ABSTRACTIn substantial numbers of affected populations, disasters adversely affect well-being and influence the development of emotional problems and dysfunctional behaviors. Nowhere is the integration of mental and behavioral health into broader public health and medical preparedness and response activities more crucial than in disasters such as the 2009-2010 H1N1 influenza pandemic. The National Biodefense Science Board, recognizing that the mental and behavioral health responses to H1N1 were vital to preserving safety and health for the country, requested that the Disaster Mental Health Subcommittee recommend actions for public health officials to prevent and mitigate adverse behavioral health outcomes during the H1N1 pandemic. The subcommittee's recommendations emphasized vulnerable populations and concentrated on interventions, education and training, and communication and messaging. The subcommittee's H1N1 activities and recommendations provide an approach and template for identifying and addressing future efforts related to newly emerging public health and medical emergencies. The many emotional and behavioral health implications of the crisis and the importance of psychological factors in determining the behavior of members of the public argue for a programmatic integration of behavioral health and science expertise in a comprehensive public health response.(Disaster Med Public Health Preparedness. 2012;6:67–71)
Many people exposed to climate-related or weather-related disasters experience stress and serious mental health consequences. Depending on the type of the disaster, these consequences include post-traumatic stress disorder (PTSD), depression, and general anxiety, which often occur at the same time [Very High Confidence]. The majority of affected people recover over time, although a significant proportion of exposed individuals develop chronic psychological dysfunction [High Confidence].
terrorist nuclear detonation of 10 kilotons would have catastrophic physical, medical, and psychological consequences and could be accomplished with a device in a small truck. Tens of thousands of injured and ill survivors and uninjured, concerned citizens would require medical care or at least an assessment and instructions. In proximity to the incident location, there would be a huge imbalance between the demand for medical resources and their availability. 1-3 Beyond the immediate blast area, much of the infrastructure would remain intact. Most people would reach medical care by selfreferral and require sorting and assessment to determine what medical intervention is necessary, appropriate, and possible. No society has the resources to deliver the full spectrum of care needed in the time frame required. Yet, careful planning and a clear understanding of how best to allocate scarce resources, triage and evacuate patients, and implement crisis standards of care have the potential to save thousands of lives and provide comfort to those unlikely to survive. The US government and nongovernment experts continue to develop planning guidance, 1,4-8 medical countermeasures, 9,10 and medical specialty capacity and capabilities. 11-13 This Scarce Resources for a Nuclear Detonation Project provides data, supporting information, and tools for medical planners and responders to address the issues of scarce resources 14 and plan for triage and resource allocation in the first 4 days postdetonation, when there will be severe shortages.
ABSTRACTThe close interplay between mental health and physical health makes it critical to integrate mental and behavioral health considerations into all aspects of public health and medical disaster management. Therefore, the National Biodefense Science Board (NBSB) convened the Disaster Mental Health Subcommittee to assess the progress of the US Department of Health and Human Services (HHS) in integrating mental and behavioral health into disaster and emergency preparedness and response activities. One vital opportunity to improve integration is the development of clear and directive national policy to firmly establish the role of mental and behavioral health as part of a unified public health and medical response to disasters. Integration of mental and behavioral health into disaster preparedness, response, and recovery requires it to be incorporated in assessments and services, addressed in education and training, and founded on and advanced through research. Integration must be supported in underlying policies and administration with clear lines of responsibility for formulating and implementing policy and practice.(Disaster Med Public Health Preparedness. 2012;6:60–66)
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