Using a socio-ecological model to describe the long-term mental health consequences of disaster in the United States

This presentation will describe how unresolved, long term psycho-socio-ecological needs of individuals post-disaster may impair mental health functioning. National Center for Disaster Preparedness research found mental health issues to be the most enduring of Hurricane Katrina's disabling effects. Their findings indicate that more than 60% of surveyed parents or care-givers showed symptoms of depression, post traumatic stress disorder, or anxiety two years after the storm. Four times as many children (of surveyed parents) were likely to have depression or anxiety disorders post-Hurricane Katrina. The presentation will discuss the importance of Urie Bronfenbrenner's Ecological Systems theory which specifies four types of nested environmental systems with bi-directional influences within and between the systems. These are the Microsystem: immediate environments (family, school, peer group, neighborhood, and childcare environments); Mesosystem: connections between immediate environments (e.g., a child's home and school); Exosystem: external environmental settings which indirectly affect development (such as parent's workplace); and Macrosystem: the larger cultural context (Eastern vs. Western culture, national economy, political culture, subculture). The Chronosystem (patterning of environmental events and transitions over the course of life) was added to the theory later and is relevant to our presentation. We will also describe and explain the relevance of Derrick Silove's ADAPT (Adaptation and Development after Persecution and Trauma) model to our recommendations to prevent or ameliorate post-disaster mental health problems. This model suggests that essential psychosocial elements (safety, security, interpersonal networks, systems of justice, social identities and roles and institutions that confer meaning and coherence) are at risk after a disaster.