Mental distress is common in public health emergencies
After a disaster, population rates of psychological distress tend to double or triple. Acute-phase reactions and disorders generally resolve within a year; however, there is considerable variation in recovery times.1 Subsequent to the accident at the Fukushima Daiichi Nuclear Power Plant, for example, 6% of people affected remained severely distressed 3 years after the incident.2
Prolonged exposure to war and conflict increases the prevalence of mental illness
Among people who have experienced war in the previous 10 years, 21% have a mental health disorder, and 9% meet standardized criteria for moderate or severe mental illness.3 However, focusing exclusively on psychiatric disorders overlooks a range of health risk behaviours, such as substance misuse, which is associated with increased domestic violence and accidents.1
Clinicians can focus their attention on those at risk for mental health disorders
Much of the initial distress in a population is self-limiting. Risk factors for prolonged and more intense distress include a pre-existing psychiatric disorder, poverty and inadequate housing.4 Subjective sleep insufficiency, substance overuse and poor social support are associated with more severe psychological distress.1,2
Misinformation can contribute to distress
Without access to relevant and accurate information about the disaster there is increased community distress, leading to a reduction in positive health behaviours, which can strain public health systems.1
Safety and security are first priorities
Addressing personal, family and workplace safety is fundamental to a competent response to disaster. Maintaining a regular schedule for sleep, exercise and eating helps regulate emotions. Connecting at both the individual and community level is key to optimizing health.5
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Footnotes
CMAJ Podcasts: author interview at https://soundcloud.com/cmajpodcasts/200736-five
Competing interests: None declared.
This article was solicited and has been peer reviewed.
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