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Managing the Mental Health Dimensions of the Traumatic Stress

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Yuki, Lin and friends....
 
We have here in Washington DC (Bethesda actually) a world leading research center on the mental health effects of disaster and traumatic stress - the Center for the Study of Traumatic Stress (CSTS), headed by Dr. Bob Ursano, who is also Chair of Psychiatry Dept at Uniformed Services University. I'm also copying another expert from CSTS, Dr. Bob Gifford, (Exec Dir) on this email.  I know they are doing some innovative things in tracking mental health response following disasters, both natural and man-made.
 
 
 
here are some quick thoughts on the mental health sequelae of disaster exposure in the Japan crisis:
 
-Most survivors will do fine (resilience), and show no long-term ill effects in terms of mental health despite some acute symptoms.
 
-A significant number of survivors will develop stress-related mental health problems. The most common reactions include depression, anxiety disorders including PTSD (post traumatic stress disorder), disrupted sleep, and alcohol/substance abuse problems.
 
-One of the key issues in the aftermath of Japan earthquake / tsunami disaster now is to try to avoid (or at least reduce) "secondary trauma," that is, adding to the initial traumatic stress load by further stressing the survivors in various ways. This obviously extends to availability of basic medical care and life support items such as food, water, shelter, etc, but in this case also addressing fears re: radiation exposure. The location of missing family members, whether dead or alive, is a major concern, and can be a significant source of stress for many survivors.  Anything that can be done to facilitate reliable information flow, and help survivors determine the fate of their loved ones, will help reduce the secondary trauma load.
 
-Re: potential radiation exposure, it's important that gov't and industry leaders provide frequent and accurate updates to the public re: the continuing nuclear reactor situation and any radiation exposure threat. In the absence of credible and reliable information from trusted sources, people will create their own narratives, suspecting the worst and reacting acccordingly.  I am also copying Dr. Ross Pastel, who is an expert on psychological effects of radiation exposure and potential exposure.
 
-What leaders (government, industry, community) leaders say and do in the aftermath of disasters can have a major influence on how the public responds, in terms of healthy vs unhealthy coping and adaptation processes ("grief leadership"). Efffective leaders must be highly visible, openly admit the loss and devastation, and work energetically to address the needs of survivors and family members.  Effective leaders also provide reason for optimism and hope, often by linking rebuilding and mutual assistance efforts to the memory and honor of those who have died.  This may be an even greater inluence in community-oriented cultures like Japan.
 
-Most of what I've said above is supported by sound research, much of which has been done by people at the CSTS.
 
Hope this helps.  All the best,
 
Paul
 
 
Paul T. Bartone, PhD.
Senior Research Fellow
Center for Technology and National Security Policy
National Defense University
300 5th Avenue, SW
Fort McNair, Washington, DC  20319
 
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Yuki and Lin

Although we have not met, if we can be of any help let us know.

Our colleague at the Military Medical School June Shigemura MD was at the National Defense University School of medicine after he left his fellowship time with us and is also very helpful and skilled.

Bob

Robert J. Ursano, M.D.
Professor of Psychiatry and Neuroscience
Chair
Dept of Psychiatry
USUHS

Director
Center for the Study of Traumatic Stress

Uniformed Services University
School of Medicine
4301 Jones Bridge Rd 
Bethesda, MD 20814

howdy folks