Dr. George Christodoulou, Chair of the World Psychiatric Association’s Institutional Program on Disasters and Mental Health, gave an overview of the mental health consequences of man-made and natural disasters. Many more people, he said, could be expected suffer psychological damage than were physically injured in such events. He began by discussing which survivors of disasters might be most vulnerable to psychological consequences (those directly exposed to trauma; children, adolescents and women) and the forms these consequences might take (acute stress reaction, post-traumatic stress disorder, panic attack, depression, generalized anxiety disorder, substance abuse, sleep disturbance, etc.).
The response of mental health professionals in the country that experienced the disaster should be:
- To provide advice to the government
- To provide consultation to the health authorities
- To provide mental health promotion advice to the public, with a unified viewpoint
Professionals from outside the country should contact and collaborate with the local psychiatric associations in the disaster-hit area, starting with a simple phone call to express solidarity and ask what they need.
The World Psychiatric Association has addressed the situation with a Consensus Statement on the Mental Health Implications of Disaster (August 26, 2002); educational programs and published material; and the creation of a series of task forces in response to individual disaster situations (the South Asian tsunami; hurricane Katrina; the Honduras and Guatemala disaster; the Kashmir earthquake; the Central Java disaster). The WPA Institutional Program on Disasters and Mental Health has also been working recently with psychiatric professionals in Israel, Lebanon and Palestine on the psychosocial effects of war.
Dr. Christodoulou noted that although it was highly desirable to secure scientific backing for activities, research on the appropriateness of responses to disaster situations raised profound ethical issues. It is important to work with governments and local professional associations, and not to intervene independently or solely for research purposes.
Dr. Christodoulou made the following recommendations:
- Professionals abroad should show solidarity with local colleagues responding to a disaster
- Ethical issues deserve careful attention
- Practical advance preparation for disasters should include setting up mobile mental health units with special training, and the establishment of dual functions for health centers (creating the ability of normal mental health centers to function as disaster mental health response centers in an emergency).