Perceptions about one’s safety during a disaster—even from a distance—can leave emotional scarring and long-term issues with mental health.
These findings are part of a study that focused on 1,500 residents of Stockholm who had been in the disaster area during the 2004 tsunami that occurred in the Indian Ocean. Surprisingly, some of those displaying signs of long-term mental distress had not been affected directly by either self harm or harm to friends and family.
“A difficult experience can lead to an excess of feelings and impressions. This is normal and can be seen as a sign that the mind and body need time to work through what happened,” said Dr. Lars Wahlström of the Crisis and Disaster Psychology Unit at the Center for Family and Community Medicine (CeFAM) in Stockholm.
Part of the doctoral thesis “Disaster and Recovery,” conducted at the Karolinska Institute in Sweden, researchers had participants—all over 15 years of age—fill out a questionnaire regarding their experiences 14 months after the incident.
Results revealed that 30 percent of those interviewed were still experiencing symptoms that included post-traumatic reactions, mood disturbances or sleep issues. Of those still experiencing mental health issues, 20 percent had not been directly affected, but they had perceived their presence and experience in the region as life-threatening.
“It would seem that the very experience of threat to life leaves traces,” Wahlström said, adding that survivors of disasters could possibly be better evaluated for potential long-term effects by asking more pointed questions about their perceptions. “It might be enough for a nurse at the emergency ward to sit down for a moment and ask what the survivor has been through and how the experience felt. After survivors’ first reactions have subsided, at the latest within a month, those who felt a threat to life should be contacted again to find out how they are doing.”
The thesis suggested that this type of questioning could be added to assessments that occur after major disasters as well as after such traumatic events as car accidents and violent assaults.
While most people will suffer negative effects after a disaster or traumatic event, those who develop post-traumatic stress disorder (PTSD) may have long-term lingering symptoms such as nightmares, extreme fear, isolation, depression and anxiety.
Those who experienced more than one traumatic event in connection with the tsunami—such as direct effects on both the individual and loved ones—were clearly suffering the most extreme psychological difficulty, according to the study. Also, those who felt they had not received adequate support following the event were also more likely to have mental health issues than those who were satisfied with the help they received.
Most of those involved—roughly 70 percent—expressed satisfaction with the help they had received and said that their recovery was going well. Family and friends were identified as the most important sources of support.
“To cope well and move forward, disaster survivors need a positive initial encounter with first responders, and they need the right help in a timely manner,” Wahlström said. “Our results can be used in the care of survivors of both large and small disasters and accidents. It’s especially important for health care personnel to increase their knowledge about disaster response, and about which survivors should be approached again after their first reactions have subsided.”
Source: Doctoral thesis: “Disaster and recovery,” Lars Wahlström, Karolinska Institute