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Robert J. Ursano, MD, Chair, Department of Psychiatry, Director, Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd., Bethesda, MD 20814-4799, 301-295-2470, rursano@usuhs.mil, Nancy T. Vineburgh, MA, Asst. Prof, Dept. of Psychiatry, Director, Office of Publice Education and Preparedness, Uniformed Services University, 4301 Jones Bridge Rd, Bethesda, MD 20814-4799, and Carol S Fullerton, PhD, Associate Prof, Department of Psychiatry, Scientific Director, Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd., Bethesda, MD 20814-4799.
Mental health is the target of terrorist events. Because the psychological impact of terrorism is so pervasive, large populations are affected by increased distress, psychiatric disease, and behavioral responses that may be adaptive or maladaptive. The Institute of Medicine endorses a public health approach to managing the psychological impact of terrorism that includes prevention, health promotion and treatment. Interventions that integrate mental health and public health are needed in the pre-event, event and post-event phases that address the agent, the vector, and populations at risk. Pre-event interventions include public education for preparedness and mental health surveillance.
Disaster behavior is an important new concept to inform public health interventions. Disaster behaviors include evacuation, shelter-in-place, quarantine. For biological terrorist agents it is important to recall that the only countermeasures available early in an outbreak, and for an extended time for a new disease agent are behavioral interventions. The issues of compliance and adherence, behavioral issues, are critical factors in protecting our public health. Prevention and treatment of mental disorders are also critical. While the majority of those faced with a terrorist event will experience only transitory distress, many individuals have been found to increase their use of alcohol, tobacco, and other drugs, especially those with pre-existing alcohol abuse or other psychiatric difficulties. People exposed to terrorism are at increased risk for depression, generalized anxiety disorder and panic disorder.
Planning for the psychological responses to terrorism requires an integrated response across medical, emergency and public health authorities at local, regional and federal levels.
Learning Objectives:
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.