Psychosocial and mental health assistance to populations affected by the tsunami: WHO projections and recommendations. (Observed rates vary with setting (for example, sociocultural factors in coping and community social support, previous and current disaster exposure, population response set tendencies) and assessment method but give a rough indication what WHO expects the extent of morbidity and distress to be)
|
Description |
Before disaster: baseline 12 month prevalence |
After disaster: projected 12 month prevalence |
Recommended aid response |
Sector |
|
Severe disorder (for example, psychosis, severe depression, severely disabling form of anxiety disorder) |
2-3%* |
3-4%† |
Make mental health care available in general health services and in community mental health services Develop social services to support in rehabilitation |
Health and social services sector |
|
Mild or moderate mental disorder (for example, mild and moderate forms of depression and anxiety disorders, including of post-traumatic stress disorder) |
10%* |
20% (reduces over time to 15% through natural recovery without intervention)‡ |
Make mental health care available in general health services and in community mental health services Make social interventions and basic psychological support interventions available in the community |
Health and a variety of other sectors |
|
Moderate or severe psychological distress that does not meet criteria for disorder that may resolve over time or mild distress that does not resolve over time |
No estimate |
30-50% (reduces over time to an unknown extent through natural recovery without intervention)§ |
Make social interventions and basic psychological support interventions available in the community |
A variety of sectors |
|
Mild psychological distress that resolves over time |
No estimate |
20-40% (increases over time as people with severe problems recover, sometimes partially) |
No response |
|
*Assumed baseline rates are the median rates across countries as observed in the World Mental Health Survey 2000.9
†Trauma and loss may exacerbate previous mental disorder (for example, it may turn moderate depression into severe depression), and may cause a severe form of trauma induced common mental disorder in some people.
‡Trauma and loss increase the risk of common mental disorders (depression and anxiety disorders, including post-traumatic stress disorder)1 and a large number of people recover without intervention.10
§This group covers the people that tend to be labelled with psychiatric diagnoses in many surveys involving psychiatric instruments that have not been validated for the local culture and in the context of disasters.11