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Table of Contents   
LETTER TO THE EDITOR  
Year : 2015  |  Volume : 8  |  Issue : 6  |  Page : 321-323
Are we well-equipped to restore the mental health of the traumatized in emergencies?


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Chennai, Tamil Nadu, India

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Date of Web Publication20-Nov-2015
 

How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Are we well-equipped to restore the mental health of the traumatized in emergencies?. Ann Trop Med Public Health 2015;8:321-3

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Are we well-equipped to restore the mental health of the traumatized in emergencies?. Ann Trop Med Public Health [serial online] 2015 [cited 2019 Dec 8];8:321-3. Available from: http://www.atmph.org/text.asp?2015/8/6/321/162620
Dear Sir,

Globally, lives of almost 80 million people are jeopardized by the humanitarian emergencies resulting from natural disasters (cyclone Pam in Vanuatu, earthquake in Nepal, etc.) or armed conflicts (namely, Syrian Arab Republic, South Sudan, etc.). [1] It is a proven fact that prompt and sustained delivery of psychosocial support and mental health services plays a crucial role in restoring the health of the traumatized both during and after emergencies. [1],[2] In fact, the recent estimates released by the World Health Organization (WHO) suggested that close to four to eight million people worldwide suffered from a mental health condition that was secondary to a public health emergency. [1]

Mental health impairment is a very common phenomenon in the modern world, with most of the people (adults or kids or elderly) across the globe being exposed to grief, stress, and other mental disorders. [3] It is a well-acknowledged fact that a major section of people with mental illnesses have to counter the challenge of accessibility to specialized health professionals, especially in low- and middle-income nations. [4],[5] These existing gaps in the field of mental health and psychosocial support get further widened in case of an emergency. [4],[5] This is attributed to the consequences that are generally associated with an emergency-like displacement of a large number of people, massive damage to the health care establishments, interruptions in the supply of logistics including drugs, shift in the attention of the health workers toward the current emergency with minimal attention to the mental health component, breakdown of the referral system, and limited availability of specialists in the higher centers. [1],[6] Furthermore, those who already have a preexisting mental disorder (such as psychosis, intellectual impairment, and epilepsy) are much more vulnerable to the psychological ailments than their normal counterparts. [7]

Secondary to the exposure to emergency conditions, such as depressive disorder, post-traumatic stress disorder, and other mental illnesses, have been precipitated that seriously questions the ability of the person to perform routine functions. [2],[5] From the policy makers' perspective, it is very important to realize that in order to ensure restoration of mental health, prolonged psychosocial support is required. [6] There is no doubt that immediately after a disaster or such emergencies, humanitarian relief is provided by various nations or international agencies; nevertheless, this assistance is often short-lived. [8] Now, the question that arises is about what we have done to ensure restoration of mental health (that actually necessitates the implementation of a comprehensive mental health policy) after the immediate relief phase. [6],[8] This is something that all the concerned stakeholders have to respond to and work together to develop an effective response.

It is very much true that generally emergencies are associated with all types of negative things; nevertheless, from a managerial perspective, it does offer an opportunity to correct the shortcomings of the health system. [9],[10] For instance, the simultaneous presence of a team of experts from international welfare agencies and allocation of monetary support could have never been achieved under normal circumstances, especially in low-resource settings. [9],[11] Furthermore, because of the destruction of the health infrastructure due to the emergency, the stakeholders can now redesign and implement more efficient and people-centric systems of care. [9],[12] In addition, as mental health is more often than not a priority for most of the policy makers (as it does not result in acute adverse consequences), such emergency forces the stakeholders to think otherwise and even the media and emotional support from people across the globe play a crucial role in changing their mind-set. [9],[10],[11],[12]

Furthermore, realizing the massive impact of emergencies on the mental health of millions of people, the WHO in collaboration with other agencies has formulated a "Mental Health Gap Action Programme Humanitarian Intervention Guide." [1] This guide has been developed with an aim to assist the nonspecialist health workers to not only identify promptly the mental health needs but even thoroughly assess and manage the identified needs, as very often specialist services do not reach those regions where they are needed the most. [6] Simultaneously, this guide even empowers the team of health professionals to address the concern of substance abuse in emergency situations. [1],[6]

However, in order to ensure sustained benefit it is very much essential that political attention is sought and all measures are taken to integrate the mental health services with primary health care so that it can reach even the remote areas. [13],[14] Innovative approaches such as mobile health clinics in Nepal for the victims of earthquake, psychological first aid to the cases of Ebola virus disease in West Africa, and the training of nonspecialist health workers in the Syrian Arab Republic have been implemented in heterogeneous settings to address the rising concern of mental impairment. [15],[16],[17]

To conclude, in order to ensure the sustained global development it is essential to implement a strategic and comprehensive policy to address the mental health needs of the traumatized individuals in each incident of emergency. Responding to the mental health needs of people will not only improve the mental health indicator but even enhance the pace of recovery of the community from such public health emergencies.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
World Health Organization. WHO/UNHCR Issue New Guide on Mental Health in Humanitarian Emergencies; 2015. Available from: http://www.who.int/mediacentre/news/notes/2015/mental-health-in-emergencies/en/. [Last accessed on 2015 May 6].  Back to cited text no. 1
    
2.
Tol WA, Barbui C, Galappatti A, Silove D, Betancourt TS, Souza R, et al. Mental health and psychosocial support in humanitarian settings: Linking practice and research. Lancet 2011;378:1581-91.  Back to cited text no. 2
    
3.
World Health Organization. Mental Disorders - Fact Sheet No 396; 2014. Available from: http://www.who.int/mediacentre/factsheets/fs396/en/. [Last accessed on 2015 May 5].  Back to cited text no. 3
    
4.
Shrivastava SR, Shrivastava PS, Ramasamy J. Childhood and adolescence: Challenges in mental health. J Can Acad Child Adolesc Psychiatry 2013;22:84-5.  Back to cited text no. 4
    
5.
Saraceno B, van Ommeren M, Batniji R, Cohen A, Gureje O, Mahoney J, et al. Barriers to improvement of mental health services in low-income and middle-income countries. Lancet 2007; 370:1164-74.  Back to cited text no. 5
    
6.
World Health Organization. mhGAP Humanitarian Intervention Guide (mhGAP-HIG): Clinical Management of Mental, Neurological and Substance use Conditions in Humanitarian Emergencies. Geneva: WHO Press; 2015. p. 5-11.  Back to cited text no. 6
    
7.
World Health Organization. Mental Health and Development: Targeting People with Mental Health Conditions as a Vulnerable Group. Geneva: WHO Press; 2010. p. 1-5.  Back to cited text no. 7
    
8.
van Ommeren M, Saxena S, Saraceno B. Aid after disasters. BMJ 2005;330:1160-1.  Back to cited text no. 8
[PUBMED]    
9.
Jones LM, Ghani HA, Mohanraj A, Morrison S, Smith P, Stube D, et al. Crisis into opportunity: Setting up community mental health services in post-tsunami Aceh. Asia Pac J Public Health 2007;19:60-8.  Back to cited text no. 9
    
10.
Epping-Jordan JE, van Ommeren M, Ashour HN, Maramis A, Marini A, Mohanraj A, et al. Beyond the crisis: Building back better mental health care in 10 emergency-affected areas using a longer-term perspective. Int J Ment Health Syst 2015;9:15.   Back to cited text no. 10
    
11.
Eaton J, McCay L, Semrau M, Chatterjee S, Baingana F, Araya R, et al. Scale up of services for mental health in low-income and middle-income countries. Lancet 2011;378:1592-603.  Back to cited text no. 11
    
12.
Ventevogel P, van de Put W, Faiz H, van Mierlo B, Siddiqi M, Komproe IH. Improving access to mental health care and psychosocial support within a fragile context: A case study from Afghanistan. PLoS Med 2012;9:e1001225.  Back to cited text no. 12
    
13.
World Health Organization, World Organization of Family Doctors. Integrating Mental Health Into Primary Care: A Global Perspective. Geneva: WHO Press; 2008. p. 9-11.  Back to cited text no. 13
    
14.
World Health Organization. Mental Health Action Plan 2013-2020. Geneva: WHO Press; 2013. p. 1-4.  Back to cited text no. 14
    
15.
World Health Organization. Mobile Health Clinics help Tackle Post-Earthquake Mental Health Problems in Nepal; 2015. Available from: http://who.int/features/2015/mental-health-in-nepal/en/. [Last accessed on 2015 May 5].  Back to cited text no. 15
    
16.
World Health Organization, CBM, World Vision, UNICEF. Psychological First Aid for Ebola Virus Disease Outbreak. Geneva: WHO Press; 2014. p. 1-3.  Back to cited text no. 16
    
17.
World Health Organization. Syrian Arab Republic Builds Capacity for Mental Health Care during Conflict; 2015. Available from: http://who.int/features/2015/mental-health-syria-conflict/en/. [Last accessed on 2015 May 5].  Back to cited text no. 17
    

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Correspondence Address:
Saurabh RamBihariLal Shrivastava
3rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur - Guduvancherry Main Road, Sembakkam Post, Kancheepuram - 603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.162620

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