Mental Health Response to Disasters: Is There a Role for a Primary Care-Based Clinician?

Abstract

Introduction: Following natural disasters, rural general practitioners (GPs) are expected to undertake several roles, including identifying those experiencing psychological distress and providing evidence-informed mental health care. This paper reports on a collaborative mental health program developed to support a rural GP practice (population <1,500) and a disaster response service. Methods: The program provided specialized disaster mental health care via the placement of a clinician in the GP facility. In collaboration with the GP practice, the program offered opportunistic screening using the Primary Care Posttraumatic Stress Disorder (PTSD) Scale (PC-PTSD) for probable PTSD as the primary measure and the Kessler 6 (K6) as a secondary measure. Those scoring higher than two on the PC-PTSD scale were referred to the mental health clinician (MHC) for further assessment and treatment. Results: Sixty screening assessments were completed. Fourteen patients (male = 3; female = 11) scored higher than two on the PC-PTSD. The referred group PC-PTSD mean score was 3.14 and K6 mean score of 19. Those not referred had a PC-PTSD mean score = 0.72 and K6 mean score = 7.30. The treatment and non-treatment groups differed significantly (PC-PTSD: P <.00001 and K6: P <.00001). A prior history of trauma exposure was notable in the intervention group. Eight reported a history of domestic violence, seven histories of sexual abuse, five childhood sexual abuse, and eight intimate partner violence (IPV). Conclusion: A post-disaster integrated GP and mental health program in a rural community can assist in identifying individuals experiencing post-disaster psychological distress using opportunistic psychological screening. The findings indicate that collaborative mental health programs may effectively support rural communities post-disaster.

Climate's silent impact: reframing primary care in the era of environmental distress

“…For instance, the use of questionnaires that assess feelings of environmental grief, anxiety related to climate change, and symptoms of solastalgia could become standard practice in patient evaluations. This approach not only acknowledges the direct impacts of climate change on mental wellbeing but also validates the patient's experiences, facilitating a more empathetic and comprehensive care strategy ( 21 , 22 ).…”

“…To further strengthen the support system within primary care, it is essential to direct practitioners to existing evidence-based clinical guidelines that address common mental health conditions, ensuring adherence to best practices. Concurrently, recognizing the unique challenges posed by climate-related psychoterratic syndromes, there is a critical need to develop and integrate new evidence-based interventions ( 21 , 22 ). These should not only focus on psychological aspects but also consider broader ecological and societal impacts, thereby providing a comprehensive response to the multifaceted nature of these disorders.…”