National Council on Disability Calls for Sweeping Changes for People with Psychiatric Disabilities in Emergency Evacuation Situations

NCD #06-514
June 14, 2006 

WASHINGTON—The National Council on Disability (NCD) today released The Needs of People with Psychiatric Disabilities During and After Hurricanes Katrina and Rita: Position Paper and Recommendations 
(/publications/2006/peopleneeds), calling on federal, state, and local governments to enact sweeping changes.

According to NCD chairperson Lex Frieden, “The destructive forces of Hurricanes Katrina and Rita in fall 2005 wreaked an emotional as well as a physical toll on residents of the Gulf Coast region. Millions of Americans from across the country reached out to hurricane survivors, opening their homes and their hearts. Government employees at local, state and federal levels worked long and hard to help evacuate and rescue people in the Gulf Coast. Many of these people are still in the Gulf Coast helping to rebuild communities. In the months since the hurricanes devastated the Gulf Coast, media coverage of the hurricane survivors has waned. However, for hurricane survivors with psychiatric disabilities, the hurricanes’ destruction resulted in ‘trauma that didn’t last 24 hours, then go away. …It goes on and on.’ Some of these challenges were unavoidable. As one government official said, ‘No one ever planned for what happens when your social service infrastructure is completely wiped out.’ Nonetheless, many of the problems could have been avoided with proper planning.”

“As NCD predicted in its April 2005 report, Saving Lives: Including People with Disabilities in Disaster Planning, ‘[i]f planning does not embrace the value that everyone should survive, they will not.’ As a result of its research, NCD found that much pre-Katrina disaster planning did not contemplate the needs of people with psychiatric disabilities, and as a result, many people died or unnecessarily suffered severely traumatic experiences,” Frieden concluded.

This paper includes the following major findings and recommendations, as well as various specific recommendations for emergency management officials and policymakers at the local, state and federal levels.

Major Findings

• In violation of federal policy and law, people with psychiatric disabilities were discriminated against during evacuation, rescue, and relief phases
• Mismanaged evacuations resulted in the loss, mistreatment, and inappropriate institutionalization of people with psychiatric disabilities
• People with psychiatric disabilities were not included in disaster planning or relief and recovery efforts
• Disaster management efforts often failed because no individual or office had responsibility, accountability, and authority for disability related issues
• Disaster plans were shortsighted and relief services were terminated prematurely

Major Recommendations

Nondiscrimination in the Administration of Emergency Services

The federal National Response Plan and state and local emergency plans should require that services and shelters be accessible to people with disabilities, including people with psychiatric disabilities (who live independently or in congregate living situations such as hospitals, group homes, or assisted living), in compliance with the Americans with Disabilities Act and Section 504 of the Rehabilitation Act. State plans should be reviewed by independent disability experts familiar with that state.

Plans for the Evacuation of People with Psychiatric Disabilities

Evacuation planners should have a plan that (a) tracks the transfer of residents of group homes and psychiatric facilities; (b) maintains contact between people with psychiatric disabilities and their family members and caretakers; (c) helps facilitate the return of evacuees to their homes; (d) ensures that sites that receive evacuees are equipped to meet the needs of people with psychiatric disabilities; and (e) prevents the inappropriate institutionalization of evacuees with psychiatric disabilities.

Inclusion of People with Psychiatric Disabilities in Emergency Planning

People with psychiatric disabilities must be involved at every stage of disaster and evacuation planning and with the administration of relief and recovery efforts. Communities should develop interagency, multi-level disaster planning coalitions that include people with disabilities, similar to the coalition developed in Houston.

Person or Office Responsible for Disability Issues During Disasters

A single person or office must be responsible, accountable and able to make decisions related to disability issues. This person or office would be responsible for training first responders and organizing disability-specific evacuation, relief and recovery efforts. This person or office would also serve as a communication link between people with disabilities and the respective local, state or federal government.

Disaster Relief Should Continue for at least Two Years After the Disaster

Relief and recovery efforts should continue for at least two years from the date of the disaster, including Medicaid waivers, HUD housing waivers, and FEMA housing for people with disabilities. Disasters often result in long-term psychiatric consequences for people, and in some cases, the traumatic impact of the disaster does not manifest itself until many months or years later. Additionally, the social service infrastructure in some locations was utterly wiped out. Emergency planners should ensure treatment continuity by planning for relief services to be available for at least two years after the disaster.

Many of these findings and recommendations align with NCD’s 2005 report, Saving Lives: Including People with Disabilities in Disaster Planning, available on the Web at /publications/2005/saving_lives. NCD encourages policymakers, emergency planners and people with disabilities to carefully review that report. NCD stands ready to provide guidance to those who are ready to make their emergency plans and services more accessible to people with disabilities. As emergency managers and policymakers create plans that seek to ensure that all people, regardless of disability, survive catastrophes such as Hurricanes Katrina and Rita, we will incorporate the principles of inclusion and nondiscrimination into our national consciousness.