Psychological problems are expected after the recent earthquake and tsunami in Japan. In the past American psychiatrists with experience in disaster psychiatry have offered assistance to colleagues in other countries who are dealing with a catastrophic event and it is expected that this will occur with the current incident. In the initial phase psychological first aid will be given to the survivors and then symptoms of acute stress will be addressed. Between 10-50% of those impacted can be expected to develop symptoms of post traumatic stress disorder. Expertise in risk communication will also be helpful in dealing with the task of informing the public. This becomes especially relevant with the threat of radiation contamination from damaged nuclear reactors.
More than 150,000 people have died in the recent devastating earthquake in Haiti. There is fear, anxiety, depression and tremendous psychological pain. The uncertainty about the future will intensify these emotional reactions. Most likely the initial help by mental health professionals will be to assist the stunned people in getting food, shelter and information about the whereabouts of their loved ones. Psychiatrists may write prescriptions for general medical conditions or even assist in emergency surgery. There also is a need for the authorities to provide “risk communication” of truthful information. Death notifications need to be done skillfully. Mental health professionals can be helpful in training for these tasks. In the immediate aftermath of a disaster, people may deny the reality of what has happened. There will be grieving by survivors for the many people who perished. Grief after unexpected violent death especially when it includes children can be prolonged and complicated with additional emotional problems including alcohol and drug problems. At least half of the survivors will have some symptoms of PTSD. There are various forms of mental health interventions which may be helpful. The psychological effect of such a disaster can also impact on the secondary victims which include all rescue and medical personnel as well as members of the media. Psychiatrists and other mental health professionals will play an important role in helping the people of Haiti to recover from this ordeal.
After recently moving to California and experiencing a mild earthquake I decided to obtain an extra month supply of prescription medication for my family and myself as this is recommended for disaster preparedness. I found out that this is a very difficult thing to do and furthermore most insurance companies won’t pay for it. Experts working in disasters know that people frequently don’t have access to their everyday medications. While there may be some exceptions such as concern about addiction or suicidal tendencies, most people should have the ability to obtain an extra month supply of their medication above that which is usually prescribed for them. The author co-authored a resolution at the Assembly of the American Psychiatric Association that would have this organization work with other medical groups and interested parties to advocate that laws and regulations be changed to allow individuals to have extra medication on hand for emergencies and disasters. The readers of this blog were asked to check the situation where they live in the U.S. or internationally in regard to this problem and to report in the comment section of this blog.