Psychological Consequences: Responders and Community

Explosive or disaster events may result in psychological morbidity for responders, families, and the entire community. For responders, this is in part due to the impact of dealing with devastating injuries and the potential death of individuals including that of colleagues. Proper planning for prevention, mitigation, recognition, and treatment of psychological consequences is essential for all responders following explosive events. Mental health care is now based on the principles of preventive medicine. This has necessitated a paradigm shift from relief-centered post-disaster management to a multidimensional integrated community approach of health promotion, disaster prevention, preparedness, and mitigation. While not all individuals are adversely affected by a particular disaster, the evidence shows we can expect a broad range of mental and physical health consequences both in the acute and longer-term aftermath. Prevalence of mental health problems in a disaster affected population is found to be higher by at least two to three times that of the general population. Although first responders do not appear to have a higher prevalence of mental health disorder compared to other occupations, they are more often exposed to multiple traumatic events. The risk of developing psychopathology is elevated and ‘dose related’ i.e. depending on the degree and duration of exposure to the trauma scene. Exposure to trauma increases the risk of experiencing a new-onset mental health disorder, particularly in the early stages of one’s careers. This chapter will discuss strategies to decrease psychological morbidity for individuals involved in an explosive and/or disaster incident.