Grant proposal for the assessment of mental health service utilization factors following hurricane Florence to inform future response and support programs Open Access

Abstract

Extreme weather events, such as hurricanes, flooding, droughts and fires are becoming more frequent and intense. These disasters impact physical but also psychological well-being of survivors, as they are exposed to stressors such as profound loss, social disruption, deterioration of social and community resources, and loss of perceived safety. Psychological disorders have been observed among victims of natural disasters with symptoms that can linger for months or even for years. Because of the physical and psychological consequences faced by victims of natural disasters, the increase in intensity and frequency of extreme weather events is a public health concern. Hurricanes have severely impacted the US and new literature demonstrates increasing intensity of hurricanes and tropical cyclones as climate continues to warm: hurricanes will harm more and more people, leading to more severe physical and psychological consequences.

In order to foster resiliency and minimize long-term symptoms of psychological disorders, delivering mental health services (MHS) after hurricanes is required. However, literature shows that despite current supportive programs and substantial financial investments, most survivors of disasters are reluctant to use MHS and/or face barriers to access these services. The factors influencing MHS use remain unclear and this knowledge gap in utilization factors may have an impact on the efficiency and quality of post-disaster MHS. This gap may also lower their capacity to reach the most vulnerable victims and address their mental health disorders.

The main objective of this grant proposal is to conduct a quantitative survey on survivors of Hurricane Florence (September 2018) in order to collect information on the factors that led victims to use/not use mental health programs. An examination of predictors of post-disaster MHS utilization would strengthen future mental health response programs and have significant implications on how to better allocate resources in order to provide essential help to the most vulnerable.

Table of Contents

Table of Contents

CHAPTER 1: INTRODUCTION. 1

1. Background. 1

2. Problem statement 2

3. Purpose Statement. 3

4. Theoretical Framework. 4

5. Significance Statement. 5

CHAPTER 2: LITERATURE REVIEW.. 6

1. Introduction. 6

A. Outline of the literature review.. 6

B. Literature review methodology. 6

2. Body of Literature. 6

A. Extreme weather events 6

B. Psychological consequences of natural disasters 11

C. Post-disasters mental health programs 14

D. Utilization of post-disasters mental health programs 16

3. Current Problems and study relevance 17

CHAPTER 3: METHODOLOGY. 18

1. A review of funding agencies. 18

A. The National Institutes of Health (NIH) and its National Institute of Mental Health (NIMH) 18

B. The US Department of Health and Human Services (HHS) and the Substance Abuse and Mental Health Services Administration (SAMHSA) 19

2. Grant Summary. 21

3. NIMH Review criteria. 22

4. Grant review process 23

5. Grant reviewers 25

6. Protection of Human Subjects. 27

CHAPTER 4: INCORPORATION OF REVIEWERS COMMENTS. 28

1. William Michael Caudle - Committee Chair. 28

2. Tony Mendes - Field Advisor. 28

3. Gwen Biggerstaff 30

4. Katy Seib. 33

5. Ellen Whitney. 35

CHAPTER 5: FINAL VERSION OF THE GRANT PROPOSAL. 40

1. Project Summary 40

2. Project Narrative 41

3. Specific aims 41

4. Research strategy 42

A. Significance 42

B. Approach. 44

C. Expected Results and Study Limitations 49

5. Appendices. 51

Appendix A. 51

Appendix B. 52

Appendix C. 53

Appendix D. 55

Appendix E. 58

References. 64

 

About this Master's Thesis

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School	Rollins School of Public Health
Department	Executive Masters of Public Health - MPH
Subfield / Discipline	Prevention Science
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	Hurricanes Disaster Utilization factors Mental Health Services
Committee Chair / Thesis Advisor	William Michael Caudle, PhD, Emory University
Committee Members	Tony Mendes, FEMA

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