A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center 

2023 | VOLUME 18 | ISSUE 3 

Partnerships in Disaster Behavioral Health 

The Dialogue 
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.

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. 

CONTENTS 

3 In This Issue 

4 Contributors 

5 Technical Assistance Snapshot 

6 State and Local Partnerships: Making Room at the Table 

13 Private-Public Partnerships and Disaster Behavioral Health: New Resources From FEMA 

16 Successful Partnerships in Behavioral Health Disaster Recovery: Lessons Learned 

Through Crisis Counseling Programs 

27 Recent Technical Assistance Requests 

COVER Photo by Adobe Stock 
2023 | VOLUME 18 | ISSUE 3 | PAGE 3 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center 

Partnerships are crucial in responding to behavioral 

health needs after disaster and mitigating disasters’ 

behavioral health effects. The provision of disaster

behavioral health services requires a multidisciplinary 

approach, involving mental health professionals, public 

health officials, emergency responders, and community

leaders. These entities must work together before,

during, and after an emergency to effectively serve the

impacted populations. In recent years, governments

around the world have recognized the importance of

behavioral health partnerships in disaster response, 

particularly considering the increasing frequency and 

severity of natural disasters and other emergencies, 

and a clearer understanding of the devastating effects

these events can have on the mental health of affected

populations. Through partnerships, governments can

leverage resources, expertise, and knowledge to build

resilience, strengthen response capabilities, and enhance 

recovery efforts.

Collaboration between public health and emergency

management agencies, as well as with nongovernmental

and private sector organizations, is necessary to

effectively respond to the behavioral health challenges

posed by disasters. By working together, partners can

share expertise and resources to better prepare for 

and respond to disasters, actions which are known to

reduce the mental health and substance use impacts on 

individuals and communities. Effective government

partnerships require pre-planning and development of 

coordination strategies that prioritize the safety and

well-being of the public. These partnerships can ensure

that emergency plans addressing behavioral health are 

in place, training and exercises are conducted regularly, 

and communication and coordination systems are 

established before a disaster strikes.

In this issue of The Dialogue, experts share their 

experiences with building and exercising partnerships.

In the first article, two disaster behavioral health

professionals discuss their experience with engaging

In This Issue 

and maintaining partnerships at the state and local level.

The second feature is a summary of recent Federal 

Emergency Management Agency (FEMA) resources

focused on private-public partnerships. In the third

article, an expert describes the lessons learned through 

several disaster behavioral health programs and shares 

several actionable items for those in the field.

Have you been part of disaster behavioral health 

partnership planning and execution? Other planners and 

responders can learn from your efforts and experience.

Please contact us to share your stories and lessons 

learned. ■

CAPT Erik Hierholzer, B.S.N., Program Management

Officer, Emergency Mental Health and Traumatic Stress

Services Branch

erik.hierholzer@samhsa.hhs.gov

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

Emergency Mental Health and Traumatic Stress

Services Branch

nikki.bellamy@samhsa.hhs.gov

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

and Mental Health Services Administration (SAMHSA)

Disaster Technical Assistance Center (DTAC)

dtac@samhsa.hhs.gov
2023 | VOLUME 18 | ISSUE 3 | PAGE 4 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center 

Chance A. Freeman is the 

Director of Disaster Behavioral

Health Coordination at the 

Texas Health and Human 

Services Commission. He

has worked in the field of

disaster behavioral health since 

1998 and has responded to over 28 federally declared 

disasters and a variety of emergency events such as 

the Space Shuttle Columbia Recovery project; the

West Fertilizer Plant explosion; church shootings in

Sutherland Springs and White Settlement, Texas; school

shootings in Santa Fe, Texas, and Uvalde, Texas; the El

Paso Walmart shooting; the shooting spree in Midland/

Odessa; and COVID-19. Based on his experience with

the Federal Emergency Management Agency (FEMA)

CCP, Freeman has been asked to provide technical

assistance and training on CCP grant development and 

management, provided training at FEMA’s Emergency

Management Institute in Emmitsburg, Maryland, and

he is a member of the SAMHSA DTAC Cadre of

Consultants. He serves as the State Behavioral Health

Initiative Advisor to the Terrorism and Disaster Network

Committee and is a member of the Executive Advisory

Board for the Texas Law Enforcement Peer Network

where he advises organizational leadership for growth,

training, and the betterment of the services provided to 

the law enforcement professionals of Texas. 

Susan Robinson, M.Ed., is 

an Independent Health and

Human Services Senior

Consultant. She served in a

variety of leadership, program 

management, and planner roles 

in her 36+ years with the North

Carolina Division of Mental Health, Developmental

Disabilities, and Substance Abuse Services within the

state’s Department of Health and Human Services.

Contributors 

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 (CCP) 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 SAMHSA 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 states, territories,

and tribal grantees developing disaster behavioral 

health support for 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 materials, 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.
2023 | VOLUME 18 | ISSUE 3 | PAGE 5 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center 

She has served on the state emergency response team

since 1990. She has expertise in areas including suicide

prevention, 988, and crisis- and trauma-informed 

disaster behavioral health recovery supports and 

services. Her CCP experience spans a period of nearly

25 years, from responses to Hurricanes Fran (1996)

and Floyd (1999) to Hurricane Florence (2018) and the

COVID-19 pandemic (2020). She has offered training

and consultation on topics related to the CCP as well

as self-care and compassion fatigue, resilience tools 

and skills, shared risk and protective factors in disaster

behavioral health recovery, framing a sustainable plan 

for disaster behavioral health recovery, using data 

and benchmarking for success, working with special

and marginalized populations, and building creative

partnerships. She was the recipient of the 2015 System

of Care Champion for North Carolina Children,

Youth, and Families Award; the 2021 North Carolina

Department of Health and Human Services Teamwork

Leadership Award for Hope4NC Crisis Counseling

Program (COVID); and the 2022 Cornerstone Award for

Excellence in Promoting System of Care Values. She

holds a master of education from the University of North

Carolina at Chapel Hill.

TECHNICAL ASSISTANCE SNAPSHOT 

The SAMHSA Disaster Technical Assistance 

Center (DTAC) uses the Customer Feedback 

Survey (CFS) to learn about current and 

prospective audiences and their needs. 

Through the CFS, we work to gather 

information to help us create and update 

products and provide services designed to 

best meet the needs of our audiences. 

From 2017 to 2021, nearly two-thirds (65 

percent) of CFS respondents reported high 

levels of need for training and technical 

assistance on “developing interagency 

partnerships to support all-hazards planning.” 

 

Data From the 2017–2021 

SAMHSA DTAC Customer Feedback Survey 
2023 | VOLUME 18 | ISSUE 3 | PAGE 6 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center 

INTERVIEW 

Partnerships are an essential piece to 

coordinating effective and inclusive

disaster behavioral health response 

and recovery. The Dialogue recently 

spoke with Chance Freeman and

Kalie Burke, leaders in states

with exemplary and innovative

partnership practices, to discuss 

their experience with engaging and

maintaining partnerships. Freeman

and Burke shared their state’s

partnership initiatives and goals to 

highlight the value of collaborative 

disaster behavioral health work and

provide recommendations for those 

seeking to grow their partnerships.

State and Local Partnerships: 

Making Room at the Table 

By Chance Freeman, Texas Health and Human Services Commission, Kalie Burke, M.P.H., Georgia Department 

of Behavioral Health and Developmental Disabilities, and Sofia Cabrera, B.A., SAMHSA DTAC

What do you look for when 

you initiate the process of 

identifying and connecting 

with possible partners? 

Chance Freeman: We familiarize

ourselves with the skill sets available

and the resources the community 

needs. This allows us to connect

those specifically trained in

disaster behavioral health response, 

first responder peer support,

Psychological First Aid, and crisis

counseling to serve the populations 

needing support. We determine

how we can use those resources to

formulate an immediate response 

and ensure we have a strong system

for referrals, confirming they can

assist long-term with our disaster

team and the community that needs 

them. We evaluate whether they can

help us continue making connections

and establishing relationships with

other entities that have a vested 

interest in what we need to address.

Public health and emergency 

management are constantly evolving 

and changing, and recovery is an 

essential step that can’t be ignored.

When an incident occurs, our team is 

The Georgia Recovery Project partnered with local organizations to provide support across the state during the COVID-19 pandemic. Photo courtesy of 

Kalie Burke. 

INTERVIEW 
2023 | VOLUME 18 | ISSUE 3 | PAGE 7 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center 

immediately working on establishing

those partnerships and pulling 

together those entities for long-term 

recovery. So, we have to ask our

partners, “Are you in this for the long

term? Do you have the resources and 

supplies needed?” We ask the hard

questions to make sure we are on the

same page. “What are you going to

do in two years? Three years? Four?”

And that includes all our partners:

service providers, faith-based 

organizations, first responders, mental

health professionals, and providers.

That is how we identify who needs to

be at the planning table.

Kalie Burke: In terms of disaster

assistance, part of my job is to

include individuals who may have

been previously excluded from 

planning. Individuals with access

and functional needs, older adults, 

local organizations—we want to

have them at the planning table to 

open those discussions and create 

a collaborative community effort

instead of the state dictating what

local individuals do. We love our

local governments and providers.

They do a great job and have a great

network. Getting into those smaller

communities is really important to us.

There can’t be too many people 

at the table, in my opinion. I think

having a plethora of different

perspectives from different fields

is fantastic. Bring as many people

as you can to the table and have 

those discussions. Local individuals

experience things very differently—

even between rural and urban

communities, local providers are 

experiencing different populations

with different needs. Having those

niche understandings and knowledge

of these very small groups is helpful.

Once the partnership is 

established, how do you 

manage and maintain these 

working relationships? 

Freeman: Disasters start and 

end locally. Disaster response

coordination at the state level 

does not delegate or assign 

responsibilities to our partners. From

our viewpoint, the way we take

the lead is by finding community

leaders. The gatekeepers,

stakeholders, and local entities

inform who should be at the table.

When a disaster event occurs, 

there can be 15 or 20 entities at the 

table because they were invited

by someone who knew somebody,

that knew somebody. We proceed

by narrowing down the size of the

group by assessing their potential 

contribution. Who is in it for the

long term? What services can 

the organization provide without

funding? Who are they serving? 

Can their organization handle a

larger caseload? Some organizations

are not configured to meet the

rapid changes that disasters bring.

It is important to recognize that

possibility and determine that some 

partnerships may not be the right fit

for that point in time.

With the appropriate groups at 

the table, we start our weekly or

monthly meetings. Our stakeholder

groups meet once a week for nearly
2023 | VOLUME 18 | ISSUE 3 | PAGE 8 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center 

3 months. A natural leader will

emerge, and from a state level, we

no longer need to facilitate these 

conversations or need to actively 

coordinate or direct the partnerships 

and connections being made across 

the table. Our state role transitions

to staying in the periphery. These

meetings are essential to establishing 

lasting collaborations and 

partnerships. We allow the entities to

determine what their need is, what

they hope to accomplish, and how

long the partnership should last.

Burke: Processes to identify and 

coordinate partnerships naturally 

occur as we work on collaborations

and agreements. We have contracts

in place to have those working

relationships, but a lot of it is 

just built upon trust. Georgia has

established a great trust system 

for emergency response. There

are word-of-mouth and official

agreements, but there is a shared 

understanding that these partners are 

proud of their work and are good at

what they do, so they want to come

together to provide for communities 

in the best way they can. You don’t

have to partner. You want to.

COVID-19 threw a wrench into the

public health world and caused some

stakeholders to be afraid to step in.

The height of COVID-19 was a very

scary time. So much happened, so

many changes. Trying to get people

to buy in was a very difficult thing.

But we know that the locals have the

most power and stakeholders rely

on the locals for what they do, so we

don’t have to convince stakeholders

to buy in. We learn about groups

providing for the community and let 

them know we are more than happy

to support them.

What challenges have you 

encountered when managing 

partnerships, and how did you 

address these issues? 

Freeman: The political climate can 

be a challenge at times. Priorities can

change with turnover in key positions

among partners. This can cause a

learning curve. Some stakeholders

may need to move their program in 

different directions. Some partners

may have competing priorities. It can

be difficult to maintain stakeholder

interest in what one is doing.
2023 | VOLUME 18 | ISSUE 3 | PAGE 9 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center 

You may have a group that wants

to come in and participate in the 

group effort but is just not the

right fit for what is needed at that

time. You need to navigate that

discussion, letting them know that

you appreciate their help, but that 

their services are not needed at that 

time. On the other hand, you may

have a group that you need to join

the effort, but there may be some

miscommunication that causes 

conflict.

One of the biggest challenges is that 

we all have limited resources. We

are being pulled in so many different

directions. Being stretched thin after

a disaster is common for many, and 

it may be difficult to get stakeholders

to sign up for more work.

You have to recognize where you

fit in with the stakeholders and

partners. I like to run meetings

and facilitate conversations. But

I knew that, for our behavioral

health workgroup, I wasn’t the right

person to lead the conversation. I

stepped aside and let somebody else 

facilitate because they were known

in the field. They were respected

by the partners and spoke their

language, adding to their credibility.

Through that, the partners are 

able to build their own credibility.

For example, within the field of

disaster behavioral health, we have

always struggled with the use of the

terminology “crisis counseling” or 

“disaster behavioral health.” How do

we get people to come in and really

understand what we do and what

services we can provide? We want

to have someone lead the group that 

speaks the community’s language,

so we get it right. We need to be

culturally competent and aware with

our stakeholder group to achieve our

goals.

Burke: It is surprising how

many people in the emergency 

management field do not understand

mental health or the term “disaster 

behavioral health.” But it is

understandable. A lot of people

come from different backgrounds,

so they may not have that specific

knowledge or training. And it

can go the other way around. We

at the state or federal level may 

not have the specific knowledge

that group does. It happens all the

time—the dichotomy of talking to

someone who knows emergency

management so well but does not

know behavioral health, or someone

who knows behavioral health so

well but does not know emergency

management. It is a difficult

“ Partners can 

contribute to 

all aspects of 

the emergency 

management cycle 

by supporting risk 

assessments, 

communication, 

and other response 

and recovery 

activities

(Rural Health Information ”

Hub, Rural Emergency 

Preparedness and Response 

Toolkit, http://bit.ly/3J4fYGc). 
2023 | VOLUME 18 | ISSUE 3 | PAGE 10 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center 

navigation to be done, but that is 

why the partnerships are there in

the first place. We are opening the

dialogue, sharing a conversation to 

get on the same page.

It does get complicated when

you begin to look at power and

authority. We at the state level are

sometimes met with distrust or a

misunderstanding of what we do and

what we can do to help. There is also

a lot of stigma against mental health 

that is a huge concern for those wary

of establishing these partnerships.

We have met people who did not

want to partner with us, and that is

fine; we will continue reaching out.

We will not get discouraged. The

stigma is still very real, and there 

are people that do not share the 

same beliefs regarding our work.

We want to ensure our services are

out there and we are capturing all

the people that need assistance in 

any way we can serve them. When

we meet resistance, we want to

understand why they say no and how

we can still serve that population in

whatever way they are comfortable

receiving it.

What would you recommend to 

other states and organizations 

hoping to develop and 

maintain partnerships 

to improve their disaster 

behavioral health work? 

Freeman: Learn to speak

the language of emergency 

management, public health, and law

enforcement. When I speak with

my stakeholder groups, I can speak

their language. I don’t need them

to speak mine. Folks understand

the importance of behavioral 

health. They just don’t know what

to do with it. If you can enter the

conversation with clarity, you

can lead a healthy conversation.

Explain what you do, how you

can make their lives easier, and

how you can ensure the services

they are providing in the field are

complemented and supported.

Understand what your partners do

and where they do it, and, most

importantly, what you can do for

them. Approach these folks and

ask them how you can assist. A

lot of leaders are problem solvers 

and have everybody coming to 

them for everything. You can be

that one person asking them what

they need. Your priorities may not

always be the same or you may not

see how they intersect, but give

them the opportunity to ask you for

something. You may not be able

to complete their request, but you 

may know someone who can. Then

you can make that partnership and

connections for them.

We found that these entities may 

not be communicating with each

other. They are each doing their own

things—and doing them very well,

but rarely does anyone pull them 

together. That is a direct quote from

a member of our first responder

behavioral health group—“that

no one is bringing them together 

to discuss their work, their goals,

and what a larger system may look

like outside of the scope of their

organization.” Our partners are glad

to have an entity that pulled them 

together and started hosting these 

types of conversations. We support

the development of emerging 

resources, the legislative process, 

and our state strategic plans.

I learned this acronym from a

training I recently completed:

WAIT, which stands for “Why am

I talking?” I find myself asking that

question a lot during our partner 

group meetings. What am I bringing

to the table? What do my partners 

need? What can we do together

to serve the community? Why 

am I talking? Sometimes taking a

moment to sit in that uncomfortable 

silence, to not talk without a clear

Explore other disaster 

behavioral health programs 

involving partnership in 

the “Stronger Together” 

edition of the SAMHSA DTAC 

Supplemental Research Bulletin 

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

srb-community-approaches.pdf 

SAMHSA 

Disaster Technical Assistance Center 

Supplemental Research Bulletin 

Stronger Together: An In-Depth Look at 

Selected Community-Level Approaches 

to Disaster Behavioral Health 

August 2016 
2023 | VOLUME 18 | ISSUE 3 | PAGE 11 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center 

purpose, is a good way to leave

space for everyone at the table.

All of us in disaster response want

to make sure we are doing the best

job possible for those impacted by

disaster events. No organization is

out there to put a feather in their 

cap. It’s not about our disaster team

or our partners. It is about those we

serve. Each state and community

is different and will have its own

challenges. Be flexible, be creative,

and be honest with stakeholders.

Understand their capabilities and

your own.

Burke: Oftentimes, the best way to

make new partnerships is to lean on

your current partners. We have an

emergency preparedness coalition 

that I chair. For every meeting, we

ask our participants to send the

meeting invitation to two or three

new people. They are able to join the

meeting and introduce themselves, 

and suddenly our group grows

tenfold. Finding that one person to

get your foot in the door is fantastic.

That one person may have worked

for five different agencies in their

career, and they know someone who

has worked for five more. It is all

about finding someone who knows

someone. We want everybody with

an idea at our table. It is so vital to

ensure health equity and safety. No

group is too small.

I find that the best people to go to

are the people who have lived it

the longest: predecessors who have

been with the organizations longer,

those with intimate knowledge who

have been here before me, even 

if it is just one person who knows

about different nonprofit groups or

smaller organizations in your state.

You can also lean on your local 

healthcare coalitions, county health 

departments, and those types of 

groups that would be able to take

information you have and directly 

relay it.

When it comes to emergency 

planning, local organizations give a

lot of great feedback. They are able

to speak on specific populations

that are in need of help in certain 

parts of the state. Between the coast,

South Georgia, Metro Atlanta, North

Georgia—the state is so diverse,

and the populations do not look the

same. It is nice to have that buy-in

at the local level so they can voice 

local concerns that our state-level 

employees may not be able to hear 

otherwise. ■

“ It’s somewhat of a mantra in the disaster response community . . . 

 ‘Disasters are the worst time to hand out business cards.’

— Curt Drennen, Psy.D., Promising Practices in Disaster Behavioral Health Planning: ” 

Building Effective Partnerships webcast, https://bit.ly/3ZhD2XC 
2023 | VOLUME 18 | ISSUE 3 | PAGE 12 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center 

State and Local Partnerships Across the Nation 

In Louisiana, NOLA Ready has 

partnered with over 60 local and 20 

national organizations in disaster 

response. NOLA Ready is New 

Orleans’ emergency preparedness 

campaign, which is managed by the 

city’s Office of Homeland Security 

and Emergency Preparedness. 

The Florida Commission on 

Community Service has an 

emergency management partnership 

program with disaster response and 

recovery volunteer organizations. 

Partners are notified of important 

events and grant opportunities 

through the Florida Disaster Fund. 

The Missouri Governor’s FaithBased and Community Service 

Partnership for Disaster Recovery 

works with the State Emergency 

Management Agency to coordinate 

emergency human services in 

disasters. Partners include state 

departments, nonprofits, faith-based 

organizations, and professional 

associations. 

The Colorado Emergency 

Preparedness Partnership 

encompasses about 3,200 member 

organizations across all sectors 

working together to improve 

planning, preparedness, and 

emergency management. 

The Nebraska Preparedness 

Partnership brings together state 

agencies and businesses to build 

capacity for disaster preparedness, 

response, and recovery. Participants 

share information and resources and 

coordinate emergency management 

efforts. 

King County in Washington State 

has established its Trusted Partner 

Network to provide information to all 

residents in the event of a disaster 

or other emergency. The goal is for 

partners from every major language 

group in the county to serve as 

liaisons. 

Wisconsin Emergency Management 

offers several public-private 

partnership programs, all of which 

benefit all participants and help 

coordinate and improve emergency 

preparedness in the state. 

New York City Emergency 

Management’s Partners in 

Preparedness program includes 

over 670 partner organizations 

in fields ranging from arts and 

entertainment to finance and 

banking to government. 

The Virginia Department of 

Emergency Management Partners 

in Preparedness program enlists 

liaisons to help ensure disasterrelated communications reach all 

Virginians, regardless of English 

proficiency, internet access, 

socioeconomic status, and other 

types of difference and diversity in 

the state. 

2023 | VOLUME 18 | ISSUE 3 | PAGE 12 

Partnerships in emergency management and disaster behavioral health are 

the rule rather than the exception. This graphic shows examples of partnership 

programs across the United States. 
2023 | VOLUME 18 | ISSUE 3 | PAGE 13 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center 

Private-Public Partnerships and Disaster 

Behavioral Health: New Resources From FEMA 

By the SAMHSA Disaster Technical Assistance Center 

Private-public partnerships are an 

important component of disaster 

planning and recovery. A privatepublic partnership is a mutually 

beneficial formal or informal

cooperative agreement between

two or more private industry

organizations and the public sector

(Federal Emergency Management

Agency [FEMA], 2021). This type

of partnership is made to strengthen 

resilience, economic security, and 

safety in communities and can help 

survivors and communities recover 

from the behavioral health effects of

disasters.

To assist with coordinating

these essential partnerships 

across private and public 

sectors in response to 

disaster, FEMA has

released several new

resources. Restoration 

and Recovery: Guide 

for Private-Public Partnerships 

offers strategies and resources for

jurisdictions to help them plan

and coordinate restoration of 

community lifelines, plan recovery 

strategies, and start recovery 

operations by means of a privatepublic partnership which promotes

inclusive and 

equitable recovery 

from disaster.

This guide is 

for the private 

sector, community 

planners, local 

government, 

nongovernmental organizations,

and community stakeholders.

It describes how to build a

collaborative planning team, create 

long-term recovery groups, and 

establish recovery task forces, as

well as steps to take in the privatepublic partnership process.

Restoration and 

Recovery 

Guide for Private-Public Partnerships 

December 2022 
2023 | VOLUME 18 | ISSUE 3 | PAGE 14 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center 

Also released by FEMA are

several fact sheets that cover topics 

in the Building Private-Public 

Partnerships guide published in 

2021. One of these fact sheets is

Private-Public Partnerships Support 

Equitable Outcomes for Risk 

Reduction. It provides strategies

for the private-public partnership to 

consider the needs of disadvantaged 

and vulnerable communities 

and encourages the creation and 

use of data-driven guidance for 

equitable outcomes. The fact sheet

is for disaster responders, local 

governments, and community 

leaders developing disaster risk

reduction strategies. This resource

discusses disproportionate risk faced

by specific communities in disasters;

local advocates and service 

providers to include in disaster 

preparation, response, and recovery;

and the ways a private-public

partnership can reduce disaster risk.

Another fact sheet that

complements Building PrivatePublic Partnerships is PrivatePublic Partnerships Support 

Reducing Risks and Building 

Resilience. This resource gives

guidance to local governments on 

how to work with the private sector

to assess risks and vulnerabilities

and plan for risk mitigation and

management. The fact sheet

identifies key areas of potential risk

and vulnerability and steps in each 

of these areas to build resilience.

FEMA has also released the Disaster 

Resource Identification fact sheet.

This fact sheet provides information 

For further resources on disaster planning and recovery and disaster 

behavioral health for individual and communities, visit: 

• FEMA’s website at https://www.fema.gov

• The SAMHSA DTAC website at https://www.samhsa.gov/dtac

• The website of Ready, a national public service campaign of the

U.S. Department of Homeland Security, at https://www.ready.gov

on resource identification, how to

search for resources, sources of 

recovery resources, and resource 

management. This guide is for

disaster response leaders in local 

communities planning disaster 

recovery for their communities. ■

Building PrivatePublic Partnerships 

July 2021 

 

 

 

 

 

 

 
2023 | VOLUME 18 | ISSUE 3 | PAGE 15 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center 

Federal agency-federal 

agency (e.g., interagency 

agreement between 

SAMHSA and FEMA in 

support of the CCP) 

Federal-state 

State-state (emergency 

management, public 

health, public education 

departments/agencies/ 

authorities, and 

nongovernmental 

organizations and 

community leaders with 

investment and focus in 

disaster behavioral health)

State, regional, and local 

levels (local community 

mental health and 

substance use provider 

organizations, American 

Red Cross, Salvation Army, 

victim advocates, and 

private practitioners) 

Partnerships 

Have an effective leader 

Give potential partners 

the opportunity to share 

concerns 

Have entities with a shared 

set of goals and outcomes, 

where all partners see 

themselves as equal 

Include the basic 

components of program 

evaluation 

From the SAMHSA DTAC Promising Practices in Disaster Behavioral Health Planning: 

Partnerships video, http://bit.ly/3J3u7Cr

Brings partners together 

Identifies shared values, 

goals, and objectives 

Identifies a role and 

function for each partner 

Gets partners on the same 

page for a crisis response 

Effective

Partnerships 

An Effective

Partnership 

Partnership Types 
2023 | VOLUME 18 | ISSUE 3 | PAGE 16 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center 

Successful Partnerships in Behavioral Health 

Disaster Recovery: Lessons Learned Through 

Crisis Counseling Programs 

By Susan Robinson, M.Ed., Independent Health and Human Services Senior Consultant

All phases of disaster, from planning

and preparedness to response to 

recovery, rely on partnerships. This

is certainly what I found as part of

North Carolina’s state emergency

response team from 1990 to 2022, 

and as a member and leader of 

Crisis Counseling Assistance and

Training Program (CCP) grants and

other disaster and crisis response 

programs in North Carolina. In this

article I describe work I did as part

of disaster response teams, important 

lessons learned in partnership 

development and maintenance, 

examples of unique ways that

partnerships can help programs 

reach specific communities, and the

role of partnerships throughout the 

emergency management life cycle.

Begin at the Beginning 

Often in behavioral health disaster 

recovery we are faced with the

question “Where do we begin?” 

Whether we are engaged at the state,

regional, or community level, after a 

few deep breaths and longer exhales,

we pause and find ourselves asking

this question.

Within the context of the disaster 

event, more questions follow. What

did our initial needs assessment 

tell us? Who is most impacted and 

most at risk now? Where are these

survivors located at the moment 

(shelter, sheltered in place at home,

without housing, relocated to a new

medical or skilled facility)? Where

will survivors be located in the next

month? In the next 2, 6, 9, or 12

months? What needs are anticipated 

based on disaster reporting by 

emergency responders, survivor selfreports, and the state/community

emergency management network?

Who are key partners “at the ready”

to help support the behavioral health 

disaster response and recovery? 

Begin with the end in mind.

With all good planning, needs 

assessments are ongoing and require 

gathering survivor and stakeholder

perspectives in order to design and 

implement an effective, coordinated,

trauma-informed behavioral health 

disaster recovery response that 

promotes survivor behavioral health 

recovery, sustained resilience, 

wellness, and preparedness for

future events.

Consider current strengths and

gaps, and anticipate gaps in the 

recovery process in the coming 
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A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center 

weeks and months. Behavioral

health disaster recovery planning 

considers how to be innovative in

building on state and community 

strengths; identifying key partners;

and prioritizing gaps that may

impede survivor behavioral health 

recovery, resilience, wellness, and

preparedness.

Identify strategic partnerships

and collaborative opportunities

through which behavioral health

disaster recovery response can be 

strengthened or created. Strategic

partnerships increase successful 

survivor outreach and engagement 

with needed behavioral health

supports and services, including 

referrals to more intensive services 

as needs are identified and linkages

made.

Create and grow partnerships.

Initiate communications; be

persistent, and make connections

with existing community partners.

Prepare a simple message and 

fact sheet to share on disaster 

behavioral health, emotional health 

and wellness through recovery,

and how to seek CCP services.

Be sure to include CCP team

branding in the state/region and

in specific communities impacted.

In North Carolina, I served as the

former State Suicide Prevention

and Crisis Counseling Services

Coordinator (retired) with the North

Carolina Department of Health and 

Human Services, in coordination

the Director of North Carolina

Emergency Management. We

administered the CCP Hope4NC

in response to Hurricane Florence 

(DR-4393-NC) and later through

the COVID-19 global pandemic

(DR-4487-NC). In this capacity, I

found that effective, consistent team

branding across disaster responses 

provided “ready” recognition and 

connection with CCP staff statewide.

Survivors especially connected

with ease to help provided by our

Hope4NC blue shirt counselors, as

did community partners.

Determine common goals and 

populations most impacted 

and potential “early wins” of

collaborative survivor outreach 

and engagement. Public health and

rural health departments along with

“ The delivery of disaster behavioral health 

is too large of an activity to be handled 

effectively by any one organization or agency. 

Without effective partnerships in place 

prior to the disaster, we risk significant and 

negative impacts on individuals, families, and 

communities.

— Curt Drennen, Psy.D., Promising Practices in Disaster ” 

Behavioral Health Planning: Building Effective Partnerships 

webcast, https://bit.ly/3ZhD2XC
2023 | VOLUME 18 | ISSUE 3 | PAGE 18 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center 

public social services/child and

adult welfare departments are often

existing relationships to build upon 

when providing behavioral health

disaster services and supports.

4 Recovery through hurricanes,

flooding, and tornadic events

brings opportunities to collaborate

with different offices within

public and environmental health

regarding basic self-care in the

areas of physical and emotional

health, including accessing safe

drinking water and temporary

facilities to shower and wash,

cleaning supply distribution sites,

and mosquito and other pest

abatement services.

4 Behavioral health disaster

recovery during the COVID global

pandemic required combined 

and coordinated public and rural 

health outreach with community 

health workers and pop-up

clinics in hard-to-reach, often 

culturally and/or linguistically

marginalized neighborhoods,

including communities of 

migrant farmworkers and people

experiencing homelessness.

4 Also during the COVID pandemic,

it was essential to provide crosstraining and coordination among

community health workers

and crisis counselors as well

as offering coaching support in

self-care to mitigate the impact of

trauma and compassion fatigue

staff experienced. These supports

helped to sustain effective

recovery efforts over time.

Growing and Sustaining 

Partnerships 

“What is your story? What 

happened to you?” Begin talking

with folks by listening to them

and their stories. Whether creating 

new alliances and partnerships or

working with existing partners,

meet people where they are in their

own disaster recovery experience

as survivors. Consider the diversity

of experiences related to culture, 

race and ethnicity, language, gender, 

ability, age, and family among 

communities of survivors and that 

of the CCP staff when creating and

building partnerships in providing 

behavioral health disaster recovery 

services, supports, and referrals.

Be a constant, reassuring 

presence. Practice safe, traumainformed messaging. Behavioral

health terms and concepts are often 

misunderstood along with language

we use related to mental health and

mental wellness. It is important

for outreach messaging to be safe, 

trauma-informed, clear, and simple.

This attuned messaging combined 

with consistent CCP branding, such

as the presence of “Hope4NC blue 

shirts,” brings hope and reassurance.

People with lived experience with

behavioral health challenges who

are also disaster survivors are unique 

partners in effective behavioral

health disaster recovery and safe 

messaging to find a way through the

loss and pain.
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A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center 

Peer survivors help reduce

barriers and are strategic partners

in leveraging and deploying existing 

resources to diverse populations, 

including those with sensory

impairments (vision and hearing).

Peer survivors are key partners

who can effectively conduct

outreach and engage with diverse

populations across disaster declared 

and designated service areas. It is

essential for CCP program managers 

to stay attuned to the impact of 

emotional distress of survivors and 

peers on an ongoing basis through 

reflective supervision and supportive

coaching. One program manager’s

daily staff check-ins included text

messages such as “take a deep

breath,” “sip some water,” “3-minute

stretches,” etc., to help staff practice

self-care coping skills as they

worked throughout the community.

Challenges in Starting and 

Maintaining Partnerships 

Timeframes are challenging when

implementing the CCP, especially 

in the timing of the Immediate

Services Program (ISP) transition to

the Regular Services Program (RSP)

while the application is pending

review by federal partners. This

tenuousness is unsettling for both 

the CCP staff and the communities

reliant on the CCP continuing to be 

a constant active presence, a “ready 

partner” in collaboration with others

in disaster recovery.

Staff recruitment and retention.

In addition to uncertainty of CCP

funding and timeframes, it is 

important to recognize that the

CCP team outreach model faces 

new health and community safety

risks because of COVID-19 and

increasing community violence and 

emotional unrest. To help recruit

and retain staff members, it is

essential to have attuned, intentional 

leadership; emotional support

for staff; somatic resilience skill

practice; and evidence- and traumainformed behavioral health disaster 

skills-based training recommended

by SAMHSA DTAC. Sustaining 

resilience among CCP staff is vital

to effective CCP outcomes. Begin

and sustain connections among all 

levels of CCP staff across sites/

communities with one another and

across states on a regular basis, 

even if for 30 minutes weekly (e.g.,

skill-building, successes/ challenges/

opportunities, business functions).

Connections among peers made 

through a supportive learning 

community are key to emotional

support, sustaining creativity, 

and promoting continuity and 

effectiveness among all levels of

CCP staff.

Supportive relationships are fostered

through effective partnerships

with a common understanding

and outcomes that help sustain 

collaborative efforts over time.

Stay in touch, communicate with

partners, stay focused on the CCP 

priorities, and continue services.

Collaborative partnerships with

law enforcement and other first

responders offer support as crisis

counselors engage in outreach 

activities in communities.

“ Whether creating new alliances and 

partnerships or working with existing 

partners, meet people where they are. 

Consider the diversity of experiences 

related to culture, race and ethnicity, 

language, gender, ability, age, and family 

among communities of survivors and 

that of the CCP staff when creating and 

building partnerships.” 
2023 | VOLUME 18 | ISSUE 3 | PAGE 20 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center 

Collaborative Partnerships 

Create Possibilities 

“Who are the people in your 

neighborhood?” In populationbased behavioral health disaster 

recovery, there are often challenges 

in crisis counseling outreach or 

developing responsive services 

to meet survivor needs. This is

especially true among special 

populations and survivor 

communities who are closeknit and less likely to welcome

support from outside their known

community. This may include

those who are more isolated or less

socially connected due to location, 

transportation, age, abilities, 

ethnicity, cultural and/or linguistic

differences, or those for whom the

existing health and human services 

system of care is less than equitable 

and accessible due to historic and 

current marginalization. With a

solution focus in mind, questions 

arise: “Where do we begin?” “How 

can we reach and support recovery 

in disaster survivors who are the 

most impacted and often more 

marginalized?” “What changes 

can we make to attain desired CCP 

outcomes for survivors?” Solutionfocused examples of partnerships, 

meeting survivor population needs, 

and attainable outcomes include:

4 Survivor outreach to older

adults and those living with

disabilities residing in lowincome urban housing and

rural communities. Partnering

with the state and regional area

agencies on aging and agencies

for people with disabilities and

their loved ones in the disasterimpacted regions expands outreach 

to survivors. Collaborating with

the adult, aging, and disability 

provider networks who are

engaged in meal delivery, home 

visiting, transport, and health and 

personal care resulted in increasing 

combined health and mental health 

messaging, normalizing signs

and symptoms of disaster-related 

stress and seeking and accessing

support, screening, and referrals 

to more intensive behavioral 

health services. This often helped

to re-engage in needed services, 

and provided crisis counseling 

support to the providers who

tirelessly were engaging with

this population and experiencing 

personal/family disaster

recovery. In my experience

with administering CCPs since

Hurricanes Fran (DR-1134-NC)

and Floyd and Irene (DR-1292-

NC) through Matthew (DR4285-NC) and especially during

Florence (DR-4393-NC), as well

as COVID-19 (DR-4487-NC),

cross-training and coordinated 

community outreach to address 

survivor emotional distress and 

isolation were essential strategies.

Improved outcomes resulted

from strengthening self-care 

skills, social connection, and

wellness through leveraging

the development of skill-based

tools such as wellness calendars,

tip sheets, and accessible voice 

messages, and 2- to 3-minute 

video skill-building tools. CCP

survivors reported an improved 

sense of connectedness and used 

coping skills; caregivers and home

visitors reported improved skills

to offer support and resources; and
2023 | VOLUME 18 | ISSUE 3 | PAGE 21 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center 

all reported an improved sense of 

wellness and feeling less alone.

4 Sustaining trauma-informed

survivor recovery learning

communities and grief and

loss support groups. We made

connections with new partners,

e.g., faith communities, and

nontraditional partners, i.e.,

small business owners, farmers,

and migrant health providers, to

continue learning communities and

support groups formed in response

to and beyond the disaster event.

Many of these and surrounding

communities acknowledge that

holidays are often challenging

for some, especially disaster

survivors. “Blue Holiday” or

“Pause for Gratitude” events are

now part of many communities’

traditional activities planned.

“Paws for Hope” offered support

to companion animal shelter/

rescue and veterinarian services

with pet deaths, surrenders, and

other disaster-related, high-stress

losses. One community leveraged

resources to help pet owners

shelter their pet or companion

animal at home when surrender

seemed the only option. These

events promote mental wellness

and resilience, honoring survivor

loss and expressing gratitude to

first responders and healthcare

professionals, among other

survivor supports.

4 Tribal and faith community

leadership in behavioral

health disaster recovery. Crisis

counselors with community health

workers among others continued

to show up and make connections

with Indigenous leaders in

communities, such as with the

trusted leaders and members 

of tribal and faith communities 

in rural North Carolina. After

several months of experiencing 

devastating disaster-related health 

and behavioral health impacts of 

the COVID-19 pandemic in their

families and communities, through 

outreach alliances, tribal leaders 

participated in filming videos and

messages highlighting the need to 

seek health and behavioral health

care to be resilient and recover 

well. A youth musician developed

a video reinforcing a message of 

hope to her peers promoting the 

CCP. These tools continue to be

used in community education and 

outreach and spurred additional 

like messaging for recovery and

preparedness prevention.

4 “One size does not fit all”

among diverse survivor

communities. Behavioral health

disaster recovery has common

components; however, the delivery

of the message and messengers

may vary. Building survivor

trust of a CCP and counselors

is essential to effective outreach

and engagement. Recruiting and

matching crisis counselors with

specific population outreach

efforts and pairing outreach with

other key partners, including

Indigenous partners and those who

are community member allies,

are often the pathways needed

for effective outreach. In most

counties in North Carolina, as in

other states, several communities

A North Carolina CCP team meeting with survivors. Photo courtesy of Susan Robinson. 
2023 | VOLUME 18 | ISSUE 3 | PAGE 22 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center 

may exist who have common

languages of origin, with

bilingual or ethnic and/or cultural

traditions. Although language

is common, dialects, traditions, 

and guiding leaders are different;

how community members relate

to one another or how local and

state services or assistance is 

welcomed may vary. Forming

strategic partnerships with local

public health and community 

health workers is invaluable in the

CCP and public, rural, and migrant 

health programs effectively

engaging with diverse survivor

communities. We have also

found it helpful to form strategic 

alliances with Latino coalitions,

immigrant and refugee sponsoring 

organizations and assistance

programs, migrant health 

centers, and employee assistance 

programs. The lesson learned over

time is that what works for one

community may not work for all.

4 Be the news employers can

use. Small businesses, vehicle

repair garages, diners, factories,

meat packing plants, grocery

stores and pharmacies, vision and

dental practices, and personal

care salons (barbers, stylists,

nails, etc.) all need resource

supports during disaster recovery

to help their employees and

families get help needed to stay

mentally and physically well

through recovery. Offer to provide

educational outreach during

breaks or mealtimes for owners

and employees—both for their

own self-care and referring their

clientele to seek crisis counseling.

Make survivors aware of common

reactions to stress, normalize stress

responses, and teach self-care

skills to cope throughout the day.

4 Be a strategic communicator.

Use state and local public agency

communications systems to

promote awareness and traumainformed, safe, normalizing

messaging on signs and symptoms

and on seeking help through crisis

counseling. Such communications

systems use multi-channel

communication strategies which

leverage local media who readily

disseminate public messaging.

Systems such as public schools

are key partners in getting the

word out in the disaster-impacted

communities and statewide as

needed. Public schools, often

used for shelters, are more readily

able to share social media posts,

emails, robocalls, and street sign

postings to promote access to

crisis counseling through disaster

recovery. Strategic relationships

can effectively extend and increase

accessible messaging among

those most impacted during

recovery. Strategic communication

strengthens consistency in

branding and normalizes helpseeking during recovery.

4 Engage peer-to-peer supportive

outreach, training, and ongoing

support. Often the eastern coast of

North Carolina is most impacted

by disasters. Over time, managed

care organizations and provider

networks in non-disaster-affected

areas have become trained and

attuned to the needs of their peer

organizations/providers. Peer-toPotential Partners for Disaster Behavioral 

Health Programs 

• Adult, aging, and disability provider networks

• Faith communities

• Tribal leaders, governments, communities, and

organizations

• Local community health workers

• Immigrant and refugee sponsoring organizations

and assistance programs

• Public schools

• Regional and state military, veteran, and National

Guard liaisons and veteran services coordinators
2023 | VOLUME 18 | ISSUE 3 | PAGE 23 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

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peer disaster behavioral health 

outreach and support to staff

and teams has been invaluable 

in recovery of help givers who

are also in the midst of recovery 

themselves. The key lesson

learned is to engage others as 

peer partners to partner with

managed care organizations and

provider networks who are not

only in the midst of crisis response 

in the immediate disaster, but 

also survivors impacted and in 

recovery themselves. This initial

and ongoing or periodic traumainformed behavioral health 

disaster recovery support is critical 

for these entities to recover well

and be resilient and prepared in 

helping their community and those 

with whom they work to recover.

4 “Ask the question”—strategic

alliances with veterans, military,

and National Guard members

and their families extend the

opportunity to effectively provide

crisis counseling services, prevent

deaths by suicide and suicide

attempts, and increase referrals

to treatment providers who can

help in recovery. Reach out to the

regional and state military, veteran,

and National Guard liaisons

and the regional and county

veteran services coordinators.

Develop relationships with statelevel veteran collaboratives or

workgroups and public school

military family liaisons. Engage

them in promoting disaster

behavioral health recovery

services and supports through their

broad stakeholder communications

portals in the disaster-impacted 

region and statewide. It is

important for crisis counselors and 

disaster case managers to “ask the

question” of survivors—“Have

you or someone you love served 

in the armed services?”—in order

to be aware of additional stress

and needs and to link survivors

with the vast array of services and

supports specifically designed to

help.

Mechanisms That Support 

Partnerships 

Formal agreements such as 

memoranda of understanding

(MOUs), while important, are

often time-intensive and can often 

take longer to draft and get formal

signature approval of than the 

timeframes for the CCP allow.

Identify existing MOUs that support

the needed functions and common 

outcomes of behavioral health 

disaster recovery. These may include

existing regional, county, or town/

city MOUs for resource or job fairs,

health fairs, or educational events 

in which crisis counselors will be

included as participants providing 

educational outreach for behavioral 

health recovery, resiliency skills, and

preparedness.

Action in lieu of a formal

agreement. In several North

Carolina rural towns and counties,

the town managers and town

councils took action, welcoming

CCP staff presentations during

their meetings, and identified ways

in which the town leaders and

businesses would learn about and

support behavioral health disaster 

recovery in their communities. One

town council hosted “meet and

greet” breakfast and lunch events to

help inform and engage community 

members in normalizing behavioral
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A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

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health responses in recovery and 

increase access to needed CCP 

services. Strategic partnerships

grew as a result to further expand

outreach and access to CCP services 

such as expanded media coverage 

aimed at educational outreach in 

understanding signs and symptoms, 

joining “listening circles,” and

seeking crisis counseling support.

Letters of intention and letters of

collaboration between entities are

often a timelier and more accessible 

way to initiate or solidify a

partnership during disaster recovery.

Examples include establishing:

4 Transportation agreements for

a negotiated period of time with

reduced fees or free passage on

ferries or toll roads for crisis

counselors who must use these

means to access survivors on

disaster-impacted coastal islands.

4 Intra-departmental budget

transfer agreements among two

state offices in order to facilitate

expedited CCP implementation.

These agreements may be between

the state office of emergency

management and the state mental 

health agency (SMHA) for the

CCP ISP implementation, or

the SMHA and the divisions of

vocational rehabilitation, services 

for the blind, and services for the 

deaf and hard of hearing in order 

to complete mailings, including in 

large print, auditory messaging, 

braille, Spanish, and other

languages, as well as videos in

American Sign Language.

4 Administrative policies and

agreements in advance of and

preparation for disaster events.

The SMHA’s budget and contract

offices need to have nimble

procedures and processes in place

or that can be readily activated to

support expedited mechanisms for

establishing budgets, accessing

and distributing funds, and

invoice processing for timely

reimbursement within a compact

CCP timeline for the ISP and

smooth transition to RSP. Delays

in funding create serious delays 

in needed CCP behavioral health 

disaster recovery response.

4 Agreements and joint

communications with local public

libraries, schools, childcare

programs, and faith communities

that welcome regularly scheduled

crisis counseling outreach, group

counseling, and “listening circles”

for staff, families, students, and

community members at large.

Be “a constant reassuring 

presence.” As a CCP, one’s goal

is to always engage with existing

partners and create new partnerships

such that the CCP will be readily

recognized as “a constant reassuring

presence” in their communities.

Being well-branded and well-known

in the eastern coastal and central 

regions of North Carolina promotes

easily renewed recognition when

future events occur. With disaster

recovery through COVID-19, this

recognition is now true across North

Carolina’s 100 counties.

During COVID-19, for many,

the CCP was a new resource that

grew statewide in recognition

as an integral behavioral health 

resource promoting wellness,

building resilience, and supporting 

recovery as well as working with

public health partners in promoting 

prevention and preparedness in 

the unprecedented times of the 

COVID-19 global pandemic.

Often many of the community 

stakeholders within existing
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A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center 

partnerships are impacted and are 

survivors of the federally declared 

disaster event. With this in mind,

CCP crisis counselors provide 

comfort, reminding survivors that 

they are not alone and someone 

cares. Stakeholders report still using

skills and strategies they learned

from CCP outreach and group 

counseling and sharing these coping 

skills and tools with those with

whom they work, family, friends,

coworkers, and faith communities.

Be stronger together. “. . . Look for

the helpers, they are always there . .

.” Key partners exist within the state

and county emergency management 

operations network as well. In

significant Individual Assistance

disaster recovery needs assessment 

plans, Disaster Case Management

(DCM) program assistance is often

approved to allow states to offer

additional support to survivors with

physical property damage. Crisis

counselors building alliances with

the disaster case managers provide

survivors with both emotional

support and coping skills to help

them be able to take the next steps in

their physical recovery process with

the disaster case managers. Crisis

counselors are often supported by 

the voluntary organizations active

in disaster (VOAD) partners who

connect with the long-term recovery

groups and community volunteer 

assistance supports through disaster 

recovery. Often, VOAD members

and crisis counselors collaborate to 

create needed survivor resources 

where gaps arise. Crisis counselors

provide training in trauma-informed 

resiliency skills and self-care

strategies for DCM and VOAD

collaborative partners.

Celebrate partnerships and

transitions. What are the 

connections that sustain hope? 

Contributions of partners, big or 

small, for a week or months, in the

disaster recovery arena are valuable.

Lessons are learned; next steps and

new strategies and new partnerships

are forged. Transition planning is

essential when implementing ISP to

RSP, acknowledging anniversaries,

and phasing down the RSP. It is

crucial to leave the disaster-impacted 

community well and survivors and

partners connected with resources

and services in communities or 

nearby. During disaster recovery,

resource directories are created or 

updated with current services and

supports. These resource directories

will continue to be used by survivors

and updated by existing community 

collaboratives and regional agencies 

on adult and aging services, veteran 

services coordinators, public 

libraries, long-term recovery groups, 

and VOADs.

Celebrate lessons learned. Crisis 

counseling services implementation 

requires ongoing needs assessment 

and data collection, planning and 

implementation, evaluation, data and 

adjustments, and beginning again.

Gather perspectives from survivors, 

partners, staff, and all stakeholders.

Use a simple survey tool or inquiry

process. Consider recommendations

and priorities in preparing for future 

behavioral health disaster recovery 

responses.

Disaster behavioral health recovery 

begins with the end in mind, leaving

communities recovering well and

resilient, and survivors and partners 

connected with nearby resources and

services. With each behavioral health

disaster recovery event new lessons

are learned to apply in preparation 

for when future events occur.

Celebrate transitions acknowledging 

individual and community strengths 

and resilience, expressing gratitude 

for partnerships, connections 

that sustain hope, contributions, 

survivors reached and success 

stories, lives saved, and lessons 

learned. ■
2023 | VOLUME 18 | ISSUE 3 | PAGE 26 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center 

RECOMMENDED RESOURCES 

Promising Practices in Disaster Behavioral Health

Planning 

This short video from SAMHSA DTAC defines the

core components of effective disaster behavioral health

partnerships and how to build them. Throughout the

video, examples are provided of successful partnerships.

You can watch the video at https://bit.ly/3J3u7Cr. 

Partners and Collaborators for Emergency

Preparedness and Response

Part of the Rural Emergency Preparedness and Response

Toolkit, this web page explains the importance of

partnerships as part of emergency preparedness and 

response and describes how they might be established.

The page also identifies potential local, state, and

national partners and provides links to more information

for and about American Indian and Alaska Native

communities in emergency preparedness and response.

The toolkit appears at the website of the Rural Health

Information Hub, which is funded by the Health

Resources and Services Administration’s Federal Office

of Rural Health Policy.

Access the page at https://bit.ly/3J4fYGc.

Partnerships for Recovery Across The Sectors

(PRACTIS) Toolkit 

This toolkit translates a study on the New York

Department of Health and Mental Hygiene Office

of Emergency Management and Response and their

existing partnerships into actionable guidance for local 

health departments. Designed for emergency managers,

community resilience coordinators, and community 

outreach staff, this resource instructs users on how to

engage and leverage relationships with communitybased organizations. The toolkit will help the user assess

current partnerships and strengthen recovery efforts.

This resource is available for download at http://bit.

ly/3n2r8m2. 

Communication Partnerships for Public Health

Emergencies 

In this webinar from the Centers for Disease Control

and Prevention’s Emergency Partners Information

Connection (EPIC), a senior health communications

specialist presents on how to plan and pursue

partnerships, how to make partnerships beneficial,

and how to work with partners to reach those who

need information the most. The presentation covers

best practices for health communication in a crisis 

supplemented with examples from EPIC’s own

partnerships.

The webinar can be viewed at http://bit.ly/3LxTDCu.
2023 | VOLUME 18 | ISSUE 3 | PAGE 27 

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 DTAC staff have provided to recent technical assistance (TA) requests.

Send your questions and comments to dtac@samhsa.hhs.gov.

Request: A representative from Disaster Behavioral

Health Services within the Texas Health and Human

Services Commission requested trainings and resources

on mass violence for disaster behavioral health 

professionals.

Response: SAMHSA DTAC provided a list of

trainings and resources on mass violence. The resources

below are a sample of those sent. For additional

information, please contact SAMHSA DTAC at 1–800–

308–3515.

4 Crisis Services: Meeting Needs, Saving Lives—The

book is composed of SAMHSA’s “National Guidelines

for Behavioral Health Crisis Care: Best Practice

Toolkit” and related papers on crisis services. The

toolkit reflects relevant clinical and health services

research and offers a review of top national program

practices, as well as replicable approaches that support

best practice implementation.

https://store.samhsa.gov/product/crisis-servicesmeeting-needs-saving-lives/PEP20-08-01-001

Request: A territory reached out to SAMHSA DTAC

to enlist the team’s assistance in updating a chapter of 

a disaster response plan specific to disaster behavioral

health.

Response: SAMHSA DTAC conducted a thorough

review of the chapter and provided recommendations.

The items below are a sample of those sent. For a review

of your state’s, territory’s, or tribe’s disaster response 

plan, please contact SAMHSA DTAC at 1–800–308–

3515.

SAMHSA DTAC recommended the following:

4 Plans for forming an emergency planning committee

should include details regarding how committee

members will be recruited, what qualifications will be

required for members, how long members will serve

on the committee, and whether committee members

will be financially compensated for their work.

4 Disaster response plans should identify applicable

grants or funding opportunities and requirements

for grant applications. SAMHSA DTAC identified

possible grants or resources of interest from the

Federal Emergency Management Agency Disaster

Case Management program or the American Red

Cross, as well as the Crisis Counseling Assistance and

Training Program.

4 The territory should establish policies and standards

regarding information management and sharing

between federal and local community partners and the

public.

4 States, territories, and tribes should identify partner

agencies to develop cooperative agreements.

SAMHSA DTAC recommends establishing

responsibilities, limitations, and possible jurisdictions

with partnering agencies.

4 Disaster response plans should identify training

opportunities provided to response staff, volunteers,

and first responders. Plans should include information

about the administration and requirements of trainings.

4 Disaster response plans should identify steps to

support demobilization of partner agencies, staff,

and volunteers transitioning from disaster response

programs.

4 Disaster response plans should include information

regarding deploying, monitoring, and demobilizing

staff and volunteers. This information may include

plans to coordinate arrangements for staff and
2023 | VOLUME 18 | ISSUE 3 | PAGE 28 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center 

volunteers such as sheltering, transportation, and 

psychosocial support to address stress, burnout, and 

other possible challenges.

Request: A state behavioral health coordinator

requested assistance revising the state’s behavioral 

health emergency response plan.

Response: SAMHSA DTAC coordinated a meeting

with the state to discuss their behavioral health service

structure and foundational documents for revising 

behavioral health emergency response plans. SAMHSA

DTAC connected the state with a consultant who was

able to support the state’s revision of their behavioral 

health emergency plans. The team highlighted resources

included in the Disaster Behavioral Health Planners

Resource Portal on the SAMHSA DTAC website as well

as other relevant resources. A sample of these resources

is included below.

4 Disaster Behavioral Health Planners Resource

Portal—This SAMHSA DTAC web page provides

resources to assist states, territories, and tribes with

aspects of disaster behavioral health planning. It

features pre-recorded webcasts and tools that explore

strategies for developing comprehensive plans and 

identifies tips for ensuring timely and effective crisis

communication.

https://www.samhsa.gov/dtac/disaster-planners

4 Psychological First Aid (PFA) Online—The National

Child Traumatic Stress Network offers this online

course to train new disaster responders in PFA, as well

as to provide a refresher training for responders who

want to review this approach to disaster response. The

course describes the core actions of PFA and how they

can be applied after a disaster and discusses provider

well-being.

https://learn.nctsn.org/course/view.php?id=596

4 Skills for Psychological Recovery (SPR) Online—

An evidence-informed intervention for disaster

response workers, SPR (https://www.nctsn.org/

treatments-and-practices/psychological-first-aid-andskills-for-psychological-recovery/about-spr) is based

on six skills disaster survivors can use to cope with

challenges encountered during disaster recovery.

People providing SPR to disaster survivors can do so

in a single session for each skill, with reinforcement

with handouts and practice done after the session. To

complete SPR Online training, you must create an

account at https://learn.nctsn.org/login/signup.php.

https://www.nctsn.org/resources/skills-psychologicalrecovery-spr-online

4 TAP 34: Disaster Planning Handbook for Behavioral

Health Service Programs—This Technical Assistance

Publication (TAP) from SAMHSA provides guidance

for management and staff creating a disaster plan. It

explores planning, response, and recovery strategies

to promote behavioral health, recovery efforts, and

partnerships.

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

Request: Lions Club International Foundation,

a national partner with the U.S. Drug Enforcement

Administration Operation Engage, was planning a

webinar to raise awareness around disaster preparedness

and response. A representative from the organization

requested assistance finding an expert to participate in

a panel focused on disaster relief and reduction of mass 

casualty events.

Response: SAMHSA DTAC shared several experts in

the field who might be able to participate in the panel.

SAMHSA DTAC provided the contact information for

these experts as well as biographical sketches for each.
2023 | VOLUME 18 | ISSUE 3 | PAGE 29 

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center 

REFERENCES 

Rural Health Information Hub.

(n.d.). Partners and collaborators

for emergency preparedness 

and response. Rural emergency 

preparedness and response toolkit.

https://www.ruralhealthinfo.org/

toolkits/emergency-preparedness/1/

partners-collaborators 

Spear, T., McGee, L., & Drennen,

C. (2011, July 27). Promising

practices in disaster behavioral

health planning: Building effective

partnerships [Webcast]. https://www.

youtube.com/watch?v=e95C4yMybP4

Substance Abuse and Mental Health

Services Administration Disaster

Technical Assistance Center. (2019,

December 17). Promising practices 

in disaster behavioral health 

planning: Partnerships [Video].

YouTube. https://www.youtube.com/

watch?v=jmffK-aPuyY

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).

Check out the new and updated 

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

Are you looking for disaster behavioral health resources? 

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

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. 
Prepare • Respond • Recover 

Inform • Assist 

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. 

CONTACT US 

SAMHSA Disaster Technical 

Assistance Center 

Toll-free: 1–800–308–3515 

dtac@samhsa.hhs.gov 

https://www.samhsa.gov/dtac