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November 2008                                                                                                   Volume 15 - Number 2

    

 

Congressional Research...

     

 

Need for Comprehensive Assistance in Post-Disaster Psychological Recovery

By Hanmin Kim

    

The Korean movie Gaeulro (a.k.a. Traces of Love) features a survivor of the Sampung Collapse who has a hard time leading a normal life after the incident. The Sampung Collapse, one of the worst disasters in Korean history, took place in 1995 when a nine story department store (including 4 underground floors) collapsed completely, causing over 500 deaths and nearly a thousand injuries. Of all survivors, three were trapped in the debris until rescued 9 to 15 days after the collapse. In the movie, 10 years has passed since the catastrophic event, but Se-jin, the last survivor, still suffers from posttraumatic stress disorder (PTSD) and claustrophobia. Because of the difficulties of her condition she cannot even hold a job.

Se-jin’s situation may seem like an extreme case, but I believe all disaster victims and survivors face a similar fate, albeit to different degrees. They all demonstrate symptoms of PTSD, depression, anxiety, behavior problems, or substance abuse. For example, research conducted after the Oklahoma City bombing revealed that there were subsequent increases in alcohol usage resulting from trauma. In general, rates of DUIs increase in communities after disasters.

To address this issue, FEMA offers the Crisis Counseling Training and Assistance Program (CCP) which provides “short-term interventions with individuals and groups experiencing psychological sequelae to large-scale disasters” and the Sesame Workshop (www.sesameworkshop.org) which was originally developed to help children cope with the mental health issues after the 9/11 attack, but also hoping to aid those suffering from other traumatic events. However, these measures are limited in duration and scope. Life stress triggered by the physical, emotional and/or economic loss due to the disaster is long-lasting, if not permanent. Also, it can be further exacerbated over time as the disaster survivors become frustrated with the slow progress or they feel isolated as the media attention dwindles and government assistance withdraws. Short-term intervention is certainly inadequate to effectively handle these effects that emerge further down the road and even worse, premature termination of intervention can adversely affect psychological recovery by leaving the survivors feeling betrayed and more vulnerable. In terms of the scope of the post-disaster mental health treatment, both CCP and Sesame Workshop are individual-oriented. Group Crisis Counseling Services of CCP involves group counseling, but the group here means the sum of individuals, not a coherent functioning unit such as the family. In cases of mass disasters such as Hurricane Katrina, disaster is experienced not on an individual level, but as a family. Life stress resulting from this life altering and disruptive force causes the family tension and conflict which can be more detrimental for the psychological recovery than the disastrous event itself. Progress in individual-oriented treatment would be greatly hampered by the negative interaction at home and there exists high risk of relapse as well.

To rebuild a healthy community in which a healthy future generation is fostered, post-disaster psychological recovery is essential. I would like to make three suggestions to improve existing programs. First, CCP should be extended to encompass long-term intervention or a new program may be developed to deal with longer-term mental health issues. Second, both CCP and Sesame Workshop must be aware of the importance of family interaction in the psychological recovery and engage the family as a participating unit in the treatment. Third, more effort must be made as part of the emergency preparedness and mitigation strategy to increase the public awareness on the possible PTSD and accompanying symptoms after major disasters. The suffering of the victims of disasters will be significantly reduced once the public is better informed of the potential emotional turmoil they would face in the aftermath of disasters and the resources available to them for relief and recovery.


<Reference>

Rowe, C. L., & Liddle, H. A. (2008). When the levee breaks: Treating adolescents and families in the aftermath of hurricane Katrina. Journal of Marital and Family Therapy, 34(2), 132.

Additional Assistance http://www.fema.gov/assistance/process/additional.shtm

Crisis Counseling Available For Floridians Affected By Wilma http://www.fema.gov/news/newsrelease.fema?id=20744

Additional FEMA Grant for Children's Mental Health Sesame Workshop to Create Program for Parents, Caregivers and Teachers to Help Children http://www.fema.gov/news/newsrelease.fema?id=3114

An Overview of the Crisis Counseling Assistance and Training Program www.fema.gov/pdf/media/2006/ccp_over.pdf

Crisis Counseling and Mental Health Treatment-Similarities and Differences www.fema.gov/pdf/media/2006/ccp_mh.pdf