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Journal Article

Citation

Berger M. Disaster Med. Public Health Prep. 2020; ePub(ePub): ePub.

Affiliation

The author is a Public Health Advisor with the Substance Abuse and Mental Health Services Administration (SAMHSA), Department of Health & Human Services. The opinions expressed are solely those of the author and should not be imputed to any public or private entity.

Copyright

(Copyright © 2020, Society for Disaster Medicine and Public Health, Publisher Cambridge University Press)

DOI

10.1017/dmp.2019.148

PMID

31955722

Abstract

I read with great interest the discussion by Ramchand et al. of the Deepwater Horizon oil spill’s impact on US Gulf Coast residents.1 The authors should be commended for an interesting study that highlights the importance of considering behavioral health in disaster mitigation, preparedness, response, and recovery. I offer the following comments and observations.

The authors report that, even though 47% of adults surveyed appeared to be in need of services for alcohol use disorder, depression, or anxiety, “only 19% had seen a mental health care provider in the past 12 months” (p. 4). This is sadly not inconsistent with national-level data, such as that from the National Survey on Drug Use and Health (NSDUH), regarding persons with a “perceived unmet need” for mental health and substance use disorder treatment. Cost continues to represent a major barrier to accessing behavioral health services.2 The impact of stigma (eg, concerns about negative opinions from one’s neighbors/community or employer), concerns about insurance payment and scope of coverage, and persons not knowing where to go for services also are notable barriers to care for mental health at a national level. Such challenges may explain in part why some of those impacted by recent disasters in the Gulf Coast are not seeking needed care. The authors’ findings reemphasize the need for a strong national commitment to parity such that access to services and quality of care for behavioral health conditions is no less than that expected for physical health conditions.3 As well, emergency planners should be aware of such resources as https://findtreatment.samhsa.gov/locator that may help identify behavioral health providers and link those in need to available services.

The authors also note in their discussion the impact of potential resource loss and financial security. This is an important national issue of growing concern to the Federal Emergency Management Agency (FEMA) and community advocates. Reports that up to 40% of Americans would have difficulty covering an unexpected $400 expense underscore the challenges many people face even without the additional challenges imposed by a disaster or ...


Language: en

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