The Delivery of Mental Health Services in the Xenia Tornado

The report consists of seven chapters and an appendix. The first chapter is background: it sets forth rather briefly the history of the organized delivery of mental health services in American disasters, the general research and analytical framework we used to study the delivery of such services in Xenia, and concludes with a discussion of the nature of the data we obtained in the study, including its limitations. Chapter II selectively describes pre-impact Xenia, the damage, destruction and disruption of community life occasioned by the tornado, and the expected as well as the actual post-impact reactions manifested by victims as well as others in the general population. The pre-impact mental health delivery service system existing in Xenia is described in Chapter III; it is seen as having evolved out of a general historical context. Chapter IV details the characteristics of the mental health delivery services attempted and provided after the tornado hit: it answers such questions as what services were delivered, how, where, and by whom. The following chapter analyzes the specific post-impact conditions, both those which arose after the tornado impact and those that were carried over from before the disaster, which lead to the kind of services described in Chapter IV. In Chapter VI we trace out at system, organizational and individual levels, some of the more salient consequences of the delivery of mental health services. The concluding chapter of the report spells out some policy implications of our study and indicates what is suggested by the research for disaster planning as well as for the pre-, trans- and post-disaster delivery of services by mental health systems. The appendix contains copies of the field instruments used