on your stakeholder work.

Step 5: Reconcile with other plans. 

Circulate a draft of the updated

plan to key groups before moving 

to the next step. Ask them to pay

particular attention to the areas that

were changed and highlighted. For

example, your plan might include

new information about how you 

are organized and deployed under

an incident management structure

by an emergency management

agency. The emergency management

agency should review your proposed

changes and check their plans to

ensure your proposed changes are

compatible with their plan language.

Step 6: Finalize and distribute the 

plan. 

Incorporate any changes from the

last step and finalize your plan.

Ensure it is signed and approved by

the right people, and you are ready 

to distribute it. Start by confirming

your partner groups have a copy and

know where to find it when needed.

Think about who needs a copy of

your plan and how they are going 

to access it during an emergency.

For example, some may want a 

hardcopy for a “go-bag” along with

a copy on a flash drive as a backup

while others may just access it on

your website when needed. Make

suggestions about how you want key 

staff to access your plan and ensure

they have the resources they need to

enact their part in the plan.

Now that your plan is up to date, it is

time to test it with another exercise!

Getting into a rhythm of exercising

and adjusting will help your plan stay 

fresh and relevant. It will also increase

awareness of the role of disaster 

behavioral health for other response 

entities and help ensure people in your 

jurisdiction get the help they need

when they need it most. ■

In a study of state disaster recovery 

implementation plans, researchers 

found that a majority of plans 

had provisions to address shortterm healthcare needs, including 

behavioral health needs, but 

only one-third addressed long-term healthcare and 

behavioral health needs (Kennedy et al., 2021). 
2024 | VOLUME 19 | ISSUE 1 | PAGE 14 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

 

Resources for Disaster Behavioral 

Health Planning 

By SAMHSA Disaster Technical Assistance Center (DTAC) staff

According to the Customer Feedback Survey, which SAMHSA DTAC uses to improve our products and services,

most disaster behavioral health (DBH) professionals have very little work time dedicated to DBH planning—an

average of 16 percent, according to the latest survey findings. Yet a lot of planning must be done to ensure effective

DBH response and recovery. This article presents resources that may help, including printed and online information,

needs assessments, and training opportunities.

Guides and Other Resources 

To Support the Planning 

Process 

SAMHSA DTAC maintains a

web portal for disaster planners. 

This portal features information 

to help planners include and

account for populations who may

be at heightened risk in disasters, 

including people with access and

functional needs, older adults, and 

people experiencing homelessness, 

as well as information about 

diversity, equity, inclusion, and

accessibility in disaster planning and

response. The portal also includes a

link to the Introduction to Promising

Practices in Disaster Behavioral

Health Planning webinar recording, 

which presents promising practices

to help strengthen planning efforts

and outcomes. In addition, the portal

offers a tool to help with DBH 

planning in the context of climate

change. 

The SAMHSA Disaster Behavioral

Health Information Series collection

also includes resources specific to

planning.

The Federal Emergency

Management Agency (FEMA)

offers several resources to support

emergency planning by states,

territories, tribes, and local

governments, as well as entities in 

other sectors. The Comprehensive 

Preparedness Guide (CPG) 101 

provides information, strategies, and 

tools to aid in developing emergency

operations plans (EOPs) at state,

territory, tribal, and local levels.

Other resources offer guidance

on private-public partnerships

in support of planning and 

preparedness, specific incident types,

and EOPs for houses of worship and

schools.

Tools for Assessing Hazards, 

Vulnerability, and Need 

The Centers for Disease Control

and Prevention (CDC) offers the

Social Vulnerability Index (SVI),

a database with information about 

levels of risk during disasters 

in locations across the United

States. The SVI is based on factors

research has found to be associated

with greater risk during disasters, 

including socioeconomic status,

household characteristics, being part

of a historically marginalized racial

or ethnic population, and access to

transportation. The SVI is designed

to help emergency managers

and public health professionals

understand and plan for vulnerability 

levels in areas where they are 
2024 | VOLUME 19 | ISSUE 1 | PAGE 15 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

 

 

developing and maintaining EOPs,

DBH plans, and disaster response 

and recovery plans. Users can access

an interactive map or download data 

for their own use.

FEMA’s National Risk Index is 

another tool for assessing needs at 

state and local levels. The National

Risk Index draws in part on the 

CDC’s SVI. Its data helps show the

U.S. communities at greatest risk for

18 natural hazards. The index shows

risk at U.S. county and Census tract

levels. Users can access the index as

an interactive map or via database 

downloads, among other methods.

The Hazards Vulnerability and

Resilience Institute at the University

of South Carolina has developed

the Social Vulnerability Index for

the United States (SoVI®). There

are 2010–2014 and 2019 versions

of the SoVI. The index is based on

data from the U.S. Census Bureau

and other sources related to 29

socioeconomic variables found

to affect community capacity to

prepare for, respond to, and recover

from disaster. A data page offers

the ability to download the SoVI

2019 for counties across the United

States, as well as SoVI 2010–2014

state-level maps that show how

counties compare. The SoVI and

tools at the SoVI website may be

helpful to planners in identifying 

areas of heightened vulnerability 

within their jurisdictions that may

need more resources for planning

and preparedness, response, and 

recovery.

The U. S. Census Bureau offers

QuickFacts, a website presenting 

statistics for all U.S. states and

counties, as well as for cities and

towns where at least 5,000 people 

live. Users can select a geographical

area and compare statistics in that

area to the entire United States,

with statistics including overall

population, age, sex, race, and

ethnicity; variables related to

housing ranging from number of 

housing units to median gross rent; 

families and living arrangements; 

and income and poverty. The site

also allows users to view data in 

a range of formats (tables, charts,

maps) and download and share data 

easily.

Developed by FEMA and Argonne

National Laboratory, the Resilience

Analysis and Planning Tool (RAPT)

allows planners to use geographic

information system mapping to view 

community resilience indicators

and other data on demographics,

infrastructure, weather, and hazards.

RAPT also features analysis tools

and the ability to print and download 

information. You can access a

website to learn how to use RAPT.

Training 

The FEMA Emergency Management

Institute offers a wide range of

Independent Study (IS) courses

you can complete online and at

your own pace. To complete the

courses, you must obtain a FEMA

Student ID, which you can register 

for online free of charge. Some of

these courses may help you get up to

speed on fundamentals of emergency

planning and management and 

how these disciplines intersect with

DBH: 

 Fundamentals of Emergency

Management (IS-230.E). This

course offers an overview

of emergency management,

identifying key partners and their

roles and steps in developing a

comprehensive EOP.

 Emergency Planning (IS235.C). This course covers the

relationship between planning and

preparedness, the planning process
2024 | VOLUME 19 | ISSUE 1 | PAGE 16 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

 

 

and the steps it includes, and

elements of an EOP.

 National Preparedness Goal and

System Overview (IS-2000).

In this course, participants

are introduced to the National

Preparedness Goal and National

Preparedness System, two

frameworks for organizing

nationwide disaster preparedness

efforts.

 National Disaster Recovery

Framework Overview (IS2900.A). This course presents

the National Disaster Recovery

Framework, its history and

background, and key elements

such as guiding principles and

recovery support functions.

 An Introduction to the National

Incident Management System

(IS-700.B). The National Incident

Management System (NIMS)

helps organizations and entities in

all sectors collaborate in incident

management to implement 

effective preparedness, response,

and recovery activities. This

course covers the basics of NIMS,

the Incident Command System

and other NIMS management and

coordination structures, and how

different structures and elements of

NIMS work together.

 The Role of Voluntary

Organizations in Emergency

Management (IS-288.A). This

course covers the history of

voluntary organizations in

the United States and their

contributions to disaster planning

and preparedness, response, and

recovery.

 Developing and Managing

Volunteers (IS-244.B). This course

prepares participants to involve

volunteers in disaster response and

recovery. The course discusses

aspects of disaster response and

recovery where volunteers can

be especially helpful, volunteer

recruitment and management, and

issues in management of volunteers.

 Community Preparedness:

Implementing Simple Activities

for Everyone (IS-909). This course

equips participants to manage

and support efforts that increase

community preparedness. It

discusses principles of community

preparedness, activities to build

preparedness, and resources to

support community preparedness. ■

Steps in the Planning Process 

In the Comprehensive Preparedness Guide 101, the Federal Emergency Management Agency provides information 

to help state, territorial, tribal, and local governments create and maintain emergency operations plans. The guide 

proposes an approach to planning that includes several steps: 

4 

Form a 

collaborative 

planning team. 

• Identify a core

planning team.

• Engage the

whole community

in planning.

Understand 

the situation. 

• Understand risk.

• Use the results

of risk analysis.

Determine 

goals and 

objectives. 

• Determine

operational

priorities.

• Set goals and

objectives.

Develop 

the plan. 

• Develop and

analyze courses 

of action. 

• Identify

resources.

• Identify

information and

intelligence

needs.

1 

2 

3 5 

Prepare and 

review the plan. 

• Write the plan.

• Review the plan.

• Approve and

disseminate

the plan.

6 

Implement and 

maintain the 

plan. 

• Train on the plan.

• Exercise the plan.

• Review, revise,

and maintain

the plan.
2024 | VOLUME 19 | ISSUE 1 | PAGE 17 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

 

RECOMMENDED RESOURCES 

SAMHSA Disaster Mobile App 

This free app from SAMHSA provides responders

with resources for every phase of disaster response

and includes tip sheets, guides, and a directory of

behavioral health service professionals. Materials can be

downloaded in advance and accessed offline. The app is

available through the Apple App Store and Google Play

Store.

Learn more about the app at http://bit.ly/3PEYl1T.

Make a Plan 

This page from Ready.gov has fields you or people you

are helping with disaster preparedness can complete

to help create a family emergency communication

plan. Users can fill out household information such as

details on each family member (including important

medical information), emergency plans and contacts,

and meeting places. When information has been entered,

users can submit the form to receive a PDF version to

print out and save.

Access the planning tool at https://bit.ly/3tiNwe4.

Red Cross Mobile Apps 

The American Red Cross has a variety of preparedness

apps available for free. The Emergency App provides

step-by-step guides to help individuals prepare, an

interactive map of open Red Cross shelters, and

information in English and Spanish. There are also first

aid apps for family and pets.

Find links to download the apps at https://rdcrss.

org/46a6Adc.

Caring for Children in a Disaster: For Kids 

and Families 

The Centers for Disease Control and Prevention has

a range of checklists designed to help families with

children prepare for an emergency. Parents and other

caregivers can learn which items to consider including

in an emergency kit and how to turn this task into a fun

game for the family. Checklists are available for families

with children, a baby or toddler, or pets, as well as

children and youth with special healthcare needs.

Find the checklists at https://bit.ly/3LMcNDX.

Stop Disasters! 

Designed for 9- to 16-year-olds, this game from the

United Nations Office for Disaster Risk Reduction

can help young people learn the risks of disasters such

as hurricanes, wildfires, earthquakes, and tsunamis.

Participants can pick their difficulty level and disaster

scenarios that help them think of the most efficient way

to build hospitals, housing, and more to protect the

population.

Play the game at https://bit.ly/48woOHr.

i
2024 | VOLUME 19 | ISSUE 1 | PAGE 18 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

 

Recent Technical Assistance Requests 

In this section, read about responses SAMHSA Disaster Technical Assistance Center (DTAC) staff have provided to

recent technical assistance requests. Send your questions and comments to dtac@samhsa.hhs.gov.

Request: SAMHSA DTAC received a phone call

from Hawaii requesting guidance on handling inbound

crisis line calls related to the 2023 Hawaii wildfires.

The state further inquired about additional resources

and information that should be shared with individuals 

impacted by the fires.

Response: SAMHSA DTAC compiled a list of

wildfire-specific resources, as well as information

pertaining to common reactions and stressors involved

in unexpected home evacuation. A sample of the

resources provided is included below:

 Disaster-specific Resources: Wildfires—This part of

the SAMHSA Disaster Behavioral Health Information

Series collection includes resources focused on

wildfire preparedness and response. The collection

includes resources for children, parents and other

caregivers, school personnel, and the public.

https://www.samhsa.gov/resource-search/

dbhis?rc%5B0%5D=type_of_disaster%3A20555

 Wildfires—The SAMHSA Disaster Distress Helpline

supports survivors, family members, responders, and

recovery workers who are affected by wildfires and

other disasters. Information on this web page includes

signs of emotional distress, populations who may be

at greater risk for distress after a wildfire, and links to

resources for more information and support.

https://www.samhsa.gov/types-disasters/wildfires

 Natural Disasters and Severe Weather: Wildfires—

The Centers for Disease Control and Prevention’s

website provides information on a host of hazards,

including wildfires. This web page offers links to

information about staying safe after a wildfire and

learning about and coping with hazards linked to

wildfires and other disasters, including emotional

distress.

https://www.cdc.gov/disasters/wildfires/index.html

The page is available in Spanish at https://www.cdc.

gov/es/disasters/wildfires/index.html.

 Wildfires: Response/Recovery—Part of the U.S.

Department of Labor, the Occupational Safety and

Health Administration (OSHA) works to ensure

safe and healthy workplace conditions across the

United States. This part of OSHA’s website offers

information on staying safe as a worker involved in

wildfire response and recovery. Links are provided

to information about the range of hazards workers

may face after wildfires, as well as information for

firefighters and other responders.

https://www.osha.gov/wildfires/response

 Recovering From Wildfires—This part of the

American Psychological Association’s website

identifies common reactions to wildfires and provides

recovery tips for individuals and families. The

resource also provides guidance for individuals caring

for children with special needs, as well as those

seeking additional assistance.

https://www.apa.org/topics/disasters-response/wildfires

Request: To aid in writing an article about disaster,

a representative from the State of Missouri contacted

SAMHSA DTAC to identify reliable sources of

information specifically related to disaster preparedness

and individuals living with serious mental illness.
2024 | VOLUME 19 | ISSUE 1 | PAGE 19 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

 

Response: SAMHSA DTAC provided several topical

resources developed by SAMHSA and SAMHSA

DTAC, including selected issues from SAMHSA

DTAC’s Supplemental Research Bulletin and The 

Dialogue. Below are some of the resources shared:

 Disasters and People with Serious Mental Illness—

This issue of the Supplemental Research Bulletin

delves into the experiences of individuals with serious

mental illness before, during, and after encountering

disasters. It focuses on the observed differences in

reactions to disasters among individuals with various

mental illnesses and offers approaches to help meet

the post-disaster needs of people with serious mental

illness.

https://www.samhsa.gov/sites/default/files/disasterspeople-with-serious-mental-illness.pdf

 Helping People With Serious Mental Illness and

Substance Use Disorder During Disasters—This

issue of The Dialogue addresses the challenges

faced by people living with serious mental illness or

substance use disorder during and after disasters. It

includes articles exploring ways to enhance disaster

preparedness and recovery support to include

people with serious mental illness and substance use

disorders.

https://www.samhsa.gov/sites/default/files/dtac/

dialogue-vol-15-issue-3-4.pdf

 TIP 57: Trauma-Informed Care in Behavioral

Health Services—Provided by SAMHSA, this manual

helps behavioral health professionals understand the

effects of trauma and better serve patients who have

experienced trauma. It also contains information to

help behavioral health program administrators develop

and sustain trauma-informed organizations.

https://store.samhsa.gov/product/TIP-57-TraumaInformed-Care-in-Behavioral-Health-Services/

SMA14-4816

 TAP 34: Disaster Planning Handbook for Behavioral

Health Service Programs—This publication offers

comprehensive guidance for both management and

staff involved in the development of disaster plans for

behavioral health service programs. The publication

delves into the nuances of planning strategies and

processes, with a focus on putting together a disaster

planning team, coordinating planning, and testing and

using the plan.

https://store.samhsa.gov/product/tap-34-disasterplanning-handbook-for-behavioral-health-serviceprograms/pep21-02-01-001

 My Mental Health Crisis Plan Mobile App—

Developed through SMI Adviser, this mobile app

enables individuals with serious mental illness to

create a psychiatric advance directive for guiding their

treatment during a mental health crisis. The app offers

a step-by-step process to state treatment preferences,

Help Improve SAMHSA’s Disaster Services and Products 

As a subscriber to this newsletter, you are invited to participate in a 

short, web-based survey to provide the SAMHSA Disaster Technical 

Assistance Center (DTAC) with feedback about your experiences 

with our products and services. The survey should take no more 

than 15 minutes. Complete the survey by going to the survey web 

page, or copy and paste the URL https://iqsolutions.qualtrics.com/ 

jfe/form/SV_ bjYCSJDUQAGi1h3 into your web browser. 
2024 | VOLUME 19 | ISSUE 1 | PAGE 20 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

 

designate decision-makers in case of incapacity, and

share the plan with healthcare professionals and loved

ones. The mobile application is available through

both the Apple App Store (https://apps.apple.com/

us/app/my-mental-health-crisis-plan/id1497373282) 

and Google Play (https://play.google.com/store/apps/

details?id=org.smiadviser.apa&hl=en_US).

https://smiadviser.org/mymhcp

 The Effects of Disaster on People with Severe

Mental Illness—This National Center for PTSD web

page discusses the impact of disasters on individuals

with severe mental illness. It examines the response

of individuals with severe mental illnesses to disaster

events and explores the question of whether people

with severe mental illness are at increased risk of

posttraumatic stress disorder (PTSD) following

disasters. The web page further emphasizes the

necessity for improved information on how individuals

with severe mental illness react to disasters and

suggests providing additional support and assessment

to this population.

https://www.ptsd.va.gov/professional/treat/specific/

disaster_mental_illness.asp

 Psychological First Aid Online—Offered by the

National Child Traumatic Stress Network, this online

course is designed to train new disaster responders

in Psychological First Aid (PFA). It also serves as a

valuable refresher for responders seeking to revisit 

this disaster response approach. The course covers the

fundamental principles of PFA and its application after

a disaster.

https://www.nctsn.org/resources/psychological-firstaid-pfa-online

Request: To further enhance the state’s disaster

preparedness and response, the Disaster Behavioral 

Health (DBH) Coordinator of North Carolina contacted

SAMHSA DTAC seeking referrals to consultants with

extensive expertise in the implementation of DBH 

response teams.

Response: SAMHSA DTAC provided North

Carolina’s DBH Coordinator with a list of recommended

consultants suitable for the state’s needs of building

upon their disaster response. SAMHSA DTAC

encouraged the coordinator to connect with the

suggested consultants and to follow up if possible with

SAMHSA DTAC about the state’s progress in disaster

planning and preparedness.

Are you looking for disaster behavioral health resources? 

Check out the new and updated 

SAMHSA DTAC Disaster Behavioral Health Information Series (DBHIS) installments. 

https://www.samhsa.gov/resource-search/dbhis 
2024 | VOLUME 19 | ISSUE 1 | PAGE 21 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

 

 

 

 

REFERENCES 

Kennedy, M., Gonick, S., & Errett, N.

A. (2021). Are we ready to build

back “healthier”? An exploratory

analysis of U.S. state-level disaster

recovery plans. International Journal

of Environmental Research and Public

Health, 18(15), Article 8003. https://

doi.org/10.3390/ijerph18158003

SAMHSA Disaster Technical Assistance

Center. (2013). Introduction to 

promising practices in disaster 

behavioral health planning [Webinar].

https://www.youtube.com/watch?v=_

tpsxPB0UoA&list=PLBXgZMI_

zqfRcTt9ndxkbieQ-pQslk-R6

SAMHSA Disaster Technical Assistance

Center. (2019). Promising practices 

in disaster behavioral health planning 

[Video]. https://www.youtube.com/

watch?v=KY1elI2Foqc&list=PLBX

gZMI_zqfSzQOahSXCeK976TFn_

Z4i4&index=5

SAMHSA Disaster Technical Assistance

Center. (2020). Promising practices 

in disaster behavioral health planning 

[Video series]. https://www.youtube.

com/playlist?list=PLBXgZMI_

zqfSzQOahSXCeK976TFn_Z4i4

The views, opinions, and content 

expressed in this publication do not 

necessarily reflect the views, opinions,

or policies of the Center for Mental 

Health Services (CMHS), the Substance 

Abuse and Mental Health Services 

Administration (SAMHSA), or the U.S. 

Department of Health and Human 

Services (HHS). 

New Online Forum for the 

Disaster Behavioral Health Field 

The SAMHSA Disaster Technical Assistance Center (DTAC) has 

set up a new online community for the disaster behavioral health 

(DBH) field: the SAMHSA DTAC DBH Google Group. The group 

provides a forum for disaster behavioral health professionals to 

share information and resources and discuss issues in the field. All

who work or volunteer in disaster behavioral health are welcome. 

The only requirement is a Google account, which can be set up free 

of charge. Visit the group today to check out high-quality disaster 

behavioral health resources, training opportunities, and more. 
Prepare • Respond • Recover

Inform • Assist

CONTACT US 

SAMHSA Disaster Technical 

Assistance Center 

Toll-free: 1–800–308–3515 

dtac@samhsa.hhs.gov 

https://www.samhsa.gov/dtac 

SUBSCRIBE 

The Dialogue is a publication for professionals in the disaster behavioral health field to 

share information, resources, trends, solutions to problems, and accomplishments. Contact 

SAMHSA DTAC to be added to The Dialogue subscription list. 

SHARE INFORMATION 

Readers are invited to contribute to The Dialogue. To author an article for an upcoming issue, 

please contact SAMHSA DTAC at dtac@samhsa.hhs.gov. 

ACCESS ADDITIONAL SAMHSA DTAC RESOURCES 

The SAMHSA DTAC Bulletin is a monthly e-communication used to share updates in the field, 

post upcoming activities, and highlight new resources. Contact SAMHSA DTAC to be added 

to the SAMHSA DTAC Bulletin subscription list. 

The SAMHSA Disaster Behavioral Health Information Series contains resource collections 

and toolkits pertinent to disaster behavioral health. Installments focus on specific populations, 

specific types of disasters, and other topics related to all-hazards disaster behavioral health 

preparedness and response. Visit the SAMHSA DTAC website at 

https://www.samhsa.gov/resource-search/dbhis to access these materials.