624 JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION VOL. 103, NO. 7, JULY 2011 o r i g i n a l c o m m u n i c a t i o n Assessment of Training Needs for Disaster Mental Health Preparedness in Black Communities Danielle J. Laborde, PhD; Kristen Brannock, MPH; Theodore Parrish, PhD INTRODUCTION M inority communities under socioeconomic stress have fewer available resources to enlist in the aftermath of disasters. 1 A review of racial disparities in disasters over the last 30 years per- formed by the National Consensus Panel on Emergency Preparedness and Cultural Diversity found that minor- ity communities were less prepared before a disaster and more likely to suffer devastating effects and expe- rience slower recovery. 2 Contributing to the excessive toll was a lack of culturally competent clinical provid- ers to address the postdisaster health needs of minority communities. Hurricanes Katrina and Floyd revealed how the lack of local provider preparedness and com- munity-level capacities to address mental health con- sequences during the immediate aftermath can differ- entially impact underresourced black communities. 3,4 The disproportionate levels of preexisting and disas- ter-related stress experienced at the individual and col- lective levels also contribute to an increase in mental health problems. 5-9 Resilience to disaster-related mental health problems has been found to be related not only to individual factors but also to factors that mitigate the effects of ongoing stressors such as informal social sup- port networks and social capital. 10,11 Given the delays in receiving mental health services and the importance of local context, response agencies have increased support for developing viable strategies to increase community engagement and responder cultural competence. The Center for Public Health Preparedness Network has proposed core competencies in disaster mental health that include consideration of context and sensitivity for the unique subgroup needs as one of the guidance prin- ciples. 12,13 Timely and effective response to postdisaster mental health in minority populations will require col- laborative predisaster training. Training can address dis- connects between clinical providers and underresourced communities and build local capacity for reaching sur- vivors in the immediate aftermath of a disaster. We conducted a feasibility study of adapting a commu- nity integration training model that uses evidence-based Author Affiliations: HERMES, LLC (Dr Laborde and Ms Brannock) and North Carolina Central University (Dr Parrish), Durham. Correspondence: Danielle Laborde, HERMES LLC, 409 Clearbrook Dr, Wilmington, NC 28409 (dlaborde@hermesllc.com). Funding/Support: This study was funded by federal funds from the National Institute of Mental Health, National Institutes of Health, and Department of Health and Human Services. Reducing racial disparities in postdisaster mental health requires the integration of unique and complex community challenges in disaster planning. We conducted focus group discussions with 13 community leaders and 7 clinical provid- ers in eastern North Carolina to inform the adaptation of a competency-based training model in postdisaster mental health for black communities. The audience-specific per- spectives on disaster mental health and training priorities were identified by structured thematic analyses. Community leaders and clinical providers without personal ties to the local black population were unaware of internal networks and other community resources. Conversely, most black community leaders and clinical providers were unaware of local disaster response resources. All participants identified training in coordination, outreach to reduce mental health stigma, and cultural competence as priority training needs. Black community leaders also were concerned about their inclusion in local planning and leveraging resources. These inputs and suggestions made for tailoring with culturally appropriate language and processes guided the develop- ment of learning objectives, content, and field testing of the feasibility of trainer the trainer delivery of postdisaster mental health training for clinical providers and community leaders serving vulnerable black populations. Keywords: disaster preparedness n needs assessment n African Americans n mental health J Natl Med Assoc. 2011;103:624-634