This chapter familiarizes emergency department (ED) physicians with the community mental health model and introduces non-inpatient community resources along the psychiatric crisis continuum. It primarily focuses on publicly funded community resources because the greater percentage of patients who present in psychiatric crisis to EDs lack private coverage benefits. Deinstitutionalization has often been cited as the single most important factor contributing to the current mental health system crisis. The chapter provides examples of the types of programs and interventions that may avert the need for inpatient care. Mobile crisis teams are a type of service along the psychiatric crisis continuum which consists of trained mental health and/or law enforcement personnel organized to respond to psychiatric crisis in a variety of locations. Crisis residential services can vary from organized, insurance reimbursed settings to consumer run levels of care. Several agencies define the expectations of effective case management.

This chapter summarizes the current state of the literature relating to each of the disaster phases across a wide range of variables, including sociocultural factors and environment and community resources. Social networks among racial/ethnic minority cultures can be a significant protective factor against adverse mental health consequences, and the emphasis on social networks among many racial/ethnic minority cultures appears to also influence evacuation efforts. Differences in risk perception between minority and majority populations contribute to differences in disaster exposure. A variety of cultural beliefs appear to affect individuals in pre- and peridisaster phases. Several factors have an impact on marginalized populations' postdisaster mental health outcomes. Environmental and community resources suggest that limited or lack of resources appears to significantly impact disaster-response in marginalized populations. The chapter further discusses the implications for research, disaster-response efforts, and practice.