The Disaster Psychiatry

Perspective
Overview
Agenda
 What is
disaster psychiatry?
 Disaster Psychiatry
Professional application of mental health
knowledge and expertise to the unique
setting of disasters.

(Garakani et al., 2004)

 Disaster Psychiatry Outreach

• Disaster Psychiatry
Outreach
• Clinical Expertise
• Field Experience
• Ongoing cooperation
with other leaders -
ARC, GAP etc.
 Subspecialties and Disaster Psychiatry

• Emergency psychiatry
Disaster psychiatry • Trauma psychiatry
synthesizes elements • Community psychiatry
of many fields of • Consult-liaison
psychiatry psychiatry
→ • International
psychiatry
• Preventive medicine
 Disaster
Trauma that overwhelms a
community’s ability to cope
Stress…
 Trauma….

A pedestrian surveys fallen trees on top of parked cars in Queens, New York, on October 30, 2012.
photo.sf.co.ua
Disaster
 Disaster Characteristics
• Cause – Natural vs. Manmade acts
(including acts of terrorism)

• Location – Central vs. Peripheral

• Type – Earthquake, Weather, Terrorism, etc.

• Other Characteristics – Severity, Predictability

 Hurricane Katrina
• Pre-hurricane residents in Gulf States 5-8
months and then another year post-Katrina

• PTSD increases from 14.9% → 20.9%

• Suicidal ideation 2.8% → 6.4%

• Suicide plans 1.0% → 2.5%

• Major mitigating factor = hurricane related

stresses
(Kessler et al., 2008)
Cycle of Disaster Psychiatry Stages

Pre- Acute
Disaster Disaster

Post- Post-Acute
Disaster Disaster
 Disaster Time Course

• Impact – first 24-48 hours of the acute phase

• Acute – extends up to 2 months after the event

• Post-acute – approximately 2 months and

beyond

(Adapted from Tyhurst, 1951)

(Katz et al., 2002)
Disaster Community

(Taylor, 1987; Wright et al., 1990)

Psychological Consequences of Concern
• Distress response – changes in how people think
and feel

• Behavioral changes – changes in how people go

about their life and do things

• Psychiatric illness – lie at the most extreme end

of response and behavioral changes and include
Post-Traumatic Stress Disorder or Major
Depression
(Institute of Medicine, 2003)
Any Questions or
Comments?