Mental Health Emergencies and Post-Traumatic Stress Disorder
By Dr. Siddharth Ashvin Shah, CEO and Founder, Greenleaf Integrative
Adapted from a chapter in Emergency Public Health:
Shah, S.A. (2010). Mental Health Emergencies and Post-Traumatic Stress Disorder. In G.B. Kapur & J.P. Smith (Eds.) Emergency Public Health: Preparedness and Response (pp. 493-516). Boston: Jones and Bartlett Publishers.
Abstract
From a public health perspective, complex emergencies and large-scale disasters produce enormous and multi-faceted mental health morbidity. Individuals will encounter symptoms of emotional distress that are primarily non-pathologic (in contrast to psychiatric illness) but, at the same time, worthy of emergency attention. However, much of the suffering that is deemed “mental” is missed, overlooked, or deferred indefinitely due to a focus on physical injuries (dialogue at Global Mental Health Discussion Group, World Bank, Nov 2009). Within psychiatry, the DSM-IV-TR defines a traumatic event as one in which a person is confronted with a significant threat and the person’s response to that threat involves “intense fear, helplessness or horror.” A broader, more working, definition of “trauma” is a stressor that overwhelms an individual’s capacity to respond and cope adaptively. In Western societies, although wide consensus exists about post-traumatic stress (PTSD) disorder being the most identifiable posttraumatic sequela, the health professional evaluating traumatized populations should have a differential diagnosis breadth that includes the following mental health morbidities: generalized anxiety disorder, panic disorder, major depression, complicated grief, acute stress disorder (thought to have predictive power of long-term morbidity), substance abuse, somatoform disorders, poor physical health, multiple idiopathic physical symptoms (or “MUS,” medically unexplained symptoms), arrest or regression of childhood developmental progression, behavioral changes, work and relationship disturbances, including family conflict. This chapter provides a “best practices” framework for selecting and applying mental health interventions for public health emergencies. It outlines the preparedness, intervention, and mitigation strategies for proactive and systematic emergency mental health response. (Download PDF to continue reading)
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