World Psychiatric Association Program on Disasters Chairs: George Christodoulou Juan-Jose Lopez-Ibor

Consensus Statement on Mental Health Implication of Disasters  Drawing Attention of: –psychiatrists –mental health professionals –health authorities –decision makers –public  Drawing Attention to: –psychological –psychopathological effects of disasters

Effects of Disasters Diverse in character, intensity and potential for chronicity  Acute Stress Reactions  Post-Traumatic Stress Disorder  Mood Disorders  Anxiety Disorders  Psychotic Disorders  Personality Changes

Causes of Disasters  Earthquakes  Floods  Hurricanes  Fires  Naval/ plane accidents  Terrorist attacks  Sanctions  Famine  Forced Migration  Others

Effects on the Population  Negative impact on social structure  For every physically damaged individual during a disaster there are three psychologically damaged individuals

Before the Disaster Strikes  Identification  Preparation  Protection of vulnerable individuals In collaboration with families, schools, employers

Role of Mental Health Professionals  Consultants to the health authorities  Advisors to decision-makers  Advisors to the general public

Involvement of WPA Program & Sections  WPA Special Program on Disasters  WPA Sections –Section on Disaster Psychiatry –Section on Preventive Psychiatry –Section on Anxiety Disorders and OCD

Recommendations The World Psychiatric Association urges:  Member Societies  Scientific Sections  WHO  Appropriate Organisations

To Join Forces in Promotion of:  Acquisition of new information (research)  Dissemination of information (education)  Prevention and Management of the behavioural consequences of disasters

Authorisation The WPA authorises:  WPA Sections on: –Disaster Psychiatry –Preventive Psychiatry –Anxiety and OCD –Other related sections  Special Program on Disasters

To prepare  Detailed document on the Behavioural Effects of Disasters, their Prevention and Treatment

Resilience vs Vulnerability to Disasters

Resilience vs Vulnerability  Risk Factors for PTSD Individual vulnerability Severity of exposure to the disaster Type and severity of trauma Mass violence (with malicious intent, in contrast to a natural disaster)

Resilience vs Vulnerability  Risk Factors for PTSD Individual response to trauma Acute Stress Reaction Early PTSD symptoms Early symptoms persisting for >1 year Failed coping behaviour (giving up, denial)

Resilience vs Vulnerability  Risk Factors for PTSD Life stressors after the trauma Lack of psychological support Lack of social support

Resilience vs Vulnerability  Risk Factors for PTSD School-aged children Women Middle age Medical or Psychiatric history

Reactions of the Community  Collective Behaviour is not the sum of individual behaviours  Adaptive collective behaviour is characterised by preservation of the group structure, preservation of leadership and solidarity

Reactions of the Community  Maladaptive collective behaviour may manifest as: The opposite of the above Collective inactivity Collective panic Hetero-blame Dependence Psychopathic or paranoid behaviour