Mental health of survivors of 1984 Bhopal disaster: A continuing challenge

Disaster and Mental Health Preparedness in India: A Scoping Review

Background: Disaster and mental health preparedness are inseparable domains highlighted during all the major disasters in India. To build Disaster-Mental health Preparedness (Disaster MHP), one has to understand the existing strategies, systemic efforts, and ground-level implementation. In this scoping review, we have analyzed the mental health preparedness efforts during major disasters in India. Methodology: We followed the Peters MDJ et al framework for scoping review named ‘Guidance for conducting systematic scoping reviews. This included the searching relevant articles on PubMed and google Scholar, and concept-context of the review. Results: The review identified major efforts taken during ten disasters in past 40 years and mapping of the potential areas for development of sustainable efforts towards Disaster MHP. Conclusion: This is the first systematic scoping review from India that provides insight into strength and sustainability of disaster mental health preparedness in India. The mapping of the review focuses on the models emerged from Bhopal, Odisha, Tamilnadu and NIMHANS for the future infrastructure, capacity building, and environment required for Disaster-MHP in India.

Mental health effects of the Gangwon wildfires

Background

The April 2019 wildfires in Gangwon Province, South Korea forced the evacuation of 1500 individuals and cost more than $100 million in damages, making it the worst wildfire disaster in Korean history. The purpose of this paper was to investigate the mental health effects on survivors following the wildfires.

Methods

Between April and May 2019, outreach psychological support services were delivered to people impacted by the wildfires. Post-disaster psychological responses using a checklist and the Clinical Global Impression Scale-Severity (CGI-S) were evaluated for 206 wildfires survivors. The CGI-S was administered consequently at 1, 3, and 6 months after baseline measurement.

Results

Among four response categories, somatic responses (76.2%) were most frequently observed among the wildfire survivors. Specifically, insomnia (59.2%), anxiety (50%), chest tightness (34%), grief (33%), flashbacks (33%), and depression (32.5%) were reported by over 30% of the participants. The mean CGI-S scores were significantly decreased at 1 month (mean score = 1.94; SE = 0.09) compared to baseline (mean score = 2.94; SE = 0.08) and remained at the decreased level until 6 months (mean score = 1.66; SE = 0.11). However, participants with flashbacks showed significantly higher CGI-S scores compared to those without flashback at 6 months.

Conclusions

Wildfire survivors have various post-disaster responses, especially somatic responses. While most participants’ mental health improved over time, a few of them may have experienced prolonged psychological distress after 6 months. Flashbacks were particularly associated with continuing distress. These results suggest that the characteristics of responses should be considered in early phase intervention and in follow-up plans for disaster survivors.

Health anxiety, coping mechanisms and COVID 19: An Indian community sample at week 1 of lockdown

It is critical to gain an understanding of the impact of the COVID 19 pandemic and the associated lockdown restrictions on the psychological, social and behavioural functioning of the general public, in order to inform public health promotion and future health service resource allocation. This cross-sectional study, completed during week 1 of lockdown in India, reports on data from 234 participants using an online survey. Data regarding health anxiety, coping mechanisms and locus of control was collected. Structural equation modelling was used to assess the relationship between locus of control, coping mechanisms, health anxiety and age. Age related differences in both locus of control and coping strategies were found. Younger people experienced more health-related anxiety and were more likely to engage with social media as a coping mechanism. Mindfulness-based strategies may reduce health anxiety by increasing tolerance of uncertainty experienced during the COVID 19 pandemic.

Learnings from conducting mental health research during 2004 tsunami in Tamil Nadu, India

Background

The Indian Ocean tsunami experience in 2004 caused a major loss of life and subsequent emotional trauma for survivors. Psychosocial needs in the aftermath of this disaster were extensive, yet the cohesion and effectiveness of response were limited due to lack of preparedness and relevant policy. The Schizophrenia Research Foundation (SCARF) was one of the organizations that quickly responded to provide psychosocial assistance to people in the tsunami affected areas and recognized a need for relevant research on disaster response. Therefore, we undertook research on the challenges, success and limitations of psychosocial interventions in alleviating post-traumatic symptomology.

Discussion

Both community-level workers and researchers were limited in their preparedness to carry out tasks related to response. Language barriers, cultural differences, and a gap in long-term services limited the breadth and scope of research that was able to be completed. Lack of policy, poor co-ordination of services, lack of trained researchers and limited resources were challenges that emerged during this period and various strategies were adopted to meet these challenges.

Conclusions

Continued research and evaluation of data has brought crucial considerations to light, including the variance in symptomology, effective tools of measurement, and the nuanced response of survivors. Future research should take relevant factors into consideration including barriers to care. Understanding of the local language and religious beliefs are significant resources in understanding the nature of survivors’ trauma response and effective means of coping. Lastly, limitations regarding time frame and scope of research should be evaluated to provide more effective, comprehensive methods in future studies.

Disaster and its impact on mental health: A narrative review

The purpose of this study is to understand the linkages between disaster and its impact on mental health. To fulfil this objective, an attempt has been made to examine the existing qualitative literature on disaster and mental health. In this paper, disaster and mental health as a concept has been used in a holistic sense. Based on the review of literature, the following broad themes have been identified: natural disaster and its impact on mental health, man-made disaster and its effect on mental health, effects of industrial disaster on mental health. It examines the post-disaster behavioural and psychological symptoms associated with an impairment in functioning. By this review, various protective factors, including resilience and other coping strategies which amplified the individual's capacity while encountering negative situations, have been identified. The effectiveness of post-disaster intervention techniques is also highlighted. Better preparedness and community empowerment can improve the condition of the vulnerable population affected by the disaster. Thus, efforts should be given for holistic rehabilitation of the affected population.

Destruction of the World Trade Center Towers. Lessons Learned from an Environmental Health Disaster

The assault and subsequent collapse of the World Trade Center towers in New York City on September 11, 2001 (9/11), released more than a million tons of debris and dust into the surrounding area, engulfing rescue workers as they rushed to aid those who worked in the towers, and the thousands of nearby civilians and children who were forced to flee. In December 2015, almost 15 years after the attack, and 5 years after first enactment, Congress reauthorized the James Zadroga 9/11 Health and Compensation Act, a law designed to respond to the adverse health effects of the disaster. This reauthorization affords an opportunity to review human inhalation exposure science in relation to the World Trade Center collapse. In this Special Article, we compile observations regarding the collective medical response to the environmental health disaster with a focus on efforts to address the adverse health effects experienced by nearby community members including local residents and workers. We also analyze approaches to understanding the potential for health risk, characterization of hazardous materials, identification of populations at risk, and shortfalls in the medical response on behalf of the local community. Our overarching goal is to communicate lessons learned from the World Trade Center experience that may be applicable to communities affected by future environmental health disasters. The World Trade Center story demonstrates that communities lacking advocacy and preexisting health infrastructures are uniquely vulnerable to health disasters. Medical and public health personnel need to compensate for these vulnerabilities to mitigate long-term illness and suffering.