Article

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: 3.94). 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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    • "Screening procedures may allow for the rapid diagnosis of those with psychiatric disorders requiring immediate attention (e.g., delirium and psychosis) or near-term follow-up. The greatest demand for mental health providers in the immediate aftermath of major disasters may be providing intervention for those seriously mentally ill patient that have been acutely destabilized by the disaster and who have made it to medical attention, and yet less than half of potential victims actively seek out care (Rodriguez & Kohn, 2008). Reassurance and educational/supportive interventions may be sufficient for some persons seeking care. "

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    • "Results suggest that providing general social support may decrease the risk for mental health problems, but that problems with colleagues (such as conflicts, negative atmosphere, absence of appreciation) need to be targeted as well since it is an independent predictor. Many victims with severe and ongoing symptomatology or mental disorders do not or wait to seek treatment (Van derVelden 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.
    Full-text · Article · May 2014 · Psychiatry Research
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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). "
    [Show abstract] [Hide abstract]
    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.
    Full-text · Article · Jan 2014
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