Natural and man-made disasters carry with them major burden and very often the focus is on immediate survival and management of resulting infectious diseases. The impact of disasters directly and indirectly on the well-being and mental health of those affected often gets ignored. The reasons are often stigma and lack of attention to mental health consequences. In addition, often the focus is on preventing the spread of infectious diseases such as waterborne or airborne diseases. This is further complicated by the fact that often aid agencies in offering aid tend to focus on communicable diseases and not on mental health of populations. This focus may reflect easily to measure outcomes in comparison with mental illnesses as the global burden of disease is likely to increase in the next few decades. There is an urgent need to apply the principles of social justice on social and health care policies, which will lead to elimination of stigma. In this article, we propose that the impact of mental illness as a result of disasters needs to be taken seriously in any planning and delivery of relief. Mental health is likely to be affected both directly and indirectly as a result of disasters and also likely to be influenced by ongoing factors such as poor housing, overcrowding and other social determinants. In addition to deliver equity between physical and mental illnesses, appropriate and adequate resources are needed so that identifiable needs can be met with clear outcomes.
In the previous accompanying paper, we described geopolitical factors which affect mental health of individuals who suffer directly and indirectly. These disasters whether they are natural or man-made often attract significant amounts of aid and resources – financial and human. In addition, those who offer foreign aid need to be aware of where and how the aid is being spent. In this paper, we propose that aid giving agencies give due attention to the impact the aid should have on mental health of recipients. Global mental health has become a movement, but concerns remain about its efficacy. Therefore, it is imperative that any aid given is given and utilised in a culturally appropriate and culturally sensitive way. In an interconnected and interlinked world, it is likely that when one country or nation is affected by disasters or trauma, it will impact upon others around both directly and indirectly. We present a new measurement tool-CAPE Vulnerability Index which can be used to identify most vulnerable communities so that international aid may be more appropriately targeted. We believe that this index may go some way in assisting governments and policymakers in ascertaining the impact of their aid on the emotional and mental health of individuals. We suggest that their needs to be a ring-fencing of aid to ensure that population mental health is protected and enhanced with a strategic approach inbuilt into the foreign policy the focus needs to shift towards public mental health.
y también los 12 peores dentro de la CAPE VI-LAC en su conjunto. De los 33 países de ALC, sólo San Cristóbal y Nieves no figuraba en ninguno de los 20 países peores en ningún momento. Conclusión: Lo que podemos concluir con un alto grado de certeza es que los 12 países con peores puntuaciones son posiblemente estados frágiles; países donde los gobiernos no tienen el control o la autoridad completos, a menudo son represivos y corruptos, participan en graves abusos de los derechos humanos y se caracterizan por la inestabilidad política de diversas formas, la desventaja por los cambios climáticos extremos, la pobreza extrema, la desigualdad social y étnica divisiones, incapaces de proporcionar servicios básicos y sufren focos de insurgencia en forma de terrorismo, que a menudo son violentos y brutales. Los gobiernos, los donantes de ayuda, las organizaciones regionales y los profesionales y las asociaciones de salud mental deben trabajar juntos para abordar estas situaciones.
In response to Peter Wright’s Lateral Thoughts article “Doomsday numbers” (January p52) in which he proposes a set of numbers that are as significant as R, the number of secondary infections produced by a single infected person, but could disrupt the integrity and wellbeing of our planet.
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