Letter written for NAMI NJ, published with permission.
Remember Hurricane Sandy in NJ, or Katrina in Louisiana in 2005? Even now with the Pandemic or the war in Ukraine, I always find myself asking during events like these, “what about people with mental health issues, substance use issues, alcoholism?” Are they getting the care and resources they need?
Usually there are little if any media reports on the welfare of people managing their lives around a behavioral health diagnosis, or individuals hospitalized in the midst of a mental health crisis. If it is hard for the average everyday person to bring forth the coping skills needed to navigate an environmental crisis such as a hurricane/ flood or a manmade crisis such as war, try to imagine the strength needed to manage a pending or actual behavioral health crisis. To try and remain connected to community support networks, such as AA and self-help groups.
As a psychiatric nurse, I think about such things, as I’m sure nurses who work in other health care specialties do as well. But those are the areas that get front page attention, not mental illness or substance use. Of course there is a great need for mental health services in response to emergencies. Almost all people affected by emergencies will experience distress which most people will recover from over time. However, according to the World Health Organization (WHO), “people with severe pre-existing mental disorders are especially vulnerable during emergencies and need access to mental health care and other basic needs”.
I often wonder how this especially vulnerable population will get needed medication and other supports without records that have been lost, are inaccessible or destroyed? When there is a FEMA response to an emergency in the US, how well are they trained to deal with persons who have a pre-existing serious and persistent behavioral health diagnosis?
WHO recommends the following as an effective emergency response:
- Community self-help and social supports: “…creating or re-establishing community groups in which members solve problems collaboratively…
- Basic clinical mental health care covering priority conditions (e.g. depression, psychotic disorders, epilepsy, alcohol and substance abuse) should be provided at every health-care facility by trained and supervised general health staff.
- Protecting and promoting the rights of people with severe mental health conditions and psychosocial disabilities is especially critical in humanitarian emergencies. This includes visiting, monitoring and supporting people at psychiatric facilities and residential homes.
- Links and referral mechanisms need to be established between mental health specialists, general health-care providers, community-based support and other services (e.g. schools, social services and emergency relief services such as those providing food, water and housing/shelter).
Lastly, as we emerge from the Pandemic and other predictable/ unpredictable humanitarian crises in the future, we are invariably faced with an opportunity for “lessons learned”. The health care community, particularly behavioral health care, can continue to play an integral role in developing reforms that focus on long term service development, rather than the short term surge of aid that typically accompanies a crisis; to build a better mental health care system during and after a crisis.
Happy National Nurses Week, May 6th to 12th,
Mark T. Williams, RN, President of NAMI NJ
Mark Williams is a member of First Unitarian New Jersey.