Post-Traumatic Stress Disorder May Be Haiti's Next Disaster

In the melee of fallen homes and amputated limbs, we forget that some of the longer-term consequences of the earthquake in Haiti may be even more devastating. A Psychology Today blog, though, reminds us of the psychiatric fallout from this kind of disaster. As PT writes, “While the survivors of such tragedies may recover from their physical injuries, the emotional damage may be permanent.”

Post-Traumatic Stress Disorder (PTSD) is often a disease associated with war, but there's evidence that natural disaster can leave survivors with crippling flashbacks, anxiety and attention difficulties, as well. There aren't many studies on the prevalence of PTSD after natural disasters, but those that do exist find levels of PTSD of 20-30 % in affected populations as many as 14 years after the event.

According to the World Health Organization, neuropsychological disease accounts for 14% of the global burden of disease. To put this in perspective, that's more than the burden of all cancers combined.

In this case, “burden” means the number of years of productive life lost.  In short, Haiti’s earthquake survivors may have major psychological trauma that's not only terrible for their own health, but might also hurt the Haitian economy’s chance of recovery.

Should foreign aid in Haiti be providing help for psychological trauma, or is this a low priority?  Is psychological help something that foreign assistance even can provide, given the cultural and linguistic differences? One Chinese team is providing psychological aid to earthquake survivors, but of course, we won't have any sense of this program's impact for some time.

In 2007, I worked in Rwanda with women who became HIV positive as the result of being raped during the genocide. One can hardly think of a place more in need of good psychotherapy than Rwanda. But at that time, there were exactly four psychiatrists there -- this in a country of 8 million people -- and worse yet, there were no available first-line psychiatric medications. And only two of these psychiatrists were actually from Rwanda.

Personally, I believe that shipping in foreign psychiatrists is an inadequate response, and that local mental health professionals are needed to have a long-term impact. So how should the international community respond to mental health crises like natural disasters and genocide?  Should we train psychiatrists in Haiti or train Haitians living abroad? Should we set up hotlines, foundations, and government agencies? I'd love to hear your thoughts in the comments on the best ways to respond to mental health needs after disaster.

Photo Credit: Talia Frenkel/American Red Cross.