Linkage with Collaborative Services
To link survivors with available services needed at the time or in the future.
Provide Direct Link to Additional Needed Services
As you provide information, also discuss which of the survivor’s needs and current concerns require additional information or services. Do what is necessary to ensure effective linkage with those services (for example, walk the survivor over to an agency representative who can provide a service, set up a meeting with a community representative who may provide appropriate referrals). Examples of situations requiring a referral include:
- An acute medical problem that needs immediate attention
- An acute mental health problem that needs immediate attention
- Worsening of a pre-existing medical, emotional, or behavioral problem
- Threat of harm to self or others
- Concerns related to the use of alcohol or drugs
- Cases involving domestic, child, or elder abuse (be aware of reporting laws)
- When medication is needed for stabilization
- When pastoral counseling is desired
- Ongoing difficulties with coping (4 weeks or more after the disaster)
- Significant developmental concerns about children or adolescents
- When the survivor asks for a referral
In addition, reconnect survivors to agencies that provided them services before the disaster including:
- Mental health services
- Medical services
- Social support services
- Child welfare services
- Drug and alcohol support groups
When making a referral:
- Summarize your discussion with the person about his/her needs and concerns.
- Check for the accuracy of your summary.
- Describe the option of referral, including how this may help, and what will take place if the individual goes for further help.
- Ask about the survivor’s reaction to the suggested referral.
- Give written referral information, or if possible, make an appointment then and there.
Referrals for Children and Adolescents
Remember that children and adolescents under the age of 18 will need parental consent for services outside of immediate emergency care. Youth may be less likely to self-refer when they are experiencing difficulties, and are less likely to follow through on referrals without an adult who is engaged in the process. To maximize the likelihood that youth will follow through with a referral, you should:
- Recommend that any follow-up services for the family include (at least) a brief evaluation of child and adolescent adjustment.
- Make your interactions with children and adolescents positive and supportive to help them develop a positive attitude towards future care providers.
- Remember that children and adolescents have an especially difficult time telling and retelling information related to traumatic events. When working with youth, summarize in writing the basic information about the event that you have gathered and communicate this information to the receiving professional. This will help minimize the number of times that they will have to retell the story of their experiences.
Referrals for Older Adults
Help with plans for an elder who is going home or needs access to alternative housing. Make sure the elder has referral sources for the following, if needed:
- A primary care physician
- A local senior center
- Council on Aging programs
- Social support services
- Meals on Wheels
- Senior housing or assisted living
- Transportation services
Promote Continuity in Helping Relationships
A secondary, but important concern for many survivors is being able to keep in contact with responders who have been helpful. In most cases, continuing contact between survivors and you will not be possible because survivors will leave triage sites or family assistance centers and go to other sites for continuing services. However, loss of contacts made during the acute aftermath of disasters can lead to a sense of abandonment or rejection. You can create a sense of continuing care if you:
- Give the names and contact information for the local public health and public mental health service providers in the community. There may also be other local providers or recognized agencies who have volunteered to provide post-disaster follow-up services for the community. (Be wary of referring to unknown volunteer providers.) Such information may not be known for several hours or days, but once available, it can be helpful to disaster survivors.
- Introduce survivors to other mental health, health care, family service, or relief workers, so that they know several other helpers by name.
Sometimes, survivors feel as if they are meeting a never-ending succession of helpers, and that they have to go on explaining their situation and telling their story to each one in turn. To the extent possible, minimize this. If you are leaving a response site, let the survivor know, and if possible, ensure a direct “hand-off” to another provider, one who will be in a position to maintain an ongoing helping relationship with the person. Orient the new provider to what he/she needs to know about the person, and if possible, provide an introduction.