|Year : 2018 | Volume
| Issue : 2 | Page : 27-34
An overview of psychosocial impacts of disaster
Preethi T Louis
Sr. Demonstrator, College of Nursing, CMC, Vellore, India
|Date of Web Publication||5-Jun-2020|
Source of Support: None, Conflict of Interest: None
Disaster or calamity causes widespread destruction or distress. For any catastrophe, we determine the degree of suffering by the size, shape, impact and the probability of reoccurrence. Stress and emotional pain can have a significant effect on individuals and communities. Recovering from the impact of the calamity and regaininga sense of control is a vital focus in delivering psychosocial interventions. The present article attempts to explore the psychosocial profiles of victims of flood, drought, storms, and cyclones that have occurred in the Indian subcontinent over the last decade and the immediate and long-term implications of the disaster. We discuss essential methods of providing relief and rehabilitation in this paper. Finally, although many South East Asian countries have been deliberating on several useful models for disaster management, further research on understanding the psycho-social impact of calamities are recommended.
Keywords: disaster, psychosocial impact, victims, rehabilitation, intervention
|How to cite this article:|
Louis PT. An overview of psychosocial impacts of disaster. Indian J Cont Nsg Edn 2018;19:27-34
| India’s Disaster Profile|| |
On account of its geographic region and climatic conditions, India tops the list as the most catastrophe inclined zones of the world. Around 58.7% of the total land mass experiences seismic tremors. About 40 million hectares of the Indian land (12%) is continuously affected by surging floods, and 68% of the area is prone to starvation (Mohandas, 2009). Tsunamis have continually influenced India since 2004 (Ministry of Home Affairs, 2011). Around 76% of the land encounters cyclones each year. In the Himalayas, torrential landslides have been a noteworthy and disastrous event causing enormous destruction to life and property. Cold and heat waves in different parts of India are common and numerous people encounter catastrophies.
| Aims and Objectives|| |
This article revolves on providing an account of cataclysms over the past ten years and the associated psychosocial issues. We also explore psychosocial mediations that might be applicable for people encountering loss and misery. This paper gives an emotional examination of a wide variety of issues in disasters over the last decade and draws on the implications to cultivate mental well-being. In short, this article aims to :
- Provide a brief overview of the overall disasters that occurred a decade ago
- Audit the psychosocial profile of the survivor victims.
- Provide a record of psychosocial intercessions
| Disaster and Mental Health|| |
The manner in which an individual sees catastrophe changes from individual to individual. It depends on the type of calamity, level of adversity, a person’s strategy for managing pressure, and the resources available. It likewise relies upon the lifestyle of that society, and even on the country’s monetary and political hierarchy. To a specific degree people might not have the ability to adjust or adapt suitably to the conditions and experiences of the calamity. They may experience signs of distress and mental concerns. It becomes crucial to comprehend that not all psychological and emotional reactions are adverse. It can create feelings of endurance and increase the chances of survival. Traumatic experiences can transform the way we perceive events.
| General Psychological Concerns|| |
The mental health of an individual may improve when one understands that he or she needs to adapt to the demands posed. Overwhelming reactions can emerge after a disaster. People react contrastingly to disasters depending on their experiences and traits. However, there are some typical responses experienced by individuals affected (Beigel & Berren, 1985). They are as follows:
- Emotional problems (freezing, panic, shock, fear, aggravation, outrage, pity and blame intent)
- Psychosomatic symptoms (sleep deprivation, eating issues, physical issues, muscle strain, palpitation, migraines, loose bowels, and breathing challenges)
- Cognitive problems (recalling unpleasant memories, reliving it, having bad dreams, perplexity, flashbacks, trouble in concentrating, memory issues, and losing the capacity to focus)
- Behavioral and attitudinal concerns (disturbances in social relationships and friendships, poor inspiration, rumination, dormancy, misery, and loss of intrigue)
| Stress, Post Traumatic Stress Disorder (PTSD), Depression|| |
PTSD is a psychiatric condition which can arise after any traumatic, catastrophic life event. A systematic review on post disaster PTSD showed that symptoms of PTSD were seen more in the initial one to two years after natural disasters in the victims. The first responders such as fire fighters and police officers also had PTSD symptoms (Neria, Nandi, & Galea, 2008). The tsunami which occurred on 26th December 2004 in the Indian coastal areas was because of the tremor experienced in the Indian Ocean. In February 2005, scientists reviewed the seriousness of the earthquake to be 9.0 (McKee, 2005). Studies revealed that 78.5% of women had concerns of PTSD when contrasted with 61.7% of men. Women belonging to rural regions and from lower financial strata had higher risks for PTSD. They were 6.35% more likely to be at risk as compared to men (Pyari, Kutty, & Sarma, 2012). The encounters of Oxfam an NGO which worked for the tsunami affected territories in South India also found that women essentially experienced more stress (Mac Donald, 2005). Depression was the most common psychological effect and anxiety was seen more in women after the tsunami in Tamil Nadu (Nambi, Desai, & Shah, 2007). In the Kanyakumari districts, nearly 43% of male survivors had significant mental distress, and 31% had abnormal or severe levels of distress (George, Sunny, & John, 2007). Moreover, investigations on long term well-being outcomes (Kar, Krishnaraaj, & Rameshraj, 2014) demonstrated that 33% of the sample studied had depression (33.6%), uneasiness (23.1%), PTSD (70.9%) and associated comorbidities (44.7%). PTSD was also seen in many after the Chennai, South India floods in 2016 (Fernandes, Borah, & Shetty, 2016).
| Sleep Deprivation and Somatoform Disorders|| |
In 2007 Bihar witnessed floods, and the United Nations depicted this as the most noticeable and awful surge in the living memory of Bihar. It was accepted to be the most exceedingly terrible flood in Bihar over the most recent 30 years. The flooding had affected an expected 10 million individuals İn Bihar. Individuals experienced severe epidemics, distress, and anxiety. Hundreds had fever, diarrheas and these resulted in deaths accounting to nearly 1,287 (Jha & Raghavan, 2008).
During the 2013 Uttarakhand tragedy, survivors experienced mental injury, melancholy, a sleeping disorder, and numerous other issues. Individuals who lost their dear ones had terrible dreams, episodes of resentment, misery and self-destructive contemplations. Females who expressed concerns of depression and anxiety were far greater in number than men. Women survivors had sleep deprivation, and men found it hard to refrain from worrying. The mental well-being of those affected was thus of significant concern (Channaveerachari et al., 2015). Among children and teenagers, nervousness, adjustment disorders, shock, somatoform disorders, and PTSD were present. Of the adolescents studied, 18% continued to experience psychological distress and 13% stress-related psychiatric symptoms one month post the catastrophe (Aneelraj et al., 2016). Different studies done on the elderly populations uncovered that nearly 16.13% experienced intermittent flashbacks following the disaster. There were 14.52% who experienced difficulties with sleep while 12.9% had recurrent memories of the catastrophe. About 6.45% suffered the loss of well-being and security while 20.97% experienced restlessness and immense physiological arousals. It was the geriatric group that experienced more prominent physical issues when compared to adults. Adults reported increasing concerns in mental problems (Chandran et al., 2015).
The 2016 Chennai floods was another very exhausting emotional experience. The rains and flooding left behind permanent damages to life and property. It was hard to measure the mental and psychological decline in well-being, but it was not hard to understand that there would be immediate and aberrant impacts. Individuals experienced flashbacks. They rehearsed recollections of the excruciating occasion that lead to physical responses, for example, fast heartbeat, loss of awareness, perspiring, extreme fear and so on. They reported intense anxiety about whether the calamity would recur. Individuals experienced irritability, exceptional uneasiness, mood swings, and grief. Victims reported a loss of memory, suicidal thoughts, symptoms of sickness, tics, gastrointestinal problems, migraines, and chest pain (Fernandes et al., 2016). They experienced a lack of concentration, trouble in basic leadership skills, difficulty in sleeping and eating etc. Accoring to reports from the Institute of Mental Health victims, of the recent Kaja winds in South India stated that they couldnot sleep even for two hours. Fear of survival was also present (Ezhilarasan, 2018)
| Substance Abuse|| |
Men victims often responded to disaster by indulging in or escalating substance abuse. After the 2004 tsunami, substance abuse became common among men (Nambi et al., 2007). Depression, panic, fear lead to liquor abuse which was a great concern after the Chennai, South India floods, 2016 (Fernandes et al., 2016).
|Figure 2: Uttarakhand Floods: Devastated Pithoragarh, Chamoli Regions Look to Limp Back To Normalcy (2016)|
Click here to view
The staggering Gaja violent wind in 2018, affected 12 regions in Tamil Nadu devouring 63 human lives. It resulted in 3.4 lakh destruction of homes out of which 2.8 lakhs were cottages. The poorest of people have been enormously affected. A few people used the money to build themselves roofs with gunny sacks. Unfortunately, they couldnot brave the severe rains. Loss ofjobs and property has made numerous individuals mentally discouraged. Individuals became terrified and began disturbing Government officials. Numerous survivors reported feelings of restlessness and palpitations (Ezhilarasan, 2018). A vast majority are unable to overcome the horrible encounters caused by the violent wind. Women, whose spouses took liquor, became highly anxious as they were the sole providers. Some of the symptoms that victims had were restlessness, palpitations, fretfulness and crying spells.
|Figure 3: Cyclone Gaja Leaves at least 45 Dead in Tamilnadu and Puducherry: Relief Works are in Full Swing (2018)|
Click here to view
| Self Destructive Behaviors|| |
Post Traumatic Stress Disorder (PTSD) whenever left untreated, can lead to the person experiencing severe distress and sorrow (Feng et al., 2007). A 19 year old committed suicide on discovering his mark reports destroyed, and a 54 year old hung himself on seeing his damaged house (Bidhuri, 2018). The 2018 Kerala, South India floods destroyed most of what individuals had worked over the years, and survivors are now attempting to recover from losses. They are struggling in adapting to the circumstance. As special teams are doing their best in eradicating illness and establishing psychological wellness, the affected cannot be disregarded. Post floods and avalanches, many Keralites have begun complaining about having nightmarish flashbacks of the occurrences (George, 2018). About 200 individuals reported unusual mental conditions in Chenganoor and Thiruvalla. These were two of the zones most affected by the floods and about 220 lives were lost. Huge numbers were reported to be contemplating suicide and felt enormously discouraged about their misfortune.
|Figure 4: Tripura government announces to donate Rs. 1 crore for Kerala flood victims (2018)|
Click here to view
| Debts Induced Deaths|| |
Maharashtra experiences drought, once in every 5 years (United Nations Office for Disaster Risk Reduction [UN1SDR], 2009). Since 80°/ū of the water resources are from groundwater, scarcity of rainfall had caused the Government to supply water through tankers and borewells resulting in enormous costs (Ministry of Agriculture & Farmers Welfare, 2016). The State government revealed that around 7,896 towns are enduring drought, out of which 3,299 municipalities belong to the region of Marathwada. The 2012 drought severely affected the agriculture of the State. According to the India Oilseeds and Products Update, there was a 21%, 5% and 18% decrease in cereals, pulses and food grain productions for the year 2012-13. Inland fishery also suffered the misfortune of 16% loss due to the drought. Crop failure, decrease in employment of workers and expanding costs significantly affected the country’s economy. Consequently, farmers were forced to borrow money from moneylenders and banks with high interests which influenced their financial status and additionally lowered their emotional well-being and social life (Udmale, Ichikawa, Manandhar, Ishidaira, & Kiem, 2014). The number of suicides among farmers continues to be a growing concern and worry. Studies have confirmed that similar conditions exist among other drought-prone nations (Kiem, 2013)
| Rioting and Aggression|| |
While disasters can bring a sense of community togetherness, the feelings of destruction and devastation can bring opposite emotions and reactions in individuals and communities. The 2010 Eastern Indian storm struck part of Bangladesh, Bihar, Assam, and West Bengal. In India, the storm destroyed more than 91,000 residences (Singh, 2010). Approximately 300,000 homes and almost 500,000 individuals were left homeless (Bhalla, 2010). In West Bengal, people were furious about the help rendered. They demanded more materials like food, water, and clothing and individuals were seen fighting with authorities. In Karandighi, outrage sparked, and the villagers on seeing that the supply would not be sufficient for everybody in need chose to take matters into their own hands. Looting of goods began. One victim said “What else would I be able to do? The administration is not helping us, so we need to help ourselves” (Strapped for relief, villagers strike - Anger in storm-hit North Dinajpur, 2010). People began expressing hostility and swung into aggressive acts.
| Vulnerable Population|| |
Studies have demonstrated that females experienced more prominent dimensions of mental issues, for example, uneasiness, sorrow, and PTSD (Math, Nirmala, Moirangthem, & Kumar, 2015). Gender was a risk factor for developing nervousness and PTSD. Studies reveal that women are at a higher risk for PTSD (Kumar et al., 2007). Members with a lower income or salary demonstrated a higher level of uneasiness, discouragement, and PTSD (Maj et al., 1989). Being female, being married, having lesser pay, living in impermanent lodgings were factors that lead to mental issues. The majority of the women affected by Bihar floods (2007) in flood-prone zones did not get to know about the early warning. When trapped by floods, it is was the women who decided to sleep on empty stomachs. Male individuals chose what to leave at home and what to take with them at the time of relocation. The daily wage paid to women laborers was only rupees 15 (Jha & Raghavan, 2008). Women were forced to work twice as much when their spouses relocated looking for work. They carried the entire responsibilities of the family. Children and adolescents are also vulnerable to psychological distress. Children and adolescents as primary (exposed directly to tsunami and earthquake) and secondary (those with close family and personal ties with primary survivors) survivors after a disaster were found to have adjustment disorder, depression, panic disorder, somatoform disorder, schizophrenia and other disorders (Aneelraj et al., 2016; Math et al., 2008).
| Psychosocial Interventions|| |
Psychosocial support can be tailored specifically to disaster circumstances and can enable people to respond effectively to the mental and physical needs. These interventions help victims accept the situation and adapt to it. Catastrophes have severe psychosocial outcomes. The emotional injuries might be more severe than the destruction. It takes far longer to recuperate from emotional distress than acquiring material misfortunes. Early help and adjustments are required (Murthy, 2009). Social impacts are felt due to sudden demise, separation, exploring of adversity, and vulnerability. Preventive Medicine experts regularly discuss the six R’s which are Readiness, Response, Relief, Rehabilitation, Recovery, and Resilience in rehabilitating disaster victims. Common psychological issues experienced in calamities are tension, sadness, and intense stress responses. The presence of these symptoms frequently relies upon the person’s weakness and adapting abilities. In an acute stress response, the individual might be in a bewildered or desensitized state, but this may frequently decline within a couple of days. We want to discuss some of these techniques used during interventions.
It is characterized by exchanges that happen within 48-72 hours after a disaster. It is referred commonly to as ‘mental de-briefings.' By and large, these sessions urge members to portray and share both specific and emotional aspects of their experiences (Norris, Friedman, & Watson, 2002). The aim of doing this is to enable a person to intellectually rebuild the apparent disaster event in a less traumatic manner.
2. Cognitive Behavioural Therapy (CBT)
Cognitive Behaviour Therapy (CBT) alludes to a class of interventions that focus on psychological distress and mental misery that are a result of intellectual components (Beck, 1970). The focus of this treatment approach is to deal with maladaptive thoughts that influence emotions and behaviors (Ellis, 1962). The point at which CBT was used for victims of the Wenchuan earthquake, turned out to be effective in lowering the extent of psychopathology experienced after a catastrophe (Zhang, Feng, Xie, Xu, & Chen, 2011). There have been studies to further suggest that a disaster focused CBT within three months has been promising in relieving many symptoms among disaster victims (Roberts, Kitchiner, Kenardy, & Bisson, 2009).
3. Community-Based Interventions
This method of rehabilitation focuses on organizing the day to day activities. It enables people to recoup in building their homes, participating in social and religious ceremonies, paying attention to the family, talking and overcoming self-blame (Math et al., 2008). Children are engaged through painting, singing, playing. This type of intervention focuses on enabling survivors to participate in activities such as cooking, cleaning, and rebuilding activities.
| Conclusion|| |
Aside from the quantifiable and unmistakable harm and misfortune, there is also the loss of life due to the catastrophic circumstance. Research so far in India uncovers that the insufficient number of well-being experts, the absence of institutional resources and financial problems makes it challenging to address the concerns of disaster victims on a vast scale, and this is also a tedious exercise. The South East Asian nations are continuing to develop their fruitful models of improving emotional well-being and care that may be beneficial after a calamity. Standard experience- sharing opportunities in this area would empower everyone to conquer numerous difficulties and to accomplish their goals.
Conflicts of Interest: The author has declared no conflicts of interest.
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