This installment of the Substance Abuse and Mental Health Services Administration (SAMHSA) Disaster Behavioral Health Information Series (DBHIS) focuses on adults with serious mental illness (SMI) and children with serious emotional disturbance (SED) in the context of disasters. SMI is a diagnosable mental, behavioral, or emotional disorder that an adult has experienced in the past year that causes him or her serious functional impairment that substantially interferes with or limits at least one major life activity. Examples include schizophrenia, bipolar disorder, and major depression, as well as other disorders that cause serious functional impairment. SED is a diagnosable mental, behavioral, or emotional disorder in children and youth experienced in the past year that resulted in functional impairment that substantially interfered with or limited the child’s or youth’s role or functioning in family, school, or community activities.
For adults with SMI and children and youth with SED, it may be harder to prepare for a disaster, and a disaster may worsen symptoms of their illness. These individuals require special consideration during the planning, response, and recovery phases of disaster. Consideration should focus not only on vulnerability, but also on the strengths that people with SMI and SED have and can draw on during and after a disaster. Additionally, planning for continuity of care is important for many with SMI and SED.
Just as with all people, individuals with SMI and SED may have limited reaction to a disaster or they may have a heightened reaction. This may include features that we see in anyone involved with a disaster such as heightened anxiety, irritability, sleep disturbance, sense of hopelessness, or inability to participate in healing community responses. Additionally, persons with SMI and SED may experience worsening in the features of their underlying mental illness, and this is particularly true if the treatment they usually receive that helps to manage their symptoms is unavailable.
Disaster mental health and substance use professionals, parents and families, program planners, and public health professionals can use the following resources to learn how disasters may affect people with SMI and SED and the needs they may have during and after a disaster. Emergency managers, planners, and other professionals can use these resources to learn how to incorporate mental health and substance use care for these individuals into their disaster plans. People living with mental illness can use these resources in personal disaster planning and preparedness. This installment is not meant to be a comprehensive resource for meeting the needs of adults with SMI and children and youth with SED during disasters. Rather, it provides information that a range of professionals and individuals can use to ensure inclusion and support of people with SMI and SED through all phases of disaster.