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This study has identified additional needs of caregivers from those found in other studies.

The aim of this paper is to describe the activities and observations of the team from National Institute of Mental Health and Neuro Sciences (NIMHANS) Bangalore, India in the Andaman and Nicobar Islands during the early phase of the Tsunami disaster in January and February 2005. The activities comprised mental health consultation at camps, community sensitization, mental health services to the students and children, teachers orientation sessions and training of non-governmental organization [NGO] functionaries. Initial assessment reveals 5-8% of the population were suffering from significant mental health problems following the early phase of the disaster. This may increase in the aftermath of the early relief phase. Psychiatric morbidity is expected be around 25-30% in the disillusionment phase. High resilience was seen in the joint family system of tribal Nicobarese during early phase of disaster. In developing countries like India, limited availability of mental health professionals and poor knowledge about disaster mental health among the medical and para-medical staff, may lead to poor psychosocial rehabilitation of the survivors. To respond to a high magnitude natural disaster like a tsunami, the disaster mental health team must be able to understand the local culture, traditions, language, belief systems and local livelihood patterns. They also need to integrate with the network of various governmental and non-governmental organizations to cater to the needs of the survivors. Hence the presence of a disaster mental health team is definitely required during the early phase of the disaster in developing countries.

Objective:The objective of this study was to compare the psychiatric morbidity between the displaced and non-displaced populations of the Andaman and Nicobar Islands during the first three months following the 2004 earthquake and tsunami.Methods:The study was conducted at the 74 relief camps in the Andaman and Nicobar Islands. Port Blair had 12 camps, which provided shelter to 4,684 displaced survivors. There were 62 camps on Car-Nicobar Island, which provided shelter to approximately 8,100 survivors who continued to stay in their habitat (non-displaced population). The study sample included all of the survivors who sought mental health assistance inside the camp. A psychiatrist diagnosed the patients using the ICD-10 criteria.Results:Psychiatric morbidity was 5.2% in the displaced population and 2.8% in the non-displaced population. The overall psychiatric morbidity was 3.7%. The displaced survivors had significantly higher psychiatric morbidity than did the non-displaced population.The disorders included panic disorder, anxiety disorders not otherwise specified, and somatic complaints. The existence of an adjustment disorder was significantly higher in the non-displaced survivors. Depression and post-traumatic stress disorder (PTSD) were distributed equally in both groups.Conclusions:Psychiatric morbidity was found to be highest in the displaced population. However, the incidence of depression and PTSD were distributed equally in both groups. Involvement of community leaders and survivors in shared decision-making processes and culturally acceptable interventions improved the community participation. Cohesive community, family systems, social support, altruistic behavior of the community leaders, and religious faith and spirituality were factors that helped survivors cope during the early phase of the disaster.

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We report on the design of a novel station supporting the play of exercise video games (exergames) by children with cerebral palsy (CP). The station combines a physical platform allowing children with CP to provide pedaling input into a game, a standard Xbox 360 controller, and algorithms for interpreting the cycling input to improve smoothness and accuracy of gameplay. The station was designed through an iterative and incremental participatory design process involving medical professionals, game designers, computer scientists, kinesiologists, physical therapists, and eight children with CP. It has been tested through observation of its use, through gathering opinions from the children, and through small experimental studies. With our initial design, only three of eight children were capable of playing a cycling-based game; with the final design, seven of eight could cycle effectively, and six reached energy expenditure levels recommended by the American College of Sports Medicine while pedaling unassisted.

Background: For women with perinatal mental illness, phone helplines may be a useful way of accessing help. This study assessed the feasibility, acceptability, limitations, and usage patterns of a helpline service for mothers discharged from a mother-baby psychiatry unit. Methods: Mothers discharged from a mother baby unit during an 18-month period were provided with a helpline number. A social worker answered the calls. Details of the calls, including the reasons and the interventions provided, were recorded. Feasibility and acceptability were assessed by calling all users and nonusers. Satisfaction with the helpline was recorded among users, and reasons for not calling were assessed among nonusers. Results: Among 113 mothers, 51 (45%) made 248 calls. Calls were regarding medication, sleep problems, planning pregnancies, symptom exacerbation, appointments, and suicidal ideation. Some calls were related to domestic violence ( n = 13, 5.24%), and infant health and breastfeeding ( n = 11, 4.44%). Seventy-six (67%, 44 callers and 32 noncallers) were contacted. The majority (41/44) of the callers found it useful: 91% said they got help, and 95% said they would recommend it to others. However, language difficulties (9%) and technical problems (5%) were reported. Among the noncallers, the majority reported having experienced no problem related to mental health or had contacted a doctor. However, of the noncallers, one woman died of suicide, did not have access to a phone, and the family did not choose to call. Conclusions: Helpline phone service appears to be feasible and acceptable and can be adapted in other mother-baby psychiatry units in low and middle-income countries. However, in some women, the nonavailability of a phone may be a limiting factor.

Displacement was a significant factor in the manifestations of observed pathology. Displaced women had greater psychiatric morbidity. In addition, the fact that adjustment disorder (a self-limiting disorder form of psychopathology) was more prevalent in the non-displaced group may be a reflection of the findings of overall lesser morbidity in non-displaced women. Hence, women may have to be rehabilitated in their own habitats after major disasters.