Mental Health Sequelae in Disaster Workers: Prevention and Intervention

Efforts to predict and control disaster-induced trauma are severely hampered by lack of a construct for analyzing and assessing events that may adversely affect the ability to perform occupational roles.

Abstract

When a disaster imposed by natural forces and/or man-made actions strikes a community, the immediate response of formally designated intervention personnel rarely takes into consideration the emotional impact of their tasks. Moreover, rarely do disaster planning and training deal with the potential for injury that is inherent in rescue and recovery operations [1]. It is assumed that the general training and conditioning afforded by work experience under normal conditions will suffice to protect the worker from both the physical and the mental trauma that may be suffered at a disaster site. Normal precautions against physical injuries and their treatment are considered to be covered by the use of protective clothing and devices, safety regulations in policies and training programs, and instruction in response and first-aid procedures. The potential for physical injury and monitoring of that potential are well-established administrative issues in planning disaster relief. Only recently, however, have administrators given attention to the potential for, and occurrence of, mental trauma that may result from service at a disaster site. Much of the literature recognizes the existence of disaster-induced trauma in rescue and recovery workers (generally in anecdotal reports) and discusses the nature of the job-related stress, but without documenting its magnitude [2]. Efforts to predict and control disaster-induced trauma are severely hampered by lack of a construct for analyzing and assessing events that may adversely affect the ability to perform occupational roles. Despite the considerable body of knowledge regarding stress in the protective services (police, fire, corrections, and emergency medical technicians), there has been no reliable and valid method for directly measuring levels of stress and post-traumatic reactions in workers deployed at specific disaster sites. O'Neill and co-workers [3] have pointed out that stressors are transitory conditions present, especially during a disaster, under abnormal circumstances. Sewell [4] attempted to develop a scale of critical professional life-events experienced by law-enforcement officers in order to predict times of high potential for stress in