Systematic Approach Integration for Post-Disaster Mental Health

(HealthDay News) – A systematic approach should be taken to identify individuals with adverse mental health outcomes post-disaster and to triage them appropriately, according to research published in the Aug. 7 issue of the Journal of the American Medical Association.

Carol S. North, MD, MPE, from the VA North Texas Health Care System in Dallas, and Betty Pfefferbaum, MD, JD, from the University of Oklahoma Health Sciences Center in Oklahoma City, reviewed the literature to determine how to best identify individuals in need of disaster mental health services and triage them to appropriate care.

The researchers note that the adverse mental health outcomes of disasters may not be apparent and consequently a systematic approach is needed to identify adverse outcomes and triage to appropriate interventions. In post-disaster settings, symptomatic individuals may experience new-onset disaster-related psychiatric disorders, exacerbations of preexisting psychopathology, and/or psychological distress. Many (11–38%) distressed individuals presenting for evaluation have stress-related and adjustment disorders, including bereavement, major depression, and substance use disorders, and up to 40% of distressed individuals reported preexisting disorders. Referral to mental health services was more likely among individuals with more intense reactions to disaster stress. For patients with active psychiatric disorders, evidence-based treatments are available, but psychological interventions have not been sufficiently evaluated to establish their potential harm or benefit in disaster settings.

“In post-disaster settings, a systematic framework of case identification, triage, and mental health interventions should be integrated into emergency medicine and trauma care responses,” the authors write.

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