Managing the After-effects of Disaster Trauma – The Essentials of Early Intervention

Trond Heir, Ajmal Hussain, Lars Weisæth
European Psychiatric Review, 2008;1(1):66-69
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Although disaster traumas differ widely, they usually have some common characteristics in terms of risk of developing psychopathology. Bereavement, threat to life and integrity, witnessing death and horror, suffering an emotional storm or psychic numbing, physical injuries, property loss and social disruption have all been found to affect mental health after a variety of disasters.1 Stress reactions after a disaster may include the diagnosis of post-traumatic stress disorder (PTSD), depression and anxiety disorders, as well as other psychiatric conditions such as prolonged grief reactions, somatisation and substance abuse.2 A stressful disaster exposure may exacerbate pre-existing psychiatric conditions, trigger a latent disorder or cause psychic vulnerability to later stressful events.

During a disaster there will be a discrepancy between urgent needs and immediately available medical resources. This lack of resources results in reduced possibilities for high-quality individual psychiatric care. Normally, the mental health professional focuses on the individual and his or her family; however, after a disaster the focus must shift towards public health. This calls for secondary preventative psychiatry applied on a mass scale.

The World Health Organization (WHO) has defined disasters as a public health priority in large parts of the world. The smallest and poorest countries are affected most severely by natural disasters, and the poorest and most disadvantaged members of a disaster-affected community are likely to experience the most serious consequences. Poverty is both a cause and an effect of disaster.3

The UN recognised the increasing impact of disasters on the world’s population and environment by declaring the 1990s ‘the international decade for natural disaster reduction’. One must question the effectiveness of this declaration: while the likelihood of dying in a disaster was indeed reduced during the 1990s, the number of persons affected and the costs have increased profoundly.4 After the South- East Asian tsunami in December 2004 in particular, the need to systematically reduce the impact of disasters has been gaining recognition and commitment among governments worldwide.5

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