title: Tailoring disaster mental health services to diverse needs: an analysis of 36 crisis counseling projects.
abstract: The federal Crisis Counseling Program (CCP) funds states' delivery of mental health services after disasters. These services are provided by social workers, other mental health professionals, and paraprofessionals from the local community. The present study examined whether CCP grant recipients that reported more tailoring of their interventions to the needs of diverse community segments achieved greater community penetration. The study reviewed archival records from 36 crisis counseling projects ending between 1996 and 2001. Numbers of clients and client ethnicity were determined through service logs. Tailoring ofservices was determined by content coding of projects' reports. Community demographics were determined from census data. Fifty-six percent of the projects reported using three or more tailoring strategies, suggesting a "precompetence" or greater stage of cultural competence. The proportion of members of racial or ethnic minority groups among program clients closely matched the proportion in grantees' communities. Projects that reported more types of tailored activities reached more clients and served more members ofminority groups. These findings confirm that adapting crisis counseling services to diverse local needs is associated with greater community penetration of mental health services.
authors.affiliation: Dissemination and Training Division, National Center for PTSD, Department of Veterans Affairs (VA) Palo Alto Health Care System, Palo Alto, CA, USA. craig.rosen@va.gov
authors.forename: Craig S
authors.initials: CS
authors.lastname: Rosen
authors.forename: Carolyn J
authors.initials: CJ
authors.lastname: Greene
authors.forename: Helena E
authors.initials: HE
authors.lastname: Young
authors.forename: Fran H
authors.initials: FH
authors.lastname: Norris
mesh_terms: D003156:Community Mental Health Services / Q000191:economics; D003159:Community-Institutional Relations; D003419:Crisis Intervention / Q000191:economics; D054521:Cultural Competency; D004190:Disasters; D005102:Health Expenditures; D006801:Humans; D009313:National Health Programs / Q000191:economics; D015397:Program Evaluation; D012044:Regression Analysis; D012947:Social Work; D014481:United States