Mental health services for victims of disasters.

Abstract

Disasters, whether natural or manmade, affect lives and property, devastating communities through a chain of catastrophic sequences affecting social and economic developments. They are often events difficult to predict, prevent and control. They impact on individuals to create survivors who must cope with trauma, loss and crisis. They present a challenge to mental health professionals who have to assist the traumatized population. In afflicted communities, a large number of individuals are in the ranks of survivors and rescuers. In order to design, organize and implement post-disaster crisis-oriented services, an integrated, interactive, flexible linkage system between the mental health organization and emergency management agencies needs to be established. It is important to realize that while mental health professionals organize to assist survivors, multiple activities are taking place within the governmental/public system. Decision making about the 'life situation post-disaster' of the survivor in our care is also managed by other agencies. Identification of post-disaster need differences between groups of survivors can be exemplified according to whether the physical impact of the disaster is direct or indirect (1): primary survivors are those who have experienced maximum exposure to the traumatic event; secondary survivors are the grieving close relatives of primary victims; third-level survivors are rescue and recovery personnel, medical, nursing, mental health, Red Cross, clergy, emergency staff, firefighters, police; fourth level victims are other people in the community involved in the disaster - reporters, government personnel; fifth-level victims are individuals who may experience states of distress or disturbance after seeing or hearing media reports (e.g., bodies of individuals falling down from the Twin Towers after the terrorist attack in New York in September 2001).