Use of mental health services among disaster survivors

Mental Health, Substance Abuse and Rehabilitation, Technology and Health Services Delivery, Pan American Health Organization, Washington, DC 20037, USA.
Current opinion in psychiatry (Impact Factor: 3.55). 07/2008; 21(4):370-8. DOI: 10.1097/YCO.0b013e328304d984
Source: PubMed

ABSTRACT A sizable proportion of individuals following a disaster develop mental health problems. The consequences of these disorders can be long lasting. Only recently has research focused on mental health service delivery following disasters. This review examines the rates, predictors, and barriers to mental health service utilization following a disaster.
Most of the data on mental health service delivery come from three sources: a fireworks disaster in The Netherlands, the September 11, 2001, attack on New York City, and hurricane Katrina. Most survivors of disasters are reluctant to utilize mental health services and face barriers to accessing care. Even among disaster victims who are severely mentally ill, only a minority receive treatment. Among those who do receive assistance, more than half drop out shortly thereafter. Mental health service utilization following a disaster is influenced by a set of predisposing characteristics, enabling resources, and perceived need. The model for mental healthcare delivery following a disaster that has gained acceptance is Psychological First Aid.
Research is evolving on mental health service utilization. It is limited however to developed countries, although most disasters occur in developing countries. More research is needed, particularly among populations with scarce resources.

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    • "Many victims with severe and ongoing symptomatology or mental disorders do not or wait to seek treatment (Van der Velden et al., 2007; Rodrigues and Kohn, 2008). In this perspective and because of relatively low costs, online self-screening for posttraumatic stress symptoms is becoming popular (Donker et al., 2009; Winwood et al., 2009; Vetter et al., 2011). "
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    ABSTRACT: Social organizational stressors are well-known predictors of mental health disturbances (MHD). However, to what extent these stressors predict post-disaster MHD among employed victims hardly received scientific attention and is clearly understudied. For this purpose we examined to what extent these stressors independently predict MHD 1.5 years post-disaster over and above well-known risk factors such as disaster exposure, initial MHD and lack of general social support, life-events in the past 12 months and demographics (N=423). Exposure, social organizational stressors and support were significantly associated with almost all examined mental health disturbances on a bi-variate level. Multivariate logistic regression analyses showed that these stressors, i.e. problems with colleagues, independently predicted anxiety (Adj. OR=5.93), depression (Adj. OR=4.21), hostility (Adj. OR=2.85) and having two or more mental health disturbances (Adj. OR=3.39) in contrast to disaster exposure. Disaster exposure independently predicted symptoms of PTSD symptoms (Adj. OR=2.47) and agoraphobia (Adj. OR=2.15) in contrast to social organizational stressors. Importantly, levels of disaster exposure were not associated nor correlated with (levels of) social organizational stressors. Findings suggest that post-disaster mental health care programs aimed at employed affected residents, should target social organizational stressors besides disaster-related stressors and lack of general social support. © 2014 Elsevier Ireland Ltd. All rights reserved.
    Psychiatry Research 05/2014; 219:177–182. DOI:10.1016/j.psychres.2014.05.032 · 2.68 Impact Factor
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    • "La maggior parte degli studi che forniscono informazioni sull'utilizzazione dei servizi di salute mentale in seguito a disastri si sono limitati ad esaminare i tassi di utilizzazione nelle vittime, ma non tra coloro che precedentemente utilizzavano i servizi di salute mentale . Gli studi di utilizzazione dei servizi possono essere quindi divisi in quelli che esaminano l'uso dei servizi di salute mentale tra le vittime dirette e quelli che esaminano l'uso dei servizi di salute mentale nella comunità colpita (Rodriguez & Kohn, 2008). "
    Epidemiology and Psychiatric Sciences 03/2012; 21(1):1-5. DOI:10.1017/S2045796011000813 · 3.36 Impact Factor
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    • "Psychological First Aid (PFA) is defi ned as " the provision of a supportive and compassionate presence designed to enhance natural resilience and coping, while facilitating access to continued care, if necessary " (Everly & Flynn, 2006; Parker, Barnett, et al.,2006). PFA is an extension of caring and focuses on the immediate biopsychosocial needs and fi ve principles of crisis intervention: safety, calming, connectedness , self-effi cacy, and hope, while building an action plan of recovery (Corrarino, 2008; Hobfoll et al., 2007; Maunder et al., 2008; Rodriguez & Kohn, 2008). While utilizing PFA to address the mental health needs of survivors, public health practitioners will personally benefi t from its intervention, enhancing their own well-being and perception of safety, both physically and psychologically (Everly, Smith, & Welzant, 2008; Everly, Welzant, & Jacobson, 2008; Maunder et al., 2008; Parker, Everly, et al., 2006; Shubert et al., 2008). "
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    ABSTRACT: Disaster mental health research has found that psychological casualties from a given disaster can be expected to far outnumber physical casualties. Amidst a shortage of mental health professionals and against the backdrop of natural disasters, continued terrorism, and pandemic influenza, there is a striking need to expand and operationalize available human resources to enhance the psychological resiliency of those affected. Through the utilization of psychological first aid (PFA) as an early crisis intervention tool, and by virtue of their occupation and experience, nurses are particularly well-suited to assume a leadership role in expanding the disaster mental health presence beyond the existing cadre of mental health clinicians. Here, we characterize the importance of integrating PFA in the context of other nursing functions, to augment mental health surge capacity in disaster settings.
    International journal of emergency mental health 01/2010; 12(1):21-31.


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