Mental health response to disasters and other critical incidents

Mental health response to disasters and other critical incidents has been proposed as a method of reducing short- and long-term problems that might follow a single, distinct life event or a public disturbance.[1]Giddens JB. Critical incident stress debriefing/psychological debriefing: a critical review of the literature. San Diego, CA: Alliant International University; 2008.[2]National Institute of Mental Health. Mental health and mass violence: evidence-based early psychological intervention for victims/survivors of mass violence. A workshop to reach consensus on best practices. Washington, DC: NIMH; 2002. Originally arising from concerns about soldiers and first responders, the mental health dimensions of disasters and other critical incidents are now considered a priority in disaster planning, response, and research.

Several groups have worked on consensus recommendations for the management of disasters and other critical incidents. A trauma group in the US has proposed a management strategy.[3]Hobfoll SE, Watson P, Bell CC, et al. Five essential elements of immediate and mid-term mass trauma intervention: empirical evidence. Psychiatry. 2007;70:283-319. http://www.ncbi.nlm.nih.gov/pubmed/18181708?tool=bestpractice.com The European Network for Traumatic Stress (TENTS) conducted a three-round Delphi process, and other organizations have also developed guidelines from consensus.[4]Te Brake H, Dückers M, De Vries M, et al. Early psychosocial interventions after disasters, terrorism, and other shocking events: guideline development. Nurs Health Sci. 2009;11:336-343. http://www.ncbi.nlm.nih.gov/pubmed/19909437?tool=bestpractice.com [5]Sever MS, Vanholder R; RDRTF of ISN Work Group on Recommendations for the Management of Crush Victims in Mass Disasters. Recommendation for the management of crush victims in mass disasters. Nephrol Dial Transplant. 2012;27(suppl 1):i1-i67. http://ndt.oxfordjournals.org/content/27/Suppl_1/i1.long http://www.ncbi.nlm.nih.gov/pubmed/22467763?tool=bestpractice.com [6]Bisson JI, Tavakoly B, Witteveen AB, et al. TENTS guidelines: development of post-disaster psychosocial care guidelines through a Delphi process. Br J Psychiatry. 2010;196:69-74. http://bjp.rcpsych.org/cgi/content/full/196/1/69 http://www.ncbi.nlm.nih.gov/pubmed/20044665?tool=bestpractice.com [7]Adesunkanmi AR, Lawal AO. Management of mass casualty: a review. Niger Postgrad Med J. 2011;18:210-216. http://www.ncbi.nlm.nih.gov/pubmed/21909152?tool=bestpractice.com From Chile, a similar model has been proposed based on a literature review.[8]Figueroa RA, Marín H, González M. Psychological support for disaster victims: an evidence-based care model [in Spanish]. Rev Med Chil. 2010;138:143-151. http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872010000200001&tlng=en&lng=en&nrm=iso http://www.ncbi.nlm.nih.gov/pubmed/20461301?tool=bestpractice.com While the scientific evidence base for responding to the immediate- and, to a lesser degree, long-term mental health aftermath of trauma and disaster is still emerging, the content in this topic reflects the best practices in this area based on available expert consensus and experience.