Health trends

Coordinating mental-health support during disasters

The health ministry's Mental Health and Substance Abuse Division, headed by Dr Maureen Irons-Morgan, was last week in workshops and consultations with visiting Pan American Health Organisation's (PAHO) officials and other members of the local health team as they hammer out a coordinated national mental-health and psychosocial plan for use in times of emergencies and disaster.

The more coordinated mental health and psychosocial support plan would work with existing disaster interventions now managed by the Office of Disaster Preparedness and Emergency Management.

National disasters and emergencies can create a wide range of psychological and social problems for individuals, families and communities. PAHO's Devora Kestel said, for instance, that during disasters and emergencies when people's protective support is lessened or eroded, there is increased risk for emerging problems or an amplification of existing problems.

Some psychological problems which may arise in disasters include pre-existing problems (such as severe mental disorder, depression, alcohol abuse); emergency-induced problems (such as grief, distress, alcohol and other substance abuse, depression, anxiety disorders, including post-traumatic stress disorder, and humanitarian aid-related problems (such as anxiety because of a lack of information about food distribution).

Kestel cautioned mental-health professional not to engage in the psychological debriefing of traumatised individuals. She noted that it was a popular technique but, at best, ineffective. Instead, she encouraged the training of aid workers in psychological first aid, also called PFA. This involves non-intrusive techniques focusing more on non-clinical, humane supportive responses. Clinical management would be target at the more severe cases of distress.