- Mental health needs will change as regions evolve through the phases that follow the initial destruction: the rescue phase (in which any resources available within the community are being used), the recovery phase (in which more trained treatment for post traumatic stress disorder takes place), and the re-establishment phase (in which the public interest in the disaster community decreases).
- As worldwide interest fades, those affected by the disaster will need health services that address long-term outcomes. Studies show that survivors with a high-intensity exposure have a significant risk of prolonged and enduring traumatic injury, including a range of psychiatric disorders.
- A critical factor in the short-term response is the abandonment of many survivors and the absence of any assistance that could address mental health needs. A mental-health intervention has to do more than in other post-disaster settings.
- This kind of event creates clear distinctions between those who are affected and those who are not. The contrast between the powerful tragedy and its helpless aftermath may cause a difficulty for those who have not experienced it to understand what the survivors have gone through.
- Victims will struggle to express their experience, reflecting disruption of the neural networks that control use of language.
- In order to face their helplessness, those who intervene should tolerate the loss of control and face the sense of helplessness.
- No matter how important the mission is, it is more important to be self protective, rather than take unnecessary risks.
- Victims cannot simply get on with their lives.
- The needs of those involved in the rescue and retrieval of the dead will overwhelm support structures.
Alexander McFarlane
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Alexander McFarlane is professor of psychiatry at the University of Adelaide in Australia. He is a recognised international expert in the field of post-traumatic stress disorder and is a past president of both the International Society for Traumatic Stress Studies and the Australasian Society for Traumatic Stress Studies.
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