Tsunami raises questions about disaster mental health, Science reports

mpact has been and what it will be in the long run. In part that's because many people have felt that it wouldn't be ethical to do a thorough scientific study in the immediate aftermath of the disaster. Some groups, including NGOs and university researchers, have done quick and dirty assessments to help gauge the needs for psychosocial support, and those suggest that many people have symptoms of depression and anxiety disorders.

Can you describe some of the people you met who were evidently suffering some degree of post-disaster mental-health trauma?

One woman I met in a village near Chennai, India, lost her teenage daughter in the tsunami. She said that when she hears certain sounds she has the very vivid sense that her daughter is just outside, playing with the neighbor's children. Then of course she realizes that it can't be, which is very upsetting. Many people have intrusive thoughts like this, or flashbacks of the day of the tsunami or nightmares. Other people seem to have symptoms of depression-they can't sleep, lose their appetite and their interest in things they usually enjoy. In a village near Cuddalore, India, I went around with psychiatric social workers from an NGO based in Chennai. We visited several people who have become very withdrawn since the tsunami and won't leave their houses or take part in their normal activities. This is another common situation.

Is there enough mental health service available in the tsunami zones right now? Or enough of the right kind of service?

Mental health service in most of these areas is woefully inadequate. Sri Lanka had about 40 psychiatrists for 20 million people, and the World Health Organization estimates that 384,000 Sri Lankans have serious, debilitating mental disorders like major depression and schizophrenia, and as many as 2 million have less serious disorders that could still benefit from treatment. Forty psychiatrists is clearly not enough to take c


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