State and Federal governments and national disaster response organizations have led the way in addressing mental health needs in planning for and responding to disasters. Planners and responders have recognized that people with mental illnesses may be at higher risk for distress following disasters, including the risk of posttraumatic stress symptoms over time. Disasters pose distinctive problems for people with mental health problems and abuse histories who reside in psychiatric facilities and correctional settings. In recent developments, mental health systems have focused on the development of knowledge and skills directly relevant to disaster preparedness and response; however, because the development of trauma-informed systems is in its early stages, this expertise has not been widely incorporated into disaster planning and response protocols. Also, despite their increased vulnerability in disasters, people with mental health problems and abuse histories have risen above the distress of a disaster to provide leadership and support to those who are struggling to cope with a disaster's impact. In the past few years, some of the most innovative approaches to the provision of mental health services in times of disaster have been peer-planned and peer-delivered. These efforts have been consistent with established principles of disaster response, as they have emphasized outreach, occur in natural community settings, emphasize people's strengths, avoid mental health labels, and are culturally sensitive. 26 notes