When a major earthquake strikes, public attention immediately focuses on the injured, the dead or the collapsed buildings. But something else also begins: the toll on mental health.
Traumatic stress increases after a disaster, researchers say. 1 study When examining survivors of 10 disasters, one third were diagnosed after a disaster – post-traumatic stress being the most prevalent (20%), followed by major depression (16%) and alcohol use (9%). .
Worsening mental health has been documented in a number of recent disasters, including the aftermath of the 1994 Northridge 6.7 magnitude earthquake in 1994 and the Christchurch, New Zealand magnitude 6.2 earthquake in 2011.
Sometimes the deterioration of mental health can be obscured by the stages of a disaster. Immediately following a disaster, researchers documented that there may be a high emotional level in the community when people enter a heroic rescue modefollowed by a honeymoon period where a community comes together and there is an unrealistic hope that everything can return to normal quickly. But then there may be a long downward phase and it may be accompanied by stress, exhaustion and fatigue.
"The disillusionment phase is a stark contrast to the honeymoon phase," says the US Mental Health and Substance Abuse Administration. "As optimism turns to discouragement and stress continues to cause harm, negative reactions such as physical exhaustion or substance use may begin to emerge."
Experts say it is important for authorities to recognize the impending public mental health crisis before disaster strikes. Following the Christchurch earthquake on February 22, 2011, some say that mental health services fell short and people suffered. Others say they received good care and, in subsequent years, public health authorities started an innovative public mental health campaign called “All right?"Which sought to improve the mental health of the community – a tactic that was once again highlighted after this year's mosque shootings led to the deaths of 51 people, New Zealand's worst mass killing in its modern history.
Here are the lessons that New Zealand officials have learned:
Understanding the emotional trauma of the earthquake can take time.
Following the Christchurch earthquake in 2011, there was a general deterioration in mental health, Experts say, with the worst effects closest to the strongest tremor. Children showed higher signs of posttraumatic stress. Even medical students reported their own mental health deteriorating.
More drugs that calm the brain – a class of drugs known as benzodiazepines that include Xanax and Valium – were dispensed after the earthquake. Researchers have found increasing rates of mood and anxiety disturbances in the two years after the earthquake.
After the Christchurch earthquake in 2011.
(Martin Hunter / Getty Images)
To 2016 Review From studies of 76,000 earthquake victims estimated that approximately 1 in 4 survivors experienced PTSD – making earthquakes more likely to cause PTSD than floods or spills.
"This was mainly because earthquakes were often much more devastating and destructive, and happened unexpectedly without warning." The authors I wrote.
When the aftershocks don't stop, cake – and kindness – help.
Part of what made the psychological recovery from the Christchurch earthquake difficult was the unusual length of the aftershock sequence.
"Imagine you had a terrible earthquake, and every 30 minutes or hours, or two hours or five hours, you get a little jolt that reminds you how terrible the first jolt was," said Sara McBride, one of the top information authorities. public for the emergency response effort in New Zealand. "It happens all day and night … there's no respite … and you don't know if the next change will be worse than the last."
Even the employees were prone to anguish. A solution? "Feed people's cake constantly," said McBride, who brought slices after aftershocks that left his subordinates quiet, pale and upset. "Little little moments of compassion and comfort, like a really good cake, make a surprising difference."
A public approach to mental health is essential.
Experts say health officials around the world should pay attention to Christchurch's mental health issues as a warning of what could happen if disaster strikes in their region.
"They must be absolutely concerned," said Ben Beaglehole, a psychiatrist who co-wrote many studies of Christchurch's mental health problems following the earthquakes.
Despite all its problems, Christchurch's mental health issues have been partially alleviated, Beaglehole said, for the region's concerted campaign to improve mental health and its near-universal rate of earthquake insurance among homeowners.
"If you can do things in the post-disaster environment to make people feel safe and secure enough, with a sense of purpose and belonging, and a future path, then I think the adverse effects will be minimal," Beaglehole said. "But if people keep feeling scared, insecure and insecure, that's where people fight."
Accomplished Employees The focus on rebuilding the city should be about healthy people, not healthy buildings. AN search found that over 75% of respondents said their home was damaged and nearly 2 out of 3 suffered from the "lost Christchurch church". Among the people who described how they felt when their efforts to keep things failed, men spoke of getting angry; The women described despair, depression and anxiety.
“We will never be able to deal with the consequences of one large-scale event, one consultation at a time. No system in the world could provide that, ”said Evon Currie, general manager of community and population health at the Canterbury District Health Council.
Thus, public health authorities conjured up a public outreach campaign known as All right? – emphasizing that everything was fine, and actually quite acceptableworrying about mental health and getting people not to think about issues beyond their control to a new mindset where they have power.
Employees credit this public health approach for helping the community cope with earthquake stress. A survey of Christchurch's largest residents found that the percentage of respondents quality of life was good increased from 73% in 2013 to 81% in 2018.
Most studies have found negative mental health effects from the Christchurch earthquakes, Beaglehole said. 1 study of hundreds of adults born in Christchurch found a higher rate of mental health disorders among those who suffered the earthquake than those who left before the earthquake began.
The earthquake survivors who suffered the most showed clear increases in mental health risk, the study found.
In addition, Beaglehole said, those who were already receiving specialized mental health services before the major earthquake saw the severity of their mental health worsen considerably for several years.
John Snook and his wife, Linley, visit the room where their son, Eddy, died.
(Marcus Yam / Los Angeles Times)
Disasters can trigger an acute mental health crisis.
Some people believe that the earthquake triggered a mental illness spell.
Eddy Snook became deeply interested in the earthquakes when the Christchurch earthquake sequence began in the months before the deadliest tremor occurred.
It was a natural fit for him. He was an electrical engineer and loved to find out how things worked. He drove to the Canterbury Plains over the weekend and traced fault lines.
But soon life became difficult. Sam, his childhood best friend, died of cystic fibrosis. Then the February earthquake came and he was shaken. The quake seemed to coincide with major mood swings and prospects, according to his father, John.
Snook demanded answers as to whether the building he worked in was safe.
"He was very obsessed with that," said his father. "It has become almost a little too consumed for him."
He soon quit his job and went to London. But the problems got worse; He stopped eating and his friends called his parents to pick him up. He received medical help, but in hindsight it was not working.
In 2014, he took his life.
"There are still tears every day," said his father.
Your father said Snook didn't have the right medical help. "We didn't anticipate what was going to happen … I think the help he got was not really adequate for his needs." The medical attention he received didn't address his problems, was confusing, and wasn't very careful, his father thought.
It takes work to get mentally under control.
The Christchurch earthquake in 2011 forever changed the life of Laylita "Bonnie" Singh.
As the tremor began, something hard hit her skull as the unreformed brick building where she worked as an apprentice tattoo artist and receptionist collapsed.
The blow broke two of the neck vertebrae and six in the middle of the back – compression fractures "because they were hit in the head," she said. She probably fractured the skull.
Laylita "Bonnie" Singh survived the 2011 earthquake.
(Marcus Yam / Los Angeles Times)
The coworker and friend couldn't.
Unlike Singh, who was trying to pick up her phone, Matti McEachen, 25, a fellow tattoo apprentice, ran Until the exit, he reached the door and disappeared as the walls began to fall.
Singh managed to crawl out of the rubble, digging himself. She had to learn to walk again; she suffered from the survivor's guilt. The pain persisted; constant fatigue; back and neck pain, unbearable.
Despite all this, Singh has realized a dream of becoming his own tattoo artist.
She is now co-owner of the only tattoo shop owned in the area, Paint Maid, in the nearby port community of Lyttelton, Christchurch, after becoming a master tattoo artist under the tutelage of his former colleagues and then …