Provision of mental health services immediately following a natural disaster: Experiences after Hurricane Maria in Puerto Rico


  • Michelle E. Alto, PhD
  • Andel V. Nicasio, PhD
  • Regan Stewart, PhD
  • Tania D. Rodríguez-Sanfiorenzo, PhD
  • Gisela González-Elías, PhD
  • Rosaura Orengo-Aguayo, PhD



hurricane, natural disaster, disaster mental health response, psychological first aid


Objective: The increased risk of mental health disorders in the months and years following a natural disaster highlights the need for more immediate preventive intervention. The objective of the current study was to learn from a real-time implementation of a natural disaster response following the Hurricane Maria in Puerto Rico to identify strategies for providing mental health services immediately after a natural disaster.

Methods: Two focus groups were held with faculty (n = 6) and graduate students (n = 4) from a graduate psychology program at the Universidad Carlos Albizu, Centro Universitario Mayagüez. An additional key informant interview was conducted with two faculty member participants. Data were analyzed qualitatively using thematic analysis.

Results: The delivery of mental health services was organized into three major themes: (1) finding a way to communicate, (2) targeting key access points for outreach and centralization of resources, and (3) providing triaged mental health care based on level of need.

Conclusions: Findings are used to guide recommendations for mental health response preparation in future natural disaster contexts.


Author Biographies

Michelle E. Alto, PhD

Medical University of South Carolina, Charleston, South Carolina; now at: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland

Andel V. Nicasio, PhD

Mental Health Disparities and Diversity Program, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina

Regan Stewart, PhD

Mental Health Disparities and Diversity Program, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina

Tania D. Rodríguez-Sanfiorenzo, PhD

Counseling Psychology Graduate Program, Albizu University, Mayaguez Academic Center, Mayaguez, Puerto Rico

Gisela González-Elías, PhD

Interdisciplinary Baccalaureate Program, Albizu University, Mayaguez Academic Center, Mayaguez, Puerto Rico

Rosaura Orengo-Aguayo, PhD

National Crime Victims Research & Treatment Center, Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina


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How to Cite

Alto, PhD, M. E., A. V. Nicasio, PhD, R. Stewart, PhD, T. D. Rodríguez-Sanfiorenzo, PhD, G. González-Elías, PhD, and R. Orengo-Aguayo, PhD. “Provision of Mental Health Services Immediately Following a Natural Disaster: Experiences After Hurricane Maria in Puerto Rico”. Journal of Emergency Management, vol. 19, no. 8, Sept. 2021, pp. 167-75, doi:10.5055/jem.0634.