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Mental Health and Disasters
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Book description

Since the attacks of September 11, 2001, disaster preparedness and response has developed into a discrete subspecialty in medicine, and the paramount health care initiative of the US Government. The mental health component of disaster response is a serious subject of study, as trauma is associated with a substantial and long-lasting psychologic burden, both on an individual and community level. The psychopathologies associated with disaster are also quite broad, varying from several different types of post-traumatic stress and anxiety disorders to acute variations of grief-associated depression. This book is the definitive reference on mental health and disasters, focused on the assessment and treatment of the full spectrum of psychopathologies associated with many different types of individual disasters. The logistics for utilizing pre-existing community-based mental health services, as well as the development of new programs, are covered in depth. Case studies and perspectives for improving care, incorporating lessons from Hurricane Katrina and 9/11, are included in detail.

Reviews

'All of the chapters are excellent, but 2 are exceptional … This book is must reading for anyone involved in planning the mental health response to disasters … Mental Health and Disasters is encyclopedic in its coverage of essential topics.'

Source: Journal of the American Medical Association

'… I liked the fact that the book has a forward-looking perspective … I commend this book without reservation. It is well written and the editors have achieved a good balance among the chapters. The authors are rigorous in their critical analysis of the research from which the data are derived, and they identify fruitful opportunities for researchers, practitioners and policy makers.'

Source: The British Journal of Psychiatry

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Contents

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Contents
  • 9 - Resilience after Disaster
    pp 145-160
  • View abstract

    Summary

    This introduction presents an overview of the key concepts discussed in the book Mental Health and Disasters. The book is the definitive reference on mental health and disasters. It focuses on the assessment and treatment of the full spectrum of psychopathologies associated with many different types of individual disasters. The book talks about the mental health consequences of disasters. It provides a synthesis of the current knowledge of the mental health effects of disaster. The book focuses on key aspects of vulnerability and resilience in the face of disasters. It overviews the scientific literature on the key known determinants of the mental health consequences of disasters. The book discusses the science of interventions after disasters, along with the barriers and challenges faced in providing mental health care services after these events. It presents detailed explorations of a number of sentinel natural, technological, and human-made disasters.
  • 11 - Distinctions that Matter:
    pp 175-200
  • Received Social Support, Perceived Social Support, and Social Embeddedness after Disasters
  • View abstract

    Summary

    In reviewing the development of mental health interest in and research about disasters, there are many seminal studies and publications, building progressively in their contributions to the science of disaster field. The field of disaster mental health research emerged from inquiries into the phenomena associated with the mental health impacts of war. Mental health aspects of disasters became a more specific focus during the 1970s and 1980s. Interventions have been a focus of review in terms of current knowledge, effective models, and the need for research and evaluation of interventions that are provided. Resilience has long been recognized by trauma experts, though they acknowledge it may coexist with painful emotional scars. Researchers across the globe have contributed to the expanding science of disaster mental health. A number of studies focused on the stressor components, particularly those related to psychological trauma and posttraumatic stress disorder (PTSD).
  • 12 - Women and Disasters
    pp 203-217
  • View abstract

    Summary

    This chapter summarizes the complex ways in which people experience disasters. These experiences are organized into categories of traumatic stressors, loss, ongoing adversities, and community effects and meanings. The chapter explores the most acutely severe and personally traumatic aspects of disaster exposure: loss of life and traumatic bereavement; threat to life, injury, and fear; and witnessing of horror. Damage to home and property, often accompanied by financial loss, may be the prototypical stressor associated with natural disasters. The acutely stressful experiences of trauma and loss are followed by a host of challenges associated with poor housing conditions, rebuilding, and other stressors in the postdisaster environment. Postdisaster stressors are typically captured in disaster research by measures of stressful life events or chronic stress. Development and validation of quantitative measures that encompass both universal and culture-specific responses to trauma could help address current cross-cultural and transnational assessment challenges.
  • 14 - Disaster Mental Health in Older Adults:
    pp 233-263
  • Symptoms, Policy, and Planning
  • View abstract

    Summary

    This chapter focuses on the prevalence and etiology of anxiety disorders, including posttraumatic stress disorder (PTSD), following disasters. Recently a number of large national mental health surveys have estimated the prevalence of psychiatric disorders. The anxiety disorders that have been associated with disasters are generalized anxiety disorder, panic disorder, obsessive-compulsive disorder (OCD), social phobia, and specific phobia. The discussion of these matters is influenced by the fact that the conventions for recording patterns of comorbidity have changed between Diagnostic and Statistical Manual (DSM)-III and DSM-IV. The relationship between PTSD and the associated comorbidities with other anxiety and depressive disorders is important in determining the chronicity of morbidity following disasters. Anxiety disorders other than PTSD have been looked at in more detail in children, in part because of the potential developmental impact of disorders such as separation anxiety.
  • 15 - The Effects of Disaster on the Mental Health of Individuals with Disabilities
    pp 264-276
  • View abstract

    Summary

    This chapter presents an introduction to the physical health problems following disasters as well as disaster studies. The majority of studies after traumatic events such as disasters have focused on psychological problems, such as depression, anxiety, and posttraumatic stress disorder (PTSD), and they have shown a positive relation between exposure to traumatic stress and psychopathology. Several studies have examined the prevalence of specific symptoms among survivors of disasters. The mean number of physical symptoms was compared between survivors of a disaster and a control group. Although risk factors for psychological problems after exposure to traumatic stress have been investigated in many studies after disasters, only a few risk factors for physical symptoms have been examined after several disasters. Risk factors for physical symptoms after disasters can be divided into predisaster factors, disaster-related factors and postdisaster factors.
  • 16 - Factors Associated with Exposure and Response to Disasters among Marginalized Populations
    pp 277-290
  • View abstract

    Summary

    This chapter overviews the current literature on substance use after disasters in affected populations. Several studies examined different aspects of substance use, such as prevalence, comorbidity, correlates and/or predictors of alcohol, tobacco and drugs use. The chapter outlines the prevalence of substance dependency-abuse, changes in substance use, and associations between substance use and posttraumatic stress disorder (PTSD) or other mental health problems after different categories of disasters. It describes the associations between substance use and mental health disturbances after several types of disasters. The chapter presents correlates of substance use or misuse in detail, that is, (independent) predictors of substance use, as well as substance use as a (independent) predictor for PTSD and other postdisaster mental health disturbances. It focuses on residents affected by natural and technological disasters as well as disasters caused by mass violence and terrorism.
  • 17 - Journalism and Media during Disasters
    pp 291-301
  • View abstract

    Summary

    This chapter explores both major depressive disorder (MDD) and prolonged grief disorder (PGD) as responses to disasters and terrorist events. MDD should be diagnosed in individuals for whom intense dysphoria and feelings of sadness persist and who experience related depressive symptoms. PGD is more severe and unremitting than normal grief. PGD is associated with considerable functional impairment, physical and mental health morbidity, lost productivity, suicide, and fewer quality adjusted life years. Studies have shown that PGD symptoms form a coherent cluster distinct from bereavement-related depressive and anxiety symptom clusters. Postdisaster prevalence of depression varies considerably across disasters and estimates can be misleading without additional information. Risk and resilience factors can be temporally categorized into three categories: preevent predictors, perievent predictors, and postevent predictors. Grief and depression-focused treatments are rarely implemented systematically in the wake of disasters.
  • 18 - Uniformed Rescue Workers Responding to Disaster
    pp 302-318
  • View abstract

    Summary

    This chapter describes the interface of mental health and disaster. The burden of mental illness for families, communities, and nations is substantial, and the mental illness that follows extreme traumatic events is part of this global burden. Accurate and real-time health surveillance information on the population rates of mental health and illness and the barriers to care are needed to address the mental and behavioral health-care needs of disaster populations. The chapter discusses the range of psychological and behavioral responses to disaster, from subsyndromal symptoms of distress, to initial behavior, distress and health risk behaviors, to the development of specific psychiatric disorders. Cognitive-behavioral psychotherapeutic interventions for children and adults with complex grief are under investigation. The chapter focuses on the complexity of modeling psychopathology after disaster-posttraumatic stress disorder (PTSD). The conceptualization of postdisaster pathology and PTSD requires a broader view across domains of suffering, altered functional capacity, and disability.

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