An Overlooked Need: Mental Health Care in Post-Disaster Situations

A blog post by Kari Stromhaug.

It seems like we hear about a new disaster every few weeks — or even every few days. There are always campaigns popping up on Facebook encouraging donations for the latest disaster. And in the repeated news coverage, social media posts, and conversation, it is easy to become desensitized.

When disaster relief efforts are covered on mainstream media, the primary focus is, naturally, basic needs. Immediately after a disaster, it is crucial for survivors to receive food, water, shelter, and other essentials. But in the weeks or months after, news coverage drops off, ads go away, and audiences move on to the next big news headline.

What we forget is that disaster survivors don’t immediately move on; even though survivors might have restored access to clean water and a roof over their heads, the effects that we often can’t see continue to linger.

Dr. Celso Bambaren Alatrista, a Peruvian psychologist who focuses on the impacts of various disasters on mental health, stated in a 2011 paper that “Disasters can be considered as a public health problem that could affect the psychosocial behavior of population, especially the most vulnerable groups such as children, adolescents, women, old people and people with physical and mental illness.”

It isn’t surprising that natural disasters can have serious impacts on mental health. Disasters often leave individuals without homes, and uncertain of how they will get access to basic human needs. People may have lost all of their possessions, their pets, and even family members, and face daunting uncertainty about the future. Their routines have been displaced and their livelihoods might have been put into jeopardy, sparking intense uncertainty about the future. Not only do survivors have to deal with the practical and logistical aspects of disaster recovery, but they do so in the face of trauma and startling change. Mothers in particular face these challenges and the added weight of caring for several members of the family.

Mental health consequences vary in type and severity by disaster. Of floods, volcano eruptions, and earthquakes, earthquakes tend to have the greatest negative impact on the mental well-being of survivors. Essentially, the more severe and jarring the disaster, the worse off people will be. Anxiety and depression rates are known to increase after disasters, as well as cases of PTSD. Individuals who previously suffered from mental disorders are particularly vulnerable and are likely to experience worsening symptoms.

Amidst so much sad news, is there a silver lining?

In recent years, the mental health impacts of natural disasters have received increased attention, and several leading disaster organizations are working to address such concerns. AmeriCares committed to sending 5,000 psychologists to Puerto Rico after Hurricane Maria, and International Medical Corps has dedicated a portion of their efforts to mental health care. Of thirty disaster relief sites that I visited, International Medical Corps was the only to explicitly address mental health care as a service that they provide.

Despite the recent increase in attention to mental health after disasters, there is a chronic shortage of trained mental health workers in target areas. International Medical Corps writes that only one percent of the global health workforce is working in the field of mental health. When considering the number of people impacted by disasters each day, it is clear that there is a shortage of mental health resources available to survivors. There simply aren’t enough psychologists to go around.

And this poses a new question: how else might we address a growing mental health crisis in unconventional, yet effective ways?

Given that mobile technologies are increasingly present worldwide, cell phone-based treatments show promise for impact. The challenge is then to learn how to adapt treatments, counseling, and/or coaching to a mobile-friendly platform without sacrificing effectiveness. The Libremente project aims to do just this, by leveraging the scalability of SMS to provide care and encouragement to survivors of natural disasters.

You can learn more about Libremente and the project team here: http://globalmedia.mit.edu/research/urops/