Lessons learned and forgotten: the need for prevention and mental health interventions in disaster preparedness

From the Frontline to the Homefront: The Experience of Israeli Veterans

In 1948, the state of Israel was created as a homeland for the Jewish people after 2,000 years of persecution and deportations in the diaspora. During the past 72 years, its inhabitants have experienced several wars and numerous terrorist attacks. Therefore, the issue of trauma goes beyond academic study, it is part of daily life. These circumstances have, unfortunately, turned Israel into a natural stress laboratory, which has enabled the systematic research of the biopsychosocial effects of traumatic stress on soldiers and civilians. This article reviews the findings of a series of studies that examine (a) the short- and long-term mental health effects of war on combat veterans; (b) the effects of repeated exposure to war on veterans; (c) trajectories of PTSD; and, specifically, (d) reactivation and (e) delayed-onset PTSD. We present the findings of two decades of systematic trauma research, which have followed the ongoing psychopathological effect of war on veterans. In understanding the ripple effects of trauma, it can be seen that veterans do not leave the events of the war behind once they are home; rather, it is with them wherever they go. Consequently, the trauma has a ripple effect that may carry over to veterans' spouses and offspring. The multiple manifestations and trajectories of both acute and chronic trauma will be presented. Clinical ramifications and implications will also be discussed.

Disaster mental health preparedness in the community: A systematic review study

The objective of this study was to perform a systematic review of articles that cover aspects of disaster mental health preparedness. This assessment was done by a thorough review and summary of the available studies which provided a considerable background and amplified the gaps in knowledge about community mental health preparedness. By this systematic review, we tried to identify available concept of community mental health preparedness and related tools that communities and individuals will need to prepare for natural disasters. We found there is a lack of mental health preparedness in the majority of countries; valid and reliable tools and context-bound programs should be developed based on the experiences and perceptions of the community.

The Open Line for Students in the Gulf War in Israel

The Israeli Ministry of Education and Culture Open Line for Students handled thousands of calls from students, parents and teachers during the Gulf War. The Open Line team consisted then of over thirty professionals using nine telephone lines, twelve hours a day. The professional approach was based on principles of treatment of stress, short-term counselling and intervention via the telephone. In short-term therapy and telephone intervention it is assumed that most clients are normally functioning people who have become involved in an abnormal situation. Therefore, brief orientation, guidance and counselling may assist in returning them promptly to a state of adaptive coping. The principles of treatment of stress consist of (1) strengthening the client's ability to function and cope; (2) encouraging self-perception of health and hardiness; (3) referral to a trusted leadership and creating a local one; (4) promoting social cohesion and support; and (5) legitimizing social exchange. Our experience led us to the following conclusions regarding the educational system: in emergencies, schools must continue to operate and function even when they are ordered to close; the open line can be used to assist in coping in an emergency; in emergencies, it is advisable to encourage students to turn for help to their school's staff; professionals who help others in an emergency need support for themselves; every school must prepare programmes in advance to cope with specific emergencies. The conclusions with regard to the home front in a state of emergency were that the closure of schools was a national question; advance practice in using protective gear is needed; provision of early and accurate information reduces helplessness; the community support framework must be planned.

The Psycho-Social Needs of Health Professionals Providing On-Scene Disaster Care

As evidenced in a number of recent disasters, there appears to be an increasing trend, for health care professionals to leave the confines of the hospital to provide on-scene care. This trend may be due to a number of recommendations from a variety of sources such as the National Disaster Medical System, the implementation of the United States Military Disaster Response, Federal Aviation Administration (FAA) recommended airport disaster plans, trends in community disaster planning, and Emergency Medical Services practice.