4.2 Responsibility for mental health and wellbeing services during times of disaster
Following a major disaster, a large proportion of the population will require some emotional or psychosocial support to cope with potentially traumatic events. Mainstream mental health services are typically supplemented by additional disaster-related services funded on a cost-share basis between the Australian Government and state and territory governments through the Disaster Recovery Funding Arrangements (DRFA). The DRFA also funds local community-based and enabling supports that strengthen social connections. Whether delivered through existing or standalone services, capacity to meet demand will be a challenge. Service continuity and access to pharmaceuticals need to be assured for people with existing illnesses, while new issues arise including emergency-induced social and psychological problems.
All states and territories either set out their mental health and wellbeing response to disasters in a specific plan or a more general disaster-related document (see Priorities in Action: Examples from Experience). Implementation of the National Disaster Mental Health and Wellbeing Framework needs to be tailored to each state, regional, and local context. It also needs to take into account existing health systems and disaster response and recovery systems. Operationalising the Frameworks in a way that aligns with these plans and the local context is essential.
Roles and responsibilities consistent with the National Disaster Mental Health and Wellbeing Framework are suggested in Figure 4. Some of these are dependent on funding.
Figure 4 Key roles and responsibilities for implementation
|Level of government
||Key roles and responsibilities
Local intelligence, mapping, and coordination
- • Identify features that support a tailored disaster mental health response including local population profile; components of the current service system, including current strengths and gaps; places to best situate community gatherings and drop-ins; and groups at risk of being physically or socially isolated.
- • Engage with local and regional services to integrate mental health and wellbeing actions into disaster planning, working with emergency services bodies, local businesses, charities, and community organisations.
- • Focus on the accessibility of recovery and evacuation centres to meet the widest range of community needs including young children, older people, and people with a disability; and to cater for individual needs, including households with pets.
- • Encourage local services to plan for transport and communications disruption, evacuation, and continuity of support in the face of disruption.
- • Facilitate networks of local mental health and wellbeing services before, during, and after a disaster to ensure there is coordination, functions are clear, relationships are strong, and simple referral channels exist.
|Regional bodies (Primary and Local Health
Districts or Networks)
Regional planning and coordination
- • Ensure that joint regional mental health plans include disaster mental health measures needed before, during, and after disasters. Consider social and cultural factors and geography.
- • Participate in state Recovery Committees and emergency response planning.
- • PHNs undertake comprehensive and integrated primary health response plans for emergencies.
- • Put in place or consolidate regional disaster mental health coordination.
- • Agree on a plan for community upskilling in mental health awareness, in collaboration with other levels of government and key recovery partners.
- • Contribute to a disaster mental health workforce plan for the region that considers the capability and capacity of current services; where surge workforces will be needed; and how these will ‘fade in’ and ‘fade out’ to ensure local capability is developed. Include training, including orientation to local conditions in this plan.
- • Facilitate regional mental health-related intelligence from multiple sources during disasters and share widely with recovery partners.
|State & Territory governments
Service provision and service navigation
assistance, regular information
- • Adopt a five-year planning timeframe for mental health recovery following major disasters to allow for extended mental health impacts and recovery needs.
- • Ensure that future state and territory mental health plans (including clinical services plans) address mental health concerns arising from disasters.
- • Integrate mental health considerations into preparation, relief, and recovery planning. This includes in emergency management frameworks, ensuring proactive outreach to first responders, volunteers, and their families.
- • Contribute to regional disaster mental health workforce arrangements and planning including agreements with other levels of government to provide additional workers where needed.
- • Work with other levels of government to plan which services will conduct proactive outreach and navigation assistance.
- • Ensure hospitals, state-funded mental health services, and other community services can ensure continuity of support to people with pre-existing conditions.
- • Where possible provide additional support by augmenting existing and well-established services. This maximises community trust in, and engagement with, services, and maintains long-term continuity of care.
|Australian Government Integrate disaster mental health into national funding agreements & emergency arrangements
- • Establish a standing Senior Officials Group to implement the Framework. Include representation from all levels of government and both mental health and emergency/recovery agencies.
- • Adopt a five-year planning timeframe for mental health recovery following major disasters to allow for extended and delayed mental health impacts. This is relevant to mental health response and recovery initiatives, including enhanced flexibility under Medicare for providers and patients to allow easier access to supports at a reduced cost.
- • Where possible, fund PHNs to commission services that align with priorities in regional plans while also allowing flexible responses to local disaster-related needs.
- • Work with states and territories to identify opportunities to improve workforce sharing and training in the event of a major disaster.
- • Work with states and territories to agree on a streamlined approach to disaster digital and telephone support services which refer people to assistance following triage and to local services where available.
- • Work with state and territory, regional, and local governments to develop strategies to improve collecting and sharing of consistent data across governments and agencies to support mental health disasters responses and resilience.
- • Work with state and territory governments to implement a communication strategy on disaster mental health to guide media coverage. This will reinforce good practice in relation to where to find help, and the appropriate use of language, images, and commemorations.