title: Factors predicting crisis counselor referrals to other crisis counseling, disaster relief, and psychological services: a cross-site analysis of post-Katrina programs.
abstract: An important aspect of crisis counseling is linking survivors with services for their unmet needs. We examined determinants of referrals for disaster relief, additional crisis counseling, and psychological services in 703,000 crisis counseling encounters 3-18 months after Hurricane Katrina. Referrals for disaster relief were predicted by clients' losses, age (adults rather than children), and urbanicity. Referrals for additional counseling and psychological services were predicted by urbanicity, losses and trauma exposure, prior trauma, and preexisting mental health problems. Counseling and psychological referrals declined over time despite continuing mental health needs. Results confirm large urban-rural disparities in access to services.
authors.affiliation: National Center for Posttraumatic Stress Disorder, Stanford University School of Medicine, Palo Alto, CA, USA.
authors.forename: Craig S
authors.initials: CS
authors.lastname: Rosen
authors.forename: Monica M
authors.initials: MM
authors.lastname: Matthieu
authors.forename: Fran H
authors.initials: FH
authors.lastname: Norris
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003376:Counseling / Q000458:organization & administration*; D003419:Crisis Intervention / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D055867:Cyclonic Storms; D004190:Disasters; D006297:Health Services Accessibility / Q000458:organization & administration; D054625:Healthcare Disparities; D006801:Humans; D008145:Louisiana; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D008605:Mental Health Services / Q000458:organization & administration*; D008875:Middle Aged; D020380:Needs Assessment / Q000458:organization & administration; D012017:Referral and Consultation / Q000458:organization & administration*; D012066:Relief Work / Q000458:organization & administration*; D012424:Rural Population / Q000706:statistics & numerical data; D017741:Survivors / Q000523:psychology*; D014481:United States; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult