Psychological and Social Scars- The Worst Scars in Disaster

When an event of disaster happens, it does not only cause physical damage to properties and lives, but it can also cause complicated mental health and psychosocial problems. One out of three survivors experiences severe stress that can lead to posttraumatic stress disorders, anxiety disorders, or depression.

Disasters can provoke specific emotional reactions that take on a variety of different psychological responses, affecting primary victims (those directly involved in the disaster) and secondary victims (such as relatives, co-workers, and schoolmates). Other people who can experience mental health issues include onlookers, rescuer, body handlers, health personnel, evacuees, and refugees.

The three forms of mental health problems that may follow a disaster are acute stress reaction, posttraumatic stress disorders (PTSDs), and adjustment disorders or enduring personality change.

Acute reactions are characterized by absence of emotion; lack of response to external stimuli; total inhibition or outward activity and random movements; persons being stunned or shocked; and psychosomatic symptoms such as tremor, palpitation, hyperventilation, nausea, and vomiting.

PTSD is defined as: An anxiety disorder (and diagnostic construct used in the Diagnostic and Statistical Manual of Mental Disorder-IV) that can develop after exposure to a terrifying event, or ordeal in which grave harm occurred or was threatened. The criteria for PTSD require:

a. Exposure to a traumatic event

b. Reexperiencing of the event (nightmares)

c. Persistent avoidance of stimuli associated with the trauma (substance use)

d. Persistent increased arousal (panic attacks, rage)

e. Duration of B, C, D of more than one month

f. Clinically significant distress or impairment (severe anxiety and/or severe depression)

The National Center for PTSD states the factors that might be protective, including social support, higher income and education, successful mastery of past disasters and traumatic events, reduction of exposure to trauma, and provision of regular and factual information about the emergency.

So what can be done by the health workers to help? Well, experts recommended some early intervention actions. It is provision of psychological help to victims and survivors within the first month after a critical incident, traumatic event, emergency, or disaster aimed at reducing the severity or duration of event related distress. This may involve psychological first aid, needs assessment, consultation, fostering resilience and natural support, and triage, as well as psychological and medical treatment.

Therefore, we as health workers should promptly evaluate the mental status of the disaster victims. The key to a successful intervention of their mental health problem is the early identification and early treatment.

References:

1. Disaster Management in Mental Health, dr. Bambang Hastha Yoga