Events like a storm or a flood ruin possessions and destroy homes, schools, and businesses. Events like terrorist attacks and other crimes destroy property and kill and maim individuals. Those are the stories we hear on the news. What we usually don’t hear is the effects on mental health, which can eclipse the disaster itself. After a disaster, there is the cleanup – businesses and neighborhoods are rebuilt, property replaced, physical injuries heal. People eventually get back to their daily routines.
Yet, unseen mental health problems brought on by a disaster still trouble many. A terrifying situation that has disrupted someone’s life can affect his or her mental health in everyday life, and ripple out to the entire community.
Mental health and public health professionals understand how these events affect individuals and communities. There is evidence that after disasters (including crimes and violence), the majority of injuries and trauma are psychological, not physical – at a rate of four to fifty psychological injuries for every one physical injury. Stress and fear can last for months, years, or, in some cases, a lifetime.
For some, that stress and fear may develop into a mental disorder because they did not seek treatment. Many people don’t seek help early because they are not aware of what they are feeling or that they may need help to work through their experience. And, unfortunately, assessment of mental health issues in the aftermath of these types of event is still relatively rare.
Individuals
Experiencing a traumatic event, like a natural disaster or terrorist attack, does not automatically sentence survivors to serious or long-term mental health issues. There is a range of responses:
- Most people will experience some mild distress in the short-term, such as insomnia, trouble concentrating, worry, increased alcohol use. These people usually do not require mental health treatment, but do benefit from community-wide support.
- In a small number of people, that mild distress will continue longer or be more intense and persistent. These individuals would benefit from formal mental health treatment, in addition to community support.
- A very small number of individuals (usually from 10-20%, depending on the event) will develop serious mental health conditions like acute stress disorder, post-traumatic stress disorder, or major depression, and will benefit from mental health intervention, as well as support from the community.
For all of these individuals, life in the aftermath of violent trauma can be challenging, reaching far beyond that moment of disaster. Lives and simple routines can be filled with fear and stress adn worry. For some victims, it’s hard to move past it, to leave it behind.
Community
It’s an issue for us all, though, not just those who were directly affected. While those individuals struggle, the truth is that disasters, terror, and violence don’t just hurt some of us. At a high level, these events hurt all of us. Those who are involved in responding and helping victims, such as first responders and medical personnel. Those close to someone directly affected – family, friends, colleagues. And people who share the larger community with those affected like school faculty, clergy, businesses. Like dominos falling one after the other, anyone or everyone in a community can be affected. The pain, grief, and stress from trauma know few bounds.
Unfortunately, this trauma – its ripples, how it impacts an entire community – is rarely a story we shout from the rooftops in the moment of disaster, when the dust settles, or in the long term. It outlasts the initial drama, it outlasts many (though certainly not all) of the physical injuries suffered. The story is one of our own internal mental health, something so many of us hate to talk about publicly, or privately. The story is invisible unless and until those of us who can do so share it. Until we can find a way to make the long-term aftermath and the mental and public health impact of all this trauma the story, it remains difficult for people directly or indirectly affected to understand their own feelings and fears, and to put them in context.
The truth is pretty simple: It’s normal to feel distress after something horrible happens. Those who experience a disaster directly know it in their bones. Those who haven’t need some help to understand that part of the story.