Monitoring the mental well-being of caregivers during the Haiti-earthquake.

Abstract

Introduction During disaster relief, personnel’s safety is very important. Mental well being is a part of this safety issue. There is however a lack of objective mental well being monitoring tools, usable on scene, during disaster relief. This study covers the use of validated tools towards detection of psychological distress and monitoring of mental well being of disaster relief workers, during the Belgian First Aid and Support Team deployment after the Haiti earthquake in 2010. Methodology The study was conducted using a demographic questionnaire combined with validated measuring instruments: Belbin Team Role, Compassion Fatigue and Satisfaction Self-Test for Helpers, DMAT PsySTART, K6+ Self Report. A baseline measurement was performed before departure on mission, and measurements were repeated at day 1 and day 7 of the mission, at the end of mission, and 7 days, 30 days and 90 days post mission. Results 23 out of the 27 team members were included in the study. Using the Compassion Fatigue and Satisfaction Self-Test for Helpers as a monitoring tool, a stable condition was monitored in 7 participants, a dip in 5 participants, an arousal in 10 participants and a double pattern in 1 participant. Conclusions The study proved the ability to monitor mental well being and detect psychological distress, by self administered validated tools, during a real disaster relief mission. However for practical reasons some tools should be adapted to the specific use in the field. This study opens a whole new research area within the mental well being and monitoring field. Citation: Van der Auwera M, Debacker M, Hubloue I. Monitoring the mental well-being of caregivers during the Haiti-earthquake.. PLoS Currents Disasters. 2012 Jul 18

The Mass Casualty Incident in Turin, 2017: A Case Study of Disaster Responders’ Mental Health in an Italian Level I Hospital

“…44 With respect to the level of distress, a study on EMTs deployed in Haiti evaluated the association between patterns of psychological distress and K6 results. 45 Despite the potential nature of this type of event to have a relatively high level of exposure, in this event, the actual level of PsySTART-R risk factors was found to be relatively low and the relative risk for clinical level outcomes was also correspondingly low. In our case, PsySTART-R results indicated that most of the responders were low risk.…”

“…The lower level of exposure, well below the PsySTART cut-off of 6, and the resulting low level of presumptive PTSD in our cohort confirm the specificity of this tool and are in agreement with previous studies that demonstrated an association between risk exposures, PTSD, and depression in disaster medical responders. [28][29][30][31][32][33]44,45 Different patterns were highlighted by the follow-up instruments in the participants grouped by risk category at PsySTART-R. Responders with more than 2 criteria on PsySTART-R scored higher in the depression, anxiety, and potential PTSD assessment when compared to the ones without any criteria, even if the difference was significant only for HADS depression. This could indicate that the nature of the event itself, with a low level of individual exposure to traumatic stress, may predict more depressive/fatigue type symptoms than PTSD-like symptoms.…”

“…The affirmative answer to more than 6 questions is suggested to be the cut-off predictive of risk of developing PTSD. 45,46 The 14-item Hospital Anxiety and Depression Scale (HADS) is a self-assessment scale developed to screen for clinically relevant anxiety and depression in patients attending medical clinics. 47 Seven of these items assess depression and 7 assess anxiety.…”

“…Nineteen or higher indicates a high level of distress and the potential presence of mood and anxiety disorders. 45,48 The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) 49 is a 20-item self-report instrument that evaluates how much a specific event disturbed the responder over the past month. It indicates the presumptive presence and severity of PTSD symptoms and can be used to monitor symptoms over time, screen individuals for PTSD, and assist in making a provisional or temporary diagnosis of PTSD, albeit the gold standard is a structured clinical interview such as the Clinician-Administered PTSD Scale (CAPS-5).…”

“…The recommended cut-off for PTSD diagnosis is 33. 45,[48][49][50] The questionnaire on the management of the MCI is composed of 7 questions that evaluate perceptions on the chain of command, the communication process, the definition of roles, the teamwork, the leadership, the individual skill, and the confidence in making decisions. Its rating scores varied from 1 (very poor) to 10 (very high) on a Likert scale.…”