Mental Health Response to Community Disasters: A Systematic Review
Abstract
IMPORTANCE: Exposure to a disaster is common, and one-third or more of individuals severely exposed may develop posttraumatic stress disorder or other disorders. A systematic approach to the delivery of timely and appropriate disaster mental health services may facilitate their integration into the emergency medical response. OBJECTIVE: To review and summarize the evidence for how best to identify individuals in need of disaster mental health services and triage them to appropriate care. EVIDENCE REVIEW: Search of the peer-reviewed English-language literature on disaster mental health response in PsycINFO, PubMed, Cochrane Database of Systematic Reviews, Academic Search Complete, and Google Scholar (inception to September 2012) and PILOTS (inception to February 2013), using a combination of subject headings and text words (Disasters, Natural Disasters, Mental Health, Mental Health Programs, Public Health Services, Mental Disorders, Mental Health Services, Community Mental Health Services, Emergency Services Psychiatric, Emotional Trauma, Triage, and Response). FINDINGS: Unlike physical injuries, adverse mental health outcomes of disasters may not be apparent, and therefore a systematic approach to case identification and triage to appropriate interventions is required. Symptomatic individuals in postdisaster settings may experience new-onset disaster-related psychiatric disorders, exacerbations of preexisting psychopathology, and/or psychological distress. Descriptive disaster mental health studies have found that many (11%-38%) distressed individuals presenting for evaluation at shelters and family assistance centers have stress-related and adjustment disorders; bereavement, major depression, and substance use disorders were also observed, and up to 40% of distressed individuals had preexisting disorders. Individuals with more intense reactions to disaster stress were more likely to accept referral to mental health services than those with less intense reactions. Evidence-based treatments are available for patients with active psychiatric disorders, but psychosocial interventions such as psychological first aid, psychological debriefing, crisis counseling, and psychoeducation for individuals with distress have not been sufficiently evaluated to establish their benefit or harm in disaster settings. CONCLUSION AND RELEVANCE: In postdisaster settings, a systematic framework of case identification, triage, and mental health interventions should be integrated into emergency medicine and trauma care responses.
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Pre-existing mental health conditions or problems can be exacerbated or even triggered by changes in climate.
“Crucially important to consider is that pre-existing mental health conditions or problems can be exacerbated or even triggered by changes in climate [9, 61].”
From Climate change and mental health: risks, impacts and priority actions (2018) · cites this paper as [61]
Natural hazards and man-made disasters, pandemics, and other traumatic events can lead to psychological harm.
“Natural hazards and man-made disasters (e.g., floods and mass violence; [1]), pandemics (e.g., the COVID-19 pandemic; [2]), but also other traumatic events (e.g., train accidents; [3]) can lead to psychological harm.”
A substantial number of survivors of disasters, pandemics, and other severe stressors develop persistent distress that impairs mental health and well-being.
“A substantial number of survivors of disasters, pandemics, and other severe stressors develop persistent distress that impairs mental health and well-being.”
Disasters of both natural and human origin can adversely impact mental health among those directly or indirectly exposed.
“It is well established that disasters of both natural (e.g., floods, bushfires, earthquakes) and human (e.g., mass violence, terrorism) origin can adversely impact mental health among those directly or indirectly exposed (1).”
From An Open Label Pilot Study of a Brief Psychosocial Intervention for Disaster and Trauma Survivors (2020) · cites this paper as [1]
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“, floods and mass violence; [1]), pan-”
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- Authors
- North, C. S., & Pfefferbaum, B.
- Affiliations
- VA North Texas Health Care System (US)
- University of Oklahoma Health Sciences Center (US)
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2013-08-07
- Volume
- 310
- Issue
- 5
- Pages
- 507
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W1980070228
- Cited by
- 549
- References
- 106
- Citations by year
- 2026: 52 · 2025: 49 · 2024: 44 · 2023: 31 · 2022: 50 · 2021: 64 · 2020: 64 · 2019: 30 · 2018: 41 · 2017: 33 · 2016: 31 · 2015: 35 · 2014: 21 · 2013: 4
- FWCI
- 46.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Emergency Medical Services › Disaster Response and Management
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Sociology and Political Science › Disaster Management and Resilience
- Keywords
- disaster mental health, post-traumatic stress disorder, disaster triage, case finding, emergency medical response, psychological first aid, psychological debriefing, crisis counseling, psychosocial interventions, disaster shelters, stress-related disorders, bereavement, major depressive disorder, substance use disorders, psychiatric referral
- MeSH terms
- Disasters, Emergency Medical Services, Humans, Mental Health, Mental Health Services, Risk, Stress Disorders, Post-Traumatic, Triage
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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