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Covering both natural and man-made scenarios including war and terrorism, the Textbook of Disaster Psychiatry is a vital international reference for medical professionals, community leaders and disaster responders a decade after its initial publication. Spanning a decade of advances in disaster psychiatry, this new and updated second edition brings together the views of current international experts to offer a cutting-edge comprehensive review of the psychological, biological and social responses to disaster, in order to help prepare, react and aid effective recovery. Topics range from the epidemiology of disaster response, disaster ecology, the neurobiology of disaster exposure, to socio-cultural issues, early intervention and consultation-liaison care for injured victims. The role of non-governmental organizations, workplace policies and the implications for public health planning at both an individual and community level are also addressed.
Although childhood trauma and family adversity can increase vulnerability to serious mental health problems, uncertainty exists about the nature and prevalence in a clinical population. This embedded research aims to establish the prevalence of trauma and adversity in young people seeking help from Child and Adolescent Mental Health Services (CAMHS). All children, adolescents, and their parents/guardian attending their initial assessment at a CAMHS service were invited to participate in the ‘Stressful Life and Family Difficulties study’ and a clinical interview. 162 families participated in the study. It was more common for young people to experience multiple adversities (three or more) in the last 12 months than single events. Mothers self-reported a greater number of family adversities than fathers. According to clinicians, the most frequent adversities experienced by young people were having a parent with a mental illness (66%), being bullied (63%) and parental divorce or separation (43%). Overall, clinicians reported that 69% of CAMHS clients had experienced a potentially traumatic experience (any physical, emotional or sexual abuse, child neglect or traumatic event). Moreover, young people with trauma histories were significantly more likely to have a parent with a history of trauma.
In reviewing the development of mental health interest in and research about disasters, there are many seminal studies and publications, building progressively in their contributions to the science of disaster field. The field of disaster mental health research emerged from inquiries into the phenomena associated with the mental health impacts of war. Mental health aspects of disasters became a more specific focus during the 1970s and 1980s. Interventions have been a focus of review in terms of current knowledge, effective models, and the need for research and evaluation of interventions that are provided. Resilience has long been recognized by trauma experts, though they acknowledge it may coexist with painful emotional scars. Researchers across the globe have contributed to the expanding science of disaster mental health. A number of studies focused on the stressor components, particularly those related to psychological trauma and posttraumatic stress disorder (PTSD).
The objective of this preliminary study was to evaluate the perceptions of internationally deployed Disaster Medical Assistance Team (DMAT) personnel regarding the psychosocial support needs of these teams.
The DMAT questionnaire was sent to 34 members of Australian medical teams involved in deployments to the 2004 Southeast Asian tsunami and the 2006 Java earthquake. Twenty personnel (59%) completed this survey, which reviewed key deployment stressors, specific support strategies, and the support needs of team members, their families, and team leaders. A key aspect of the survey was to determine whether the perceived psychosocial needs would be supported best within with existing provisions and structures, or if they would be enhanced by further provisions, including the deployment of mental health specialists.
There was strong support for brief reviews of stress management strategies as part of the pre-deployment briefing, and access to written stress management information for both team members and their families. However, more comprehensive provisions, including pre-deployment, stressmanagement training programs for personnel and intra-deployment family support programs, received lower levels of support. The availability of mental health-related training for the team leader role and access to consultation with mental health specialists was supported, but this did not extend to the actual deployment of mental health specialists.
In this preliminary study, clear trends toward the maintenance of current mental health support provisions and the role of the DMAT leader were evident. A follow-up study will examine the relationship between teamleader, psychosocial support strategies and team functioning.