1
|
Mao W, Shalaby R, Owusu E, Elgendy H, Shalaby N, Agyapong B, Nichols A, Eboreime E, Nkire N, Agyapong VIO. Status after Hospital Discharge: An Observational Study of the Progression of Patients' Mental Health Symptoms Six Weeks after Hospital Discharge. J Clin Med 2023; 12:7559. [PMID: 38137628 PMCID: PMC10744019 DOI: 10.3390/jcm12247559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/03/2023] [Accepted: 12/05/2023] [Indexed: 12/24/2023] Open
Abstract
(1) Background: Transitioning from mental health inpatient care to community care is often a vulnerable time in the treatment process where additional risks and anxiety may arise. We collected data for this study as part of a pragmatic cluster-randomized, longitudinal approach in Alberta. As the first phase of the ongoing innovative supportive program, this paper assessed the progression of mental health symptoms in patients six weeks after hospital discharge. Factors that may contribute to the presence or absence of anxiety and depression symptoms, as well as well-being, following return to the community were investigated. This provides evidence and baseline data for future phases of the project. (2) Methods: An observational study design was adopted for this study. Data on a variety of sociodemographic and clinical factors were collected at discharge and six weeks after via REDCap. Anxiety, depression, and well-being symptoms were assessed using the Generalized Anxiety Disorder (GAD-7) questionnaire, the Patient Health Questionnaire-9 (PHQ-9), and the World Health Organization-Five Well-Being Index (WHO-5), respectively. Descriptive, chi-square, independent t-tests, and multivariate regression analyses were conducted. (3) Result: The survey was completed by 88 out of 306 participants (28.8% response rate). The chi-square/Fisher exact test and independent t-test revealed no significant change in the mental health conditions from baseline to six weeks after discharge. It was found that the only significant factor predicting symptoms six weeks after discharge from inpatient treatment was the baseline symptoms in all three logistic regression models. It was four times more likely for those who experienced anxiety and depression at baseline to experience anxiety and depression symptoms six weeks after discharge (OR = 4.27; 95% CI: 1.38-13.20) (OR = 4.04; 95% CI: 1.25-13.05). Those with poor baseline well-being were almost 12 times more likely to experience poor well-being six weeks after discharge (OR = 11.75; 95% CI: 3.21-42.99). (4) Conclusions: Study results found no significant change in mental health conditions in the short term following hospital discharge. It is essential that researchers and policymakers collaborate in order to implement effective interventions to support and maintain the mental health conditions of patients following discharge.
Collapse
Affiliation(s)
- Wanying Mao
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada (N.N.)
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada (N.N.)
| | - Ernest Owusu
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada (N.N.)
| | - Hossam Elgendy
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada (N.N.)
| | - Nermin Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada (N.N.)
| | - Belinda Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada (N.N.)
| | - Angel Nichols
- Queen Elizabeth II Hospital, Alberta Health Services, Grande Prairie, AB T5J 3E4, Canada
| | - Ejemai Eboreime
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, 5909 Veterans Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS B3H 2E2, Canada;
| | - Nnamdi Nkire
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada (N.N.)
| | - Vincent I. O. Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada (N.N.)
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, 5909 Veterans Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS B3H 2E2, Canada;
| |
Collapse
|
2
|
Adu MK, Agyapong B, Agyapong VIO. Children's Psychological Reactions to Wildfires: a Review of Recent Literature. Curr Psychiatry Rep 2023; 25:603-616. [PMID: 37851204 DOI: 10.1007/s11920-023-01451-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 10/19/2023]
Abstract
PURPOSE OF REVIEW This review aims to synthesize currently available literature regarding the impact of wildfire on mental health, specifically the psychological reactions of children to wildfires. The information gathered from this review will help health experts understand and address the mental health needs of children during wildfire disasters and may serve as a base for future studies to evaluate evidence-based public health responses to mitigate adverse outcomes. RECENT FINDINGS The results identified post-traumatic stress disorder (PTSD), anxiety, depression, stress, alcohol/substance misuse, hopelessness, low resilience, reduced quality of life, and self-esteem as the psychological conditions manifesting in children and adolescent post-wildfire disaster. PTSD was the most evaluated psychological reaction in the participants (7 out of eight studies). This review highlights that deleterious mental health effects, such as PTSD, depression, anxiety, and suicidality, can persist in children for years post-wildfire disaster. Factors such as gender, direct exposure to the wildfire, re-traumatization, and resilience informed or ameliorated the severity of the impact of wildfire on children and adolescents. Our findings further emphasize the need for multi-year funding and programs to support children and adolescents' mental health, including children with disabilities in the communities that have experienced wildfire disasters.
Collapse
Affiliation(s)
- Medard K Adu
- Department of Psychiatry, Faculty of Medicine, Abbie J. Lane Memorial Building, Dalhousie University, QEII Health Sciences Centre, 5909 Veterans Memorial Lane, 8Th Floor, Halifax, NS, B3H 2E2, Canada
| | - Belinda Agyapong
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, T6G 2B7, Canada
| | - Vincent I O Agyapong
- Department of Psychiatry, Faculty of Medicine, Abbie J. Lane Memorial Building, Dalhousie University, QEII Health Sciences Centre, 5909 Veterans Memorial Lane, 8Th Floor, Halifax, NS, B3H 2E2, Canada.
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, T6G 2B7, Canada.
| |
Collapse
|
3
|
Korndörffer L, White C, Mackelprang JL. Psychological First Aid principles within a community-led arts initiative: lessons from the Blacksmiths' Tree. DISASTERS 2023; 47:806-829. [PMID: 36208417 DOI: 10.1111/disa.12564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Psychological First Aid (PFA) is widely used in the early phases of disaster recovery, despite limited empirical evidence supporting its application. PFA aims to reduce distress and encourage adaptive coping and is grounded in five principles: the promotion of hope, self- and collective efficacy, social connectedness, safety, and calm. Drawing on a constructivist perspective, this study analysed interview transcripts from Forged from Fire: The Making of the Blacksmiths' Tree, a documentary film about a community-led arts project initiated after the 2009 bushfires in Victoria, Australia. Using a reflexive process that employed deductive and inductive coding, the research investigated the presence of PFA principles in participants' experiences of the Blacksmiths' Tree project and whether themes not accounted for by PFA were also salient. The findings supported the PFA principles and generated two additional themes: grassroots and community leadership; and healing through creation and expression. The implications for disaster recovery in community settings are also presented.
Collapse
Affiliation(s)
- Lilith Korndörffer
- Master of Psychology (Clinical Psychology) Student, Department of Psychological Sciences, Swinburne University of Technology
- Bushfire Recovery Practitioner, Victorian Department of Education, Australia
| | - Carolynne White
- Participation and Co-design Manager, Mind Australia
- Adjunct Research Fellow, School of Health Sciences, Swinburne University of Technology, Australia
| | - Jessica L Mackelprang
- Senior Lecturer, Department of Psychological Sciences, Swinburne University of Technology, Australia
| |
Collapse
|
4
|
Woodland L, Ratwatte P, Phalkey R, Gillingham EL. Investigating the Health Impacts of Climate Change among People with Pre-Existing Mental Health Problems: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085563. [PMID: 37107845 PMCID: PMC10138675 DOI: 10.3390/ijerph20085563] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/02/2023] [Accepted: 03/14/2023] [Indexed: 05/11/2023]
Abstract
Climate change is the greatest threat to global public health, although the impacts on mental health are relatively understudied. Furthermore, there is a lack of consensus about the effects of climate change on individuals with pre-existing mental health problems. This review aimed to identify the health impacts of climate change on people with pre-existing mental health problems. The search was conducted across three databases; studies were included if they involved participants who had mental health problem(s) before a climate-driven event and reported on health outcomes post-event. A total of thirty-one studies met the full inclusion criteria. The study characteristics included 6 climate-driven events: heat events, floods, wildfires, wildfire and flood, hurricanes, and droughts, and 16 categories of pre-existing mental health problems, with depression, and non-specified mental health problems being the most common. The majority of the studies (90%, n = 28) suggest an association between the presence of pre-existing mental health problems and the likelihood of adverse health impacts (e.g., increased mortality risk, new symptom presentation, and an exacerbation of symptoms). To mitigate the exacerbation of health inequalities, people with pre-existing mental health problems should be included in adaption guidance and/or plans that mitigate the health impacts of climate change, future policy, reports, and frameworks.
Collapse
Affiliation(s)
- Lisa Woodland
- Department of Psychological Medicine, King’s College London, London SE5 9RJ, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King’s College London, London SE5 9RJ, UK
- Correspondence:
| | - Priyanjali Ratwatte
- Climate Change and Health Unit, UK Health Security Agency, Chilton OX11 0RQ, UK
- Behavioural Science and Insights Unit, UK Health Security Agency, Porton Down, Salisbury SP4 0JG, UK
| | - Revati Phalkey
- Climate Change and Health Unit, UK Health Security Agency, Chilton OX11 0RQ, UK
| | - Emma L. Gillingham
- Climate Change and Health Unit, UK Health Security Agency, Chilton OX11 0RQ, UK
| |
Collapse
|
5
|
Obuobi-Donkor G, Eboreime E, Shalaby R, Agyapong B, Adu MK, Owusu E, Mao W, Oluwasina F, Pazderka H, Agyapong VIO. Evaluating Community Resilience and Associated Factors One Year after the Catastrophic Fort McMurray Flood. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16153. [PMID: 36498243 PMCID: PMC9741375 DOI: 10.3390/ijerph192316153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Resilience after natural disasters is becoming an increasingly key area of research. In April 2020, parts of Fort McMurray were affected by severe floods. The flooding caused the loss of properties, evacuation of some residents, and effects on their mental health. OBJECTIVE This study explores the prevalence and associated factors between flood experience and low resilience a year after the 2020 floods in Fort McMurray. METHOD Data collection was accomplished one year after the flood, from 24 April to 2 June 2021, using an online survey. The data were analyzed with SPSS version 25 using univariate analysis with the chi-squared test and binary logistic regression analysis. RESULTS The prevalence of low resilience was 37.4%. Respondents under 25 years were nearly 26 times more likely to show low resilience (OR = 0.038; 95% CI 0.004-0.384) than respondents 40 years and above. Responders with a history of depression (OR = 0.258 95% CI: 0.089-0.744) and a history of anxiety (OR = 0.212; CI 95% 0.068-0.661) were nearly four to five times more likely to show low resilience than those without a history. Similarly, respondents willing to receive mental health counselling (OR = 0.134 95% CI: 0.047-0.378) were 7.5 times more likely to show low resilience. Participants residing in the same house before the flood were almost 11 times more likely to show low resilience (OR = 0.095; 95% CI 0.021-0.427) than those who relocated. Participants who received support from the Government of Alberta were less likely to express low resilience than those who received no or limited support (OR = 208.343; 95% CI 3.284-13,218.663). CONCLUSION The study showed a low resilience rate among respondents following the 2020 flooding in Fort McMurray. Factors contributing to low resilience include age, history of depression or anxiety, and place of residence after the flood. After the flood, receiving support from the government was shown to be a protective factor. Further studies are needed to explore robust risk factors of low resilience and measures to promote normal to high resilience among flood victims in affected communities.
Collapse
Affiliation(s)
| | - Ejemai Eboreime
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Belinda Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Medard K. Adu
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Ernest Owusu
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Wanying Mao
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Folajinmi Oluwasina
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Hannah Pazderka
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Vincent I. O. Agyapong
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| |
Collapse
|
6
|
Binet É, Ouellet MC, Lebel J, Békés V, Morin CM, Belleville G. Gender Differences in Usage and Subjective Appreciation of an Online Cognitive Behavioral Therapy for Wildfire Evacuees: Descriptive Study. J Clin Med 2022; 11:6649. [PMID: 36431126 PMCID: PMC9699434 DOI: 10.3390/jcm11226649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/03/2022] [Accepted: 11/08/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Based on the most common psychological difficulties of the evacuees from the 2016 Fort McMurray wildfires in Alberta, Canada, a therapist-guided cognitive behavioral self-treatment was developed. This study aimed to explore how gender influences the usage and subjective appreciation of the RESILIENT online treatment. METHODS Our study included 81 English-speaking evacuees with significant posttraumatic symptoms, or with some posttraumatic symptoms accompanied by at least mild depression symptoms or subclinical insomnia, and who logged into the platform at least once. Various usage and subjective appreciation variables were analyzed, including number of completed sessions, number of logins, number of words per session, perceived efforts, perception of usefulness and intention to continue using the different strategies. RESULTS No difference was detected in most objective usage indicators. The number of words written in sessions 7 and 10 was significantly greater for women than for men. Regarding subjective appreciation, men had a greater perception of having put strong efforts in the cognitive restructuring strategy, while women reported in a greater proportion that they wanted to continue using physical exercise as a behavioral activation strategy. CONCLUSIONS Our study offers a first look into how women and men use online treatments, and what their preferences are.
Collapse
Affiliation(s)
- Émilie Binet
- School of Psychology, Laval University, 2325 Rue de l’Université, Quebec, QC G1V 0A6, Canada
| | - Marie-Christine Ouellet
- School of Psychology, Laval University, 2325 Rue de l’Université, Quebec, QC G1V 0A6, Canada
| | - Jessica Lebel
- School of Psychology, Laval University, 2325 Rue de l’Université, Quebec, QC G1V 0A6, Canada
| | - Vera Békés
- Ferkauf Graduate School, Yeshiva University, 1165 Morris Park Ave, The Bronx, New York, NY 10461, USA
| | - Charles M. Morin
- School of Psychology, Laval University, 2325 Rue de l’Université, Quebec, QC G1V 0A6, Canada
| | - Geneviève Belleville
- School of Psychology, Laval University, 2325 Rue de l’Université, Quebec, QC G1V 0A6, Canada
| |
Collapse
|
7
|
Agyapong B, Shalaby R, Eboreime E, Wei Y, Agyapong VIO. Self-Reported Alcohol Abuse and the Desire to Receive Mental Health Counselling Predict Suicidal Thoughts/Thoughts of Self-Harm among Female Residents of Fort McMurray. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13620. [PMID: 36294198 PMCID: PMC9602661 DOI: 10.3390/ijerph192013620] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/11/2022] [Accepted: 10/16/2022] [Indexed: 06/16/2023]
Abstract
Suicidal ideation and thoughts of self-harm continue to be challenging public health problems. It is presently unknown what the prevalence and correlates of suicidal thoughts and self-harm are in female residents of Fort McMurray, a city that has endured wildfires, flooding, and the COVID-19 pandemic in the last five years. This study aimed to determine the prevalence and correlates of suicidal ideation and thoughts of self-harm among female residents of Fort McMurray. A cross-sectional study using an online survey questionnaire was used to collect sociodemographic and clinical information from the residents of Fort McMurray between 24 April and 2 June 2021. Suicidal ideation and thoughts of self-harm among females were assessed using the ninth question of the Patient Health Questionnaire-9, a validated screening tool used to assess depression symptoms. Likely generalized anxiety disorder (GAD), major depressive disorder (MDD), post-traumatic stress disorder (PTSD) and low resilience were measured using standardized rating scales. Data were analyzed with SPSS version 25 using chi-squared tests and multivariate logistic regression analysis. Among Fort McMurray residents, 249 accessed the online survey, while 186 ultimately completed it, yielding a survey completion rate of 74.7%. Of these, 159 (85%) were females. After controlling for other variables in the regression model, respondents who expressed a desire to receive mental health counselling were more than seven times more likely to report suicidal ideation and thoughts of self-harm compared to the respondents who did not desire to receive mental health counselling (OR: 7.29; 95% CI: 1.19-44.58). Similarly, respondents who reported having abused alcohol in the past year were nearly four times more likely to report suicidal ideation or thoughts of self-harm compared to the respondents who said they had not abused alcohol in the past year (OR: 3.91; 95% CI: 1.05-14.57). A high prevalence of suicidal thoughts and thoughts of self-harm were reported among female residents of Fort McMurray. Timely access to adequate mental health support should be offered to female residents of communities impacted by multiple natural disasters, particularly residents who self-report alcohol abuse or desire to receive mental health counselling.
Collapse
Affiliation(s)
- Belinda Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Ejemai Eboreime
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Yifeng Wei
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Vincent I. O. Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 2E2, Canada
| |
Collapse
|
8
|
Mao W, Adu M, Eboreime E, Shalaby R, Nkire N, Agyapong B, Pazderka H, Obuobi-Donkor G, Owusu E, Oluwasina F, Zhang Y, Agyapong VIO. Post-Traumatic Stress Disorder, Major Depressive Disorder, and Wildfires: A Fifth-Year Postdisaster Evaluation among Residents of Fort McMurray. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9759. [PMID: 35955114 PMCID: PMC9368448 DOI: 10.3390/ijerph19159759] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/25/2022] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
Background: Over 90,000 residents had to be evacuated from Fort McMurray (FMM), Alberta, Canada due to the wildfire that engulfed the city in May 2016. Overall, about 2400 homes or 10% of the housing stock in Fort McMurray were destroyed. The fire consumed about 200,000 hectors of forest, reaching into Saskatchewan. During major disasters, communities’ infrastructure is disrupted, and psychological, economic, and environmental effects are felt for years afterwards. Objective: Five years after the wildfire disaster, this study assessed the prevalence rate of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) in Fort McMurray residents and determined the demographic, clinical, and other risk factors of probable MDD and PTSD. Methodology: A quantitative cross-sectional survey was conducted to collect data through an online questionnaire administered via REDCap between 24 April and 2 June 2021. The Patient Health Questionnaire (PHQ-9) was used to assess the presence of MDD symptoms in respondents. The PTSD Checklist for DSM-5 (PCL-C) was used to assess likely PTSD in respondents. Descriptive, univariate, and multivariate regression analyses were employed. Results: 186 out of 249 individuals who accessed the survey link completed it (74.7% response rate). The median age of the subscribers was 42. The sample included a majority of 159 (85.5%) females; 98 (52.7%) > 40 years of age; 175 (94.1%) employed; and 132 (71%) in a relationship. The overall prevalence of MDD symptoms in our study sample was 45.0% (76). Four variables independently predicted MDD symptoms in the multivariate logistic regression model, including: unemployed (OR = 12.39; 95% CI: 1.21−126.37), have received a mental diagnosis of MDD (OR = 4.50; 95% CI: 1.57−12.92), taking sedative-hypnotics (OR = 5.27; 95% CI: 1.01−27.39), and willingness to receive mental health counseling (OR = 4.90; 95% CI: 1.95−12.31). The prevalence of likely PTSD among our respondents was 39.6% (65). Three independent variables: received a mental health depression diagnosis from a health professional (OR = 4.49; 95% CI: 1.40−14.44), would like to receive mental health counseling (OR = 4.36, 95% CI: 1.54−12.34), and have only limited or no support from family (OR = 11.01, 95% CI: 1.92−63.20) contributed significantly to the model for predicting likely PTSD among respondents while controlling the other factors in the regression model. Conclusions: According to this study, unemployment, taking sleeping pills, having a prior depression diagnosis, and the willingness to receive mental health counseling significantly increase the odds of having MDD and PTSD following wildfires. Family support may protect against the development of these conditions.
Collapse
Affiliation(s)
- Wanying Mao
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Medard Adu
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Ejemai Eboreime
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Nnamdi Nkire
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Belinda Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
- Global Psychological E-Health Foundation, Edmonton, AB T6G 2B7, Canada
| | - Hannah Pazderka
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | | | - Ernest Owusu
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Folajinmi Oluwasina
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Yanbo Zhang
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Vincent I O Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, 5909 Veterans Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS B3H 2E2, Canada
| |
Collapse
|
9
|
Evaluating the Prevalence and Predictors of Moderate to Severe Depression in Fort McMurray, Canada during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127090. [PMID: 35742346 PMCID: PMC9222250 DOI: 10.3390/ijerph19127090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/31/2022] [Accepted: 06/06/2022] [Indexed: 11/17/2022]
Abstract
Background: The Coronavirus disease (COVID-19) pandemic has produced adverse health consequences, including mental health consequences. Studies indicate that residents of Fort McMurray, a community which has experienced trauma from flooding and wildfires in the past, may be more vulnerable to the mental health effects of the pandemic. Objective: This study aimed to examine the prevalence and predictors of likely Major Depressive Disorder (MDD) among residents of Fort McMurray during the COVID-19 pandemic. Methods: A cross-sectional approach was adopted utilizing an online survey questionnaire to gather sociodemographic data, COVID-19 related data, and clinical information, including likely MDD using the Patient Health Questionnaire (PHQ-9) scale, from the residents of Fort McMurray between the period of 24 April to 2 June 2021. Results: Overall, 186 individuals completed the survey out of 249 residents who accessed the online survey, yielding a completion rate of 74.7%. The prevalence of likely MDD among respondents was 45%. Respondents willing to receive mental health counselling were five times more likely to experience MDD during the COVID-19 pandemic (OR = 5.48; 95% CI: 1.95–15.40). Respondents with a history of depression were nearly five folds more likely to report MDD during the era of the pandemic than residents without a history of depression (OR = 4.64; 95% CI: 1.49–14.44). Similarly, respondents with a history of taking hypnotics (sleeping tablets) were nearly six-fold more likely to express MDD than respondents with no history of receiving sleeping tablets (OR = 5.72; 95% CI: 1.08–30.30). Finally, respondents who reported receiving only partial support from the employer had three times higher odds of having likely MDD than those who received absolute support from the employer (OR = 3.50; 95% CI: 1.24–9.82). Conclusion: In addition to the effect of the pandemic and other measures taken to curb the psychopathological impact of the pandemic, policymakers need to implement policies to manage individuals with preexisting mental health conditions and provide strong employer support.
Collapse
|
10
|
Prevalence and Predictors of Generalized Anxiety Disorder Symptoms in Residents of Fort McMurray Five Years after the Devastating Wildfires. TRAUMA CARE 2022. [DOI: 10.3390/traumacare2020024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Natural disasters adversely impact individuals living in places where they occur, resulting in emotional distress. The wildfire that occurred in Fort McMurray (FMM), Alberta in 2016 is no different. Objective: This study aims to identify the prevalence and predictors of Generalized Anxiety Disorder (GAD) symptoms in residents of FMM five years after the devastating wildfires. Methods: Data for the study were collected through a cross-sectional survey conducted online from the 24th of April to the 2nd of June 2021. A validated instrument, the GAD-7 scale, was used to collect information on anxiety. Results: This study involved 186 residents of FMM, of which the majority were females (85.5%), employed (94.1%), working at school boards (50.0%), and were either married, cohabiting, or partnered (71.0%). The prevalence of likely GAD among the study sample was 42.5%. Unemployed respondents were seventeen times more likely to develop GAD symptoms (OR = 16.62; 95% C.I. 1.23–223.67) while respondents who would like to receive mental health counseling were five times more likely to experience GAD symptoms (OR = 5.35; 95% C.I. 2.03–14.15). Respondents who suffered a loss of property because of the wildfire were two times more likely to develop GAD symptoms (OR = 2.36; 95% C.I. 1.01–22.62). Conclusion: Policymakers may mitigate GAD symptoms, particularly after natural disasters, by making long-term mental health counseling available and a key component of post-disaster management, and by investing in the social capital of the people to build resilience and support to deal with the post-disaster mental health effects.
Collapse
|
11
|
COVID-19 Pandemic in a Vulnerable Population: Prevalence and Correlates of Anxiety. Behav Sci (Basel) 2022; 12:bs12010013. [PMID: 35049624 PMCID: PMC8772915 DOI: 10.3390/bs12010013] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/29/2021] [Accepted: 01/09/2022] [Indexed: 01/09/2023] Open
Abstract
Background: The COVID-19 pandemic has produced negative mental health outcomes. These effects were more prominent in vulnerable communities that experienced prior similar disasters. The study aimed to examine the likelihood and correlates of anxiety symptoms among Fort McMurray (FMM) residents, during the COVID-19 pandemic. Methods: A cross-sectional online survey questionnaire was applied between 24 April and 2 June 2021, at FMM, to gather sociodemographic, COVID-19, and clinical information, including generalized anxiety disorder (using GAD-7 scale). Results: Overall, 186 individuals completed the survey (response rate 74.7%). Most of the respondents were females (159, 85.5%); above 40 years (98, 52.7%); employed (175, 94.1%); and in relationship (132, 71%). The prevalence of moderate-to-severe anxiety was (42.5%, 71) on GAD-7 self-reported scale. Subscribers who reported that they would like to receive mental health support; have received no family support since COVID-19 declaration; and have lost their job during the pandemic were all more likely to report moderate-to-severe anxiety (OR = 3.39; 95% CI: 1.29–8.88), (OR = 4.85; 95% CI: 1.56–15.03), and (OR = 4.40; 95% CI: 1.01–19.24), respectively. Conclusions: Anxiety levels were high among FMM residents, compared to levels before COVID-19. Clinical and social factors significantly predicted likely anxiety in the Fort McMurray population, during the COVID-19 pandemic. It is imperative that resources are mobilized to support vulnerable communities during the COVID-19 pandemic.
Collapse
|
12
|
Pazderka H, Shalaby R, Eboreime E, Mao W, Obuobi-Donkor G, Agyapong B, Oluwasina F, Adu MK, Owusu E, Sapara A, Agyapong VIO. Isolation, Economic Precarity, and Previous Mental Health Issues as Predictors of PTSD Status in Females Living in Fort McMurray During COVID-19. Front Psychiatry 2022; 13:837713. [PMID: 35370820 PMCID: PMC8975535 DOI: 10.3389/fpsyt.2022.837713] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/17/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The COVID-19 pandemic represents an instance of collective trauma across the globe; as such, it is unique to our lifetimes. COVID-19 has made clear systemic disparities in terms of access to healthcare and economic precarity. Our objective was to examine the mental health repercussions of COVID-19 on adult females living in Fort McMurray, Canada in light of their unique circumstances and challenges. METHOD To investigate this issue, we analyzed responses gathered from an anonymous cross-section of online survey questionnaire responses gathered from females living in the Fort McMurray area (n = 159) during the COVID-19 pandemic (April 24-June 2, 2021). This included relevant demographic, mental health history, and post-traumatic stress disorder (PTSD), as well as COVID-19 data. Chi-squared analysis was used to determine outcome relevance, and binary logistic regression was employed to generate a model of susceptibility to PTSD. RESULTS 159 females completed the survey. The prevalence of putative PTSD in our sample was 40.8%. A regression analysis revealed 4 variables with significant, unique contributions to PTSD. These were: a diagnosis of depression; a diagnosis of anxiety; job loss due to COVID-19; and lack of support from family and friends. Specifically, women with a previous diagnosis of either depression or anxiety were ~4-5 times more likely to present with PTSD symptomatology in the wake of COVID-19 (OR = 3.846; 95% CI: 1.13-13.13 for depression; OR = 5.190; 95% CI: 1.42-19.00 for anxiety). Women who reported having lost their jobs as a result of the pandemic were ~5 times more likely to show evidence of probable PTSD (OR = 5.182; 95% CI: 1.08-24.85). Receiving inadequate support from family and friends made the individual approximately four times as likely to develop probable PTSD (OR = 4.258; 95% CI: 1.24-14.65), while controlling for the other variables in the regression model. CONCLUSIONS Overall, these results support our hypothesis that volatility in factors such as social support, economic stability, and mental health work together to increase the probability of women developing PTSD in response to a collective trauma such as COVID-19.
Collapse
Affiliation(s)
- Hannah Pazderka
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada.,Be Brave Ranch, Centre for Treatment of Child Sexual Abuse, Edmonton, AB, Canada
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Ejemai Eboreime
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada.,Global Psychological E-Health Foundation, Edmonton, AB, Canada
| | - Wanying Mao
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | | | - Belinda Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada.,Global Psychological E-Health Foundation, Edmonton, AB, Canada
| | | | - Medard Kofi Adu
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Ernest Owusu
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Adegboyega Sapara
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada.,Global Psychological E-Health Foundation, Edmonton, AB, Canada
| | - Vincent I O Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada.,Global Psychological E-Health Foundation, Edmonton, AB, Canada.,Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| |
Collapse
|
13
|
Agyapong B, Shalaby R, Eboreime E, Obuobi-Donkor G, Owusu E, Adu MK, Mao W, Oluwasina F, Agyapong VIO. Cumulative trauma from multiple natural disasters increases mental health burden on residents of Fort McMurray. Eur J Psychotraumatol 2022; 13:2059999. [PMID: 35599978 PMCID: PMC9116266 DOI: 10.1080/20008198.2022.2059999] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Fort McMurray, a city in northern Alberta, Canada, has experienced multiple traumatic events in the last five years, including the 2016 wildfire, the 2020 floods, and the COVID-19 pandemic. Traumatic events often lead to increased mental health burdens in affected communities. OBJECTIVE To assess if the number of traumatic events experienced by residents of Fort McMurray correlates with the prevalence and severity of mental health issues experienced. METHODOLOGY A cross-sectional study using an online survey questionnaire was used to gather demographic, trauma (wildfire, flooding, and COVID-19), and clinical information from the resident of Fort McMurray between April 24 to June 2 2021. Likely Generalized Anxiety Disorder (GAD), Major Depressive Disorder (MDD), Post-Traumatic Stress Disorder (PTSD) and low resilience were measured using standardised rating scales. Data were analyzed with SPSS version 26 using Chi-Square tests and multivariate regression analysis. RESULTS Respondents who experienced COVID-19 and either flood or wildfire traumas (N = 101) were eleven times more likely to have GAD symptoms (OR: 11.39; 95% CI: 1.43-91.04), four times more likely to have likely MDD, (OR: 3.85; 95% CI: .995-14.90), ten times more likely to have likely PTSD (OR: 10.47; 95% CI: 1.28-85.67), and low resilience (OR: 10.56; 95% CI: 1.21-92.17). Respondents who experienced COVID-19, flooding, and wildfire traumas (N = 47) were eighteen times more likely to express GAD symptoms (OR: 18.30; 95% CI: 2.20-152.45) and more than eleven times likely to have likely PTSD (OR: 11.41; 95% CI: 1.34-97.37) in comparison to the respondents who experienced COVID-19 only trauma (N = 19). CONCLUSION Measures to reduce climate change and associated natural disasters could reduce the impact of cumulative trauma and associated mental health burden in vulnerable populations. It is essential that more mental health resources are mobilised to support communities impacted by multiple natural disasters. HIGHLIGHTS The number of traumatic disasters experienced in residents of Fort McMurray five years after the 2016 wildfires, a year after the 2020 flooding, and during the COVID-19 pandemic correlates with the prevalence and severity of the mental health conditions reported in this study.
Collapse
Affiliation(s)
- Belinda Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, Canada.,Global Psychological E-Health Foundation, Edmonton, Canada
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Ejemai Eboreime
- Department of Psychiatry, University of Alberta, Edmonton, Canada.,Global Psychological E-Health Foundation, Edmonton, Canada
| | | | - Ernest Owusu
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Medard K Adu
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Wanying Mao
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | | | - Vincent I O Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, Canada.,Global Psychological E-Health Foundation, Edmonton, Canada.,Department of Psychiatry, Dalhousie University, Halifax, Canada
| |
Collapse
|
14
|
Verstraeten BSE, Elgbeili G, Hyde A, King S, Olson DM. Maternal Mental Health after a Wildfire: Effects of Social Support in the Fort McMurray Wood Buffalo Study. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2021; 66:710-718. [PMID: 33172310 PMCID: PMC8320544 DOI: 10.1177/0706743720970859] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Following disasters, perinatal women are vulnerable to developing post-traumatic stress disorder (PTSD)-like symptoms. Little is known about protective factors. We hypothesized that peritraumatic stress would predict PTSD-like symptoms in pregnant and postpartum women and would be moderated by social support and resilience. METHOD Women (n = 200) who experienced the 2016 Fort McMurray Wood Buffalo wildfire during or shortly before pregnancy completed the Peritraumatic Distress Inventory (PDI), Peritraumatic Dissociative Experiences Questionnaire, and the Impact of Event Scale-Revised for current PTSD-like symptoms. They also completed scales of social support (Social Support Questionnaire-Short Form) and resilience (Connor-Davidson Resilience Scale). RESULTS Greater peritraumatic distress (r = 0.56) and dissociative experiences (r = 0.56) correlated with more severe PTSD-like symptoms. Greater social support satisfaction was associated with less severe post-traumatic stress symptoms but only when peritraumatic distress was below average; at more severe levels of PDI, this psychosocial variable was not protective. CONCLUSIONS Maternal PTSD-like symptoms after a wildfire depend on peritraumatic distress and dissociation. Higher social support satisfaction buffers the association with peritraumatic distress, although not when peritraumatic reactions are severe. Early psychosocial interventions may protect perinatal women from PTSD-like symptoms after a wildfire.
Collapse
Affiliation(s)
| | - Guillaume Elgbeili
- 26632Douglas Mental Health University Institute, Montréal, Québec, Canada
| | - Ashley Hyde
- 12357Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Suzanne King
- Department of Psychiatry, 5620McGill University, Montréal, Québec, Canada
| | - David M Olson
- Department of Obstetrics & Gynecology, 3158University of Alberta, Edmonton, Alberta, Canada.,Department of Pediatrics, 3158University of Alberta, Edmonton, Alberta, Canada.,Department of Physiology, 3158University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
15
|
Mao W, Agyapong VIO. The Role of Social Determinants in Mental Health and Resilience After Disasters: Implications for Public Health Policy and Practice. Front Public Health 2021; 9:658528. [PMID: 34095062 PMCID: PMC8170026 DOI: 10.3389/fpubh.2021.658528] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/19/2021] [Indexed: 12/30/2022] Open
Abstract
In this general literature review, we will explore the impacts and contribution of social determinants to mental health and resiliency following both natural and man-made disasters. Natural disasters, such as wildfires, earthquakes, tsunamis, and hurricanes, as well as man-made disasters, such as civil wars, have been known to inflict significant damage to the mental health of the victims. In this paper, we mainly explore some most studied vulnerability and protective social determinant factors such as gender, age, ethnicity, socials support and socioeconomic status for the mental health and resiliency in survivors of such disasters. Several other possible factors such as previous trauma, childhood abuse, family psychiatric history, and subsequent life stress that were explored by some studies were also discussed. We conducted a literature search in major scientific databases, using keywords such as: mental health, social determinants, disasters, wildfires, earthquakes, terrorist attacks, and resilience. We discuss the implications for public health policy and practice.
Collapse
Affiliation(s)
- Wanying Mao
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Vincent I O Agyapong
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| |
Collapse
|
16
|
Binet É, Ouellet MC, Lebel J, Békés V, Morin CM, Bergeron N, Campbell T, Ghosh S, Bouchard S, Guay S, MacMaster FP, Belleville G. A Portrait of Mental Health Services Utilization and Perceived Barriers to Care in Men and Women Evacuated During the 2016 Fort McMurray Wildfires. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2021; 48:1006-1018. [PMID: 33641027 PMCID: PMC7914389 DOI: 10.1007/s10488-021-01114-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2021] [Indexed: 02/07/2023]
Abstract
This study examines the influence of gender on mental health services utilization and on perceived barriers to treatment one year after the 2016 Fort McMurray wildfires. Data was collected through a phone survey from May to July 2017 (N = 1510). Participants were English-speaking evacuees aged 18 and older. Mental health services utilization and barriers to mental health care were assessed with the Perceived Need for Care questionnaire. Probable diagnoses of posttraumatic stress disorder, depression and insomnia were assessed with validated self-report questionnaires. Multiple logistic regressions confirmed that gender was a significant predictor of services utilization, after controlling for associated sociodemographic variables and presence of probable diagnoses. Women were respectively 1.50, 1.55 and 1.86 times more likely than men to receive information, medication and psychological help. Self-reliance was the most frequently reported reason for not receiving help, and motivational barriers, such as pessimism and stigma, were reported in a higher proportion than structural barriers, including nonresponse and finance. No significant gender differences were found in the types of perceived barriers to services. Among the Fort McMurray fire evacuees, mental health services utilization was similar to other studies on natural disaster victims, and higher in women than in men. Efforts to increase services utilization in natural disaster victims should focus on motivational barriers and offering treatments fostering people's autonomy, such as online treatments.
Collapse
Affiliation(s)
- Émilie Binet
- School of Psychology, Université Laval, Québec, QC, Canada
| | | | - Jessica Lebel
- School of Psychology, Université Laval, Québec, QC, Canada
| | - Vera Békés
- Ferkauf Graduate School of Psychology, Yeshiva University, New York City, NY, USA
| | | | - Nicolas Bergeron
- Department of Psychiatry and Addiction, Université de Montréal, Montréal, QC, Canada
| | - Tavis Campbell
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | | | - Stéphane Bouchard
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, QC, Canada
| | - Stéphane Guay
- Department of Psychiatry and Addiction, Université de Montréal, Montréal, QC, Canada
| | | | | |
Collapse
|
17
|
Moore A, van Loenhout JAF, de Almeida MM, Smith P, Guha-Sapir D. Measuring mental health burden in humanitarian settings: a critical review of assessment tools. Glob Health Action 2020; 13:1783957. [PMID: 32657249 PMCID: PMC7480646 DOI: 10.1080/16549716.2020.1783957] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 06/03/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The effects of disasters and conflicts are widespread and heavily studied. While attention to disasters' impacts on mental health is growing, mental health effects are not well understood due to inconsistencies in measurement. OBJECTIVE The purpose of this study is to review mental health assessment tools and their use in populations affected by disasters and conflicts. METHOD Tools that assess posttraumatic stress disorder, depression, substance use disorder, and general mental health were examined. This review began with a search for assessment tools in PubMed, PsycINFO, and Google Scholar. Next, validation studies for the tools were obtained through snowball sampling. A final search was conducted for scientific studies using the selected tools in humanitarian settings to collect the data for analysis. The benefits and limitations described for each tool were compiled into a complete table. RESULTS Twelve assessment tools were included, with 88 studies using them. The primary findings indicate that half of the studies used the Impact of Events Scale-Revised. The most common limitation discussed is that self-report tools inaccurately estimate the prevalence of mental health problems. This inaccuracy is further exacerbated by a lack of cultural appropriateness of the tools, as many are developed for Western contexts. CONCLUSION It is recommended that researchers and humanitarian workers reflect on the effectiveness of the mental health assessment tool they use to accurately represent the populations under study in emergency settings. In addition, mental health assessment should be coupled with action.
Collapse
Affiliation(s)
- Ashley Moore
- Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, CT, USA
| | - Joris Adriaan Frank van Loenhout
- Centre for Research on the Epidemiology of Disasters (CRED), Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
| | - Maria Moitinho de Almeida
- Centre for Research on the Epidemiology of Disasters (CRED), Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
| | - Pierre Smith
- Institute of Health and Society IRSS, Université Catholique de Louvain, Brussels, Belgium
| | - Debarati Guha-Sapir
- Centre for Research on the Epidemiology of Disasters (CRED), Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
| |
Collapse
|
18
|
Hrabok M, Delorme A, Agyapong VIO. Threats to Mental Health and Well-Being Associated with Climate Change. J Anxiety Disord 2020; 76:102295. [PMID: 32896782 DOI: 10.1016/j.janxdis.2020.102295] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 08/02/2020] [Accepted: 08/10/2020] [Indexed: 01/16/2023]
Abstract
Climate change is a contributor to extreme weather events and natural disasters. The mental health effects of climate change are multifaceted, with post-traumatic stress disorder and depression predominant. This paper aims to describe the impact of climate change on mental health conditions, including risk and protective factors related to the expression of mental health conditions post-disaster, as well as a discussion of our local experience with a devastating wildfire to our region within Canada. The risk of the development of mental health conditions post-disaster is not equally distributed; research has consistently demonstrated that specific risk factors (e.g., gender, socioeconomic status and education, pre-existing mental health symptomatology), are associated with increased vulnerability to mental health conditions following natural disasters. There are multiple strategies that must be undertaken by communities to enhance adjustment and coping post-disaster, including improved access to care, inter-agency cooperation, enhanced community resiliency, and adequate preparation.
Collapse
Affiliation(s)
- Marianne Hrabok
- Dission of Community Psychiatry, Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Aaron Delorme
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Vincent I O Agyapong
- Dission of Community Psychiatry, Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
| |
Collapse
|
19
|
Généreux M, Schluter PJ, Hung KKC, Wong CS, Pui Yin Mok C, O’Sullivan T, David MD, Carignan ME, Blouin-Genest G, Champagne-Poirier O, Champagne É, Burlone N, Qadar Z, Herbosa T, Ribeiro-Alves G, Law R, Murray V, Chan EYY, Pignard-Cheynel N, Salerno S, Lits G, d’Haenens L, Coninck DD, Matthys K, Roy M. One Virus, Four Continents, Eight Countries: An Interdisciplinary and International Study on the Psychosocial Impacts of the COVID-19 Pandemic among Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8390. [PMID: 33202706 PMCID: PMC7697775 DOI: 10.3390/ijerph17228390] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 10/25/2020] [Accepted: 10/28/2020] [Indexed: 01/05/2023]
Abstract
The novel coronavirus disease 2019 (COVID-19) pandemic brought about several features that increased the sense of fear and confusion, such as quarantine and financial losses among other stressors, which may have led to adverse psychosocial outcomes. The influence of such stressors took place within a broader sociocultural context that needs to be considered. The objective was to examine how the psychological response to the pandemic varied across countries and identify which risk/protective factors contributed to this response. An online survey was conducted from 29 May 2020-12 June 2020, among a multinational sample of 8806 adults from eight countries/regions (Canada, United States, England, Switzerland, Belgium, Hong Kong, Philippines, New Zealand). Probable generalized anxiety disorder (GAD) and major depression episode (MDE) were assessed. The independent role of a wide range of potential factors was examined using multilevel logistic regression. Probable GAD and MDE were indicated by 21.0% and 25.5% of the respondents, respectively, with an important variation according to countries/regions (GAD: 12.2-31.0%; MDE: 16.7-32.9%). When considered together, 30.2% of the participants indicated probable GAD or MDE. Several factors were positively associated with a probable GAD or MDE, including (in descending order of importance) weak sense of coherence (SOC), lower age, false beliefs, isolation, threat perceived for oneself/family, mistrust in authorities, stigma, threat perceived for country/world, financial losses, being a female, and having a high level of information about COVID-19. Having a weak SOC yielded the highest adjusted odds ratio for probable GAD or MDE (3.21; 95% confidence interval (CI): 2.73-3.77). This pandemic is having an impact on psychological health. In some places and under certain circumstances, however, people seem to be better protected psychologically. This is a unique opportunity to evaluate the psychosocial impacts across various sociocultural backgrounds, providing important lessons that could inform all phases of disaster risk management.
Collapse
Affiliation(s)
- Mélissa Généreux
- Department of Community Health Sciences, Faculty of Medicine & Health Sciences, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
| | - Philip J. Schluter
- School of Health Sciences, University of Canterbury-Te Whare Wananga o Waitaha, Christchurch 8140, New Zealand;
| | - Kevin KC Hung
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response, JC School of Public Health and Primary Care, Chinese University of Hong Kong, Ngan Shing Street 30-32, Hong Kong SAR, China; (K.K.H.); (C.S.W.); (C.P.Y.M.); (E.Y.Y.C.)
| | - Chi Shing Wong
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response, JC School of Public Health and Primary Care, Chinese University of Hong Kong, Ngan Shing Street 30-32, Hong Kong SAR, China; (K.K.H.); (C.S.W.); (C.P.Y.M.); (E.Y.Y.C.)
| | - Catherine Pui Yin Mok
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response, JC School of Public Health and Primary Care, Chinese University of Hong Kong, Ngan Shing Street 30-32, Hong Kong SAR, China; (K.K.H.); (C.S.W.); (C.P.Y.M.); (E.Y.Y.C.)
| | - Tracey O’Sullivan
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 7K4, Canada;
| | - Marc D. David
- Département de communication, Faculté des Lettres et Sciences Humaines, Université de Sherbrooke, Sherbrooke, QC J1K 2R1, Canada; (M.D.D.); (M.-E.C.); (O.C.-P.)
| | - Marie-Eve Carignan
- Département de communication, Faculté des Lettres et Sciences Humaines, Université de Sherbrooke, Sherbrooke, QC J1K 2R1, Canada; (M.D.D.); (M.-E.C.); (O.C.-P.)
| | - Gabriel Blouin-Genest
- School of Applied Politics, Faculté des Lettres et Sciences Humaines, Université de Sherbrooke, Sherbrooke, QC J1K 2R1, Canada;
| | - Olivier Champagne-Poirier
- Département de communication, Faculté des Lettres et Sciences Humaines, Université de Sherbrooke, Sherbrooke, QC J1K 2R1, Canada; (M.D.D.); (M.-E.C.); (O.C.-P.)
| | - Éric Champagne
- School of Political Studies, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario K1N 6N5, Canada; (É.C.); (N.B.)
| | - Nathalie Burlone
- School of Political Studies, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario K1N 6N5, Canada; (É.C.); (N.B.)
| | - Zeeshan Qadar
- National Collaborating Centre for Infectious Diseases, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0T5, Canada;
| | - Teodoro Herbosa
- Department of Emergency Medicine, College of Medicine, University of Philippines, Manille Grand Manille 1000, Philippines;
| | | | - Ronald Law
- Department of Health, Manila, Manille 2932, Philippines;
| | | | - Emily Ying Yang Chan
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response, JC School of Public Health and Primary Care, Chinese University of Hong Kong, Ngan Shing Street 30-32, Hong Kong SAR, China; (K.K.H.); (C.S.W.); (C.P.Y.M.); (E.Y.Y.C.)
| | | | - Sébastien Salerno
- Université de Genève, Boulevard du Pont-d’Arve 40, 1205 Genève, Switzerland;
| | - Grégoire Lits
- Institut Langage et Communication, Université catholique de Louvain, 1348 Louvain-la-Neuve, Belgium;
| | - Leen d’Haenens
- Institute for Media Studies, KU Leuven, 3000 Leuven, Belgium;
| | - David De Coninck
- Centre for Sociological Research, KU Leuven, 3000 Leuven, Belgium; (D.D.C.); (K.M.)
| | - Koenraad Matthys
- Centre for Sociological Research, KU Leuven, 3000 Leuven, Belgium; (D.D.C.); (K.M.)
| | - Mathieu Roy
- Department of Family Medicine & Emergency Medicine, Faculty of Medicine & Health Sciences, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada;
| |
Collapse
|
20
|
Agyapong VIO, Ritchie A, Brown MRG, Noble S, Mankowsi M, Denga E, Nwaka B, Akinjise I, Corbett SE, Moosavi S, Chue P, Li XM, Silverstone PH, Greenshaw AJ. Long-Term Mental Health Effects of a Devastating Wildfire Are Amplified by Socio-Demographic and Clinical Antecedents in Elementary and High School Staff. Front Psychiatry 2020; 11:448. [PMID: 32528323 PMCID: PMC7265240 DOI: 10.3389/fpsyt.2020.00448] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 05/04/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To assess the likely prevalence rates of Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD) and Post-Traumatic Stress Disorder (PTSD) in staff of Fort McMurray School Districts eighteen months after a May 2016 wildfire, and to determine possible predictors. METHODS A quantitative cross-sectional survey was used to collect data through self-administered online questionnaires to determine likely MDD, GAD and PTSD using well validated self-report questionnaires. RESULTS Of 1,446 staff who were sent the online survey link in an e-mail, 197 completed the survey, of which there were 168 females (85%) and 29 males (15%). The one-month prevalence rates for likely MDD, GAD and PTSD among the school staff were 18.3, 15.7 and 10.2% respectively. There were statistically significant associations between multiple socio-demographic and clinical variables likely MDD, GAD and PTSD among respondents. CONCLUSION Knowledge of key factors for MDD, GAD and PTSD may be helpful for policy makers when formulating population level social and clinical programs, to mitigate the mental health effects of future natural disasters.
Collapse
Affiliation(s)
- Vincent I O Agyapong
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | | | - Matthew R G Brown
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.,Department of Computing Science, Faculty of Science, University of Alberta, Edmonton, AB, Canada
| | - Shannon Noble
- Fort McMurray Public School District, Fort McMurray, AB, Canada
| | - Monica Mankowsi
- Fort McMurray Catholic School District, Fort McMurray, AB, Canada
| | - Edward Denga
- Department of Family Medicine, Faculty of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Bernard Nwaka
- Department of Family Medicine, Faculty of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Idowu Akinjise
- Department of Family Medicine, Faculty of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Sandra E Corbett
- Department of Psychiatry, Northern Lights Regional Health Centre, Fort McMurray, AB, Canada
| | - Shahram Moosavi
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Pierre Chue
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Xin-Min Li
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Peter H Silverstone
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Andrew J Greenshaw
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| |
Collapse
|
21
|
Moosavi S, Nwaka B, Akinjise I, Corbett SE, Chue P, Greenshaw AJ, Silverstone PH, Li XM, Agyapong VIO. Mental Health Effects in Primary Care Patients 18 Months After a Major Wildfire in Fort McMurray: Risk Increased by Social Demographic Issues, Clinical Antecedents, and Degree of Fire Exposure. Front Psychiatry 2019; 10:683. [PMID: 31620033 PMCID: PMC6760025 DOI: 10.3389/fpsyt.2019.00683] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 08/23/2019] [Indexed: 11/13/2022] Open
Abstract
Objectives: To assess prevalence of likely posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD) in patients attending the only out-of-hours primary care clinic in Fort McMurray some 18 months following a major fire. Methods: A quantitative cross-sectional survey was used to collect data through self-administered paper-based questionnaires to determine likely PTSD, MDD, and GAD using the PTSD Checklists for Diagnostic and Statistical Manual (DSM) 5, Patient Health Questionnaire (PHQ) 9, and GAD-7, respectively, from residents of Fort McMurray who were impacted by the wildfires. This was carried out eighteen (18) months after a major wildfire, which required the rapid evacuation of the entire city population (approximately 90,000 individuals). Results: We achieved a response rate of 48% and results from the 290 respondents showed the 1 month prevalence rate for likely PTSD was 13.6%, likely MDD was 24.8%, and likely GAD was 18.0%. Compared to self-reported prevalence rates before the wildfire (0%, 15.2%, and 14.5% respectively), these were increased for all diagnoses. After controlling for other factors in a logistic regression model, there were statistically significant associations between individuals who had likely PTSD, MDD, and GAD diagnoses and multiple socio-demographic, clinical, and exposure-related variables as follows: PTSD: History of anxiety disorder and received counselling had odds ratios (ORs) of 5.80 and 7.14, respectively. MDD: Age, witnessed the burning of homes, history of depressive disorder, and receiving low level support from friends and family had ORs of 2.08, 2.29, 4.63, and 2.5, respectively. GAD: Fearful for their lives or the lives of friends/family, history of depressive disorder, and history of anxiety disorder had ORs of 3.52, 3.04, and 2.68, respectively. There were also associations between individuals with a likely psychiatric diagnosis and those who also had likely alcohol or drug abuse/dependence. Conclusion: Our study suggests there are high prevalence rates for mental health and addiction conditions in patients attending the out-of-hours clinic 18 months after the wildfires, with significant associations between multiple variables and likely PTSD, MDD, and GAD. Further studies are needed to explore the impact of population-based mental health interventions on the long-term mental health effects of the wildfires.
Collapse
Affiliation(s)
- Shahram Moosavi
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Bernard Nwaka
- Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Idowu Akinjise
- Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Sandra E. Corbett
- Department of Psychiatry, Northern Lights Regional Health Centre, Fort McMurray, AB, Canada
| | - Pierre Chue
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Andrew J. Greenshaw
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Peter H. Silverstone
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Xin-Min Li
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Vincent I. O. Agyapong
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| |
Collapse
|
22
|
Kaniasty K. Social support, interpersonal, and community dynamics following disasters caused by natural hazards. Curr Opin Psychol 2019; 32:105-109. [PMID: 31445427 DOI: 10.1016/j.copsyc.2019.07.026] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 07/04/2019] [Accepted: 07/10/2019] [Indexed: 12/23/2022]
Abstract
The most essential, and possibly the most reliably present, characteristic of all disasters is that they exert strong impact on social relationships. Two very different, at times conflicting, dynamic processes emerge in their aftermath: the initial outpouring of immense mutual helping and solidarity, followed by a subsequent sense of loss in the quality of interpersonal and community relationships. This review of recent findings in the area of disaster mental health confirmed two major patterns of social support dynamics following disastrous events resulting from natural hazards: a mobilization of received social support and deterioration of perceived social support and sense of community. Social support is a critical resource helping people cope with natural disasters. Its psychologically and socially protective functions for survivors and their communities unfold in a complex matrix of benefits and liabilities.
Collapse
Affiliation(s)
- Krzysztof Kaniasty
- Indiana University of Pennsylvania, Indiana, PA 15705, USA; Polish Academy of Sciences, Warsaw, Poland.
| |
Collapse
|
23
|
Agyapong VIO, Juhas M, Omege J, Denga E, Nwaka B, Akinjise I, Corbett SE, Brown M, Chue P, Li XM, Greenshaw A. Prevalence Rates and Correlates of Likely Post-Traumatic Stress Disorder in Residents of Fort McMurray 6 Months After a Wildfire. Int J Ment Health Addict 2019. [DOI: 10.1007/s11469-019-00096-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
|