In times of turmoil, in which large populations are affected by factors mostly outside of their control, community-wide efforts of keeping the situation in check can take a long-lasting emotional and psychological toll. In this Special Feature, we look at the psychological aspects of disaster management.
Since the World Health Organization (WHO) declared that the new coronavirus outbreak had become a pandemic, countries around the globe have been working hard at containing the virus’s spread at a local level.
Lockdown measures in various countries have included closing down public buildings and institutions — from restaurants to gyms to museums — and asking people to remain at home and minimize or even wholly relinquish social contact with people outside their household.
Although such measures have helped slow down the spread of the new coronavirus, an increasing sense of isolation and anxiety stemming from the situation have been taking their toll on the mental health of populations around the world.
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“As the coronavirus pandemic rapidly sweeps across the world, it is inducing a considerable degree of fear, worry, and concern in the population at large,” WHO officials have noted.
In this Special Feature, we will be looking at the psychology of disaster management and offering an overview of the impact of disaster management techniques on the mental and emotional health of populations affected by disaster. We also look at strategies that research has suggested could help mitigate this impact.
But first, what is disaster management?
According to the International Federation of Red Cross and Red Crescent Societies (IFRC), “disaster management can be defined as the organization and management of resources and responsibilities for dealing with all humanitarian aspects of emergencies, in particular preparedness, response and recovery in order to lessen the impact of disasters.”
Preparedness refers to policies and resources that different countries and organizations put in place in case of a disaster.
Response refers to the actions they take to address the impact of a disaster once it does occur.
Finally, recovery refers to the process of healing that takes place after the event. This involves long-term “programs, which go beyond the provision of immediate relief,” as per the IFRC.
All of these aspects of disaster management should include provisions for safeguarding physical health, access to primary care and resources, and economic support.
But there is one more issue that plans for preparedness, response, and recovery must take into account: the psychological impact of disasters.
Disasters and their psychological impact
It comes as a given that disasters — whether of natural origins, such as earthquakes and floods, created by humans, such as wars, or due to a pandemic — will have a profound psychological impact on communities globally.
A systematic review published in Psychological Medicine in 2008 looked at different types of disasters that occurred over almost 3 decades — from 1980 to 2008. The review suggested that many people experienced post-traumatic stress disorder (PTSD).
“The evidence suggests that the burden of PTSD among populations exposed to disasters is substantial,” the authors of the review conclude.
A study published in 2015 in the Indian Journal of Psychological Medicine, indicates that the prevalence of mental health problems among people from communities affected by disasters is two to three times higher than in the general population.
Another systematic review, published in 2017 in Health Psychology Open, may explain why disasters take such a huge emotional and mental health toll on communities, despite the presence of contingency plans in countries around the world.
This review concludes that, based on existing documentation, a significant number of countries lack appropriate preparedness in terms of preventing or responding to the mental health issues that may arise following a disaster.
While “most research shows that disaster mental health consequences and disorders have been taken into consideration in many countries,” the review warns that “the available studies about disaster mental health preparedness are few, and the number of the documents related to mental health preparedness programs, models, or tools has not increased significantly in recent years.”
Among the countries most likely to be hit by natural disasters, very few — Thailand and Myanmar are examples — have developed mental health preparedness programs.
The most vulnerable groups remain the most underserved
The researchers who conducted the 2017 review also noted a particular lack of informational material aimed at the groups that are most likely to experience mental health issues in the case of a disaster.
“[W]e found a lack of information on vulnerable groups, such as children, women, people living with disabilities, and the elderly,” the researchers write.
They also note that there is not enough support for the people who would become first-line workers in the case of a disaster, such as healthcare professionals.
The importance of this brief note, in particular, becomes apparent now that current studies are emphasizing the mental and emotional strain under which doctors and nurses find themselves as they frontline the emergency response to the COVID-19 pandemic.
What are the action points?
The most important factor required to prevent or mitigate the mental health impact of a disaster as it unfolds is access to accurate, helpful information.
As part of the global response to the COVID-19 pandemic, the WHO have repeatedly advised those from affected communities to “seek information only from trusted sources […] so that you can take practical steps to prepare your plans and protect yourself and loved ones.”
Reducing the amount of stigma around seeking mental health support is also an important step.
Research published in BMC Psychology in 2019 shows that first-line responders in the United Kingdom often avoid seeking mental health support because they fear being ostracized due to the stigma associated with mental health issues.
And stigma can also be relevant in other crucial ways. In the context of the COVID-19 pandemic, the WHO have stressed that people experiencing possible symptoms of the disease may avoid reporting their health status and seeking care because they are apprehensive that their communities may reject them.
“Since the emergence of COVID-19, we have seen instances of public stigmatization among specific populations, and the rise of harmful stereotypes,” WHO officials have noted.
“[Stigmatization] means that people are being labeled, stereotyped, separated, and [may be experiencing] loss of status and discrimination because of a potential negative affiliation with the disease,” they warn. They add:
“Governments, citizens, media, key influencers, and communities have an important role to play in preventing and stopping stigma. We all need to be intentional and thoughtful when communicating on social media and other communication platforms, showing supportive behaviors around COVID-19.”
Finally, in an official briefing, the United Nations (UN) Office for the Coordination of Humanitarian Affairs (OCHA) emphasize that individuals must seek mental health support and provide solidarity to their peers. It is also vital for governments and organizations to strengthen mental health supports at every level.
In their briefing, which focusses on the context of the current pandemic, the OCHA note that:
- there must be widespread advocacy for safe and appropriate mental health services
- there must be community-based support
- basic one-to-one mental health care (provided by a person’s doctor, for instance), as well as more specialized mental health care (provided by a therapist), must be available
And for the WHO, the management of mental health conditions counts as an essential health service and is included in the operational guidelines recently published by the agency.
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