Impact of a humanmade disaster on the utilization pattern of a psychiatric emergency service

Article Abstract:

There are two opposing viewpoints concerning the mental health effects of disasters: the individual trauma view, which holds that disasters lead to lasting psychological impairment in susceptible people; and the social fabric view, which holds that disasters usually lead to only minimal psychological consequences. Research on this topic is subject to criticism on methodologic and other grounds; a brief research review is presented. One human-made disaster, the Liberty City Miami riot in May 1980, afforded an opportunity to evaluate the utilization of a psychiatric emergency service (PES) before, during, and after the crisis. This situation fulfills several important criteria for methodologically correct research on the subject of the psychiatric effects of disasters. Liberty City is 99 percent black, and virtually all medical and psychiatric care is dispensed via the public hospital, Jackson Memorial Hospital (JMH). The riot was associated with 16 deaths, 41 gunshot wounds, 21 stabbings, and 425 arrests. Analysis of data concerning presentations to the JMH psychiatric emergency service by black people revealed no differences between the rates of presentation during the week of the riot and the week prior to it; between presentations in the riot week and the following 12 weeks; or between presentations during the 12 weeks before, and 12 weeks after, the riot. No seven-day cycles in the rate of presentations were detectable, nor was the presentation pattern in 1980 different from that in 1979. The results indicate that the riot did not affect black presentations to the PES, a finding that is different from the findings of other disaster studies. Speculations about the reasons for these results are offered: one possibility is the relatively small number of deaths and absence of lost homes in the riot. The possibility of longer-term psychiatric consequences of the riot cannot be ruled out. (Consumer Summary produced by Reliance Medical Information, Inc.)

Statistics, Demonstrations and protests, Miami, Florida, Disasters, Psychiatric emergencies, Liberty, Florida

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Psychiatric disorders among poor victims following a major disaster: Armero, Columbia

Article Abstract:

Disasters are common in developing countries; in this century, 86.4 percent of all disasters occurred in such areas, causing 78 percent of all disaster-related deaths. Moreover, in developing countries, far greater numbers of people are affected in any single disaster than in the developed world. Mental health consequences of disasters are important, but services for treating mental problems are underdeveloped. In the present study, the prevalence of emotional distress was assessed in 200 adult survivors of the Armero, Columbia mudslide that completely destroyed their town. There were over 24,000 deaths and survivors had to live in tent camps. Eight months after the disaster, subjects completed the Self-Reporting Questionnaire (SRQ), designed to identify individuals with emotional problems. The results showed that emotional problems were prevalent in 55.5 percent of the victims, with the most common diagnoses posttraumatic stress disorder and major depression. Most respondents with positive results on the SRQ met diagnostic criteria for psychiatric illness. The findings indicate that screening victims for emotional problems following disasters is simply accomplished with the SRQ. The results also show that 'emotional distress' is not truly descriptive of the emotional problems suffered by victims of disasters; more accurately, these people suffer from anxiety and depressive disorders that can be treated. While mental health resources are scarce in developing countries, the relatively narrow range of psychiatric diagnoses found makes it feasible to train disaster workers in the appropriate interventions. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Colombia, South America, Psychiatric disability evaluation

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The impact of a military air disaster on the health of assistance workers

Article Abstract:

The US Army's worst peacetime air disaster occurred on December 12, 1985 in Gander, Newfoundland, Canada. A chartered airplane carrying 248 soldiers and eight crew members crashed, killing everyone on board. After the crash, Army family assistance workers were appointed to help the surviving family members of the dead soldiers. While much attention has been paid to the impact of sudden disasters on survivors and bereaved relatives, little is known about health risks to the people appointed to help them. The study attempted to identify the major areas of stress for disaster family assistance workers, explore the relation between degree of exposure to these stressors and resulting health effects, and determine risk factors and resistance resources that could mitigate the effects of such exposure. The following variables were assessed six and 12 months after the crash in 130 family-assistance workers: duration and intensity of family-helping activities, psychological well-being, psychiatric symptoms, signs of major illness, and social and personality variables. Results indicated that more severe exposure to various stressors increased the effect on well-being, psychiatric symptoms, and illness at follow-up. Social supports (work supervisors, friends, family) and the degree of personality hardiness mitigated the effects on symptoms and well-being. Results thus showed a delayed impact of stress on family assistance workers and a protective role of social supports and personality hardiness. Additional research in this area should consider the potential effects of social and situational variables and personality disposition in disaster helpers' reactions to stress.

Services, Disaster relief, Psychiatrists

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