title: A mental health relief programme in Armenia after the 1988 earthquake. Implementation and clinical observations.
abstract: An international mental health relief programme for children and adults was implemented in Soviet Armenia after the 7 December 1988 Spitak earthquake. This paper presents: (a) the steps considered essential in the selection, preparation and support of mental health workers for the relief work; (b) a method which facilitated the screening and treating of large numbers of students in their classrooms; (c) the rate of post-traumatic stress disorder (74%) and major depressive disorder (22%) of 582 victims clinically evaluated before entering treatment three to six months after the earthquake; (d) clinical observations of significant psychological problems that may be overlooked in brief crisis-orientated psychotherapy; (e) multiple severe post-earthquake adversities (such as the collapse of the social network, the recurrence of after-shocks, the delay of reconstruction and the ongoing political turmoil) which contributed to the psychological problems of the victims and delayed their recovery; (f) the extension of the outreach programme beyond its traditional therapeutic role to an advisory one to other relief organisations.
authors.affiliation: Psychiatric Outreach Programme, Armenian Relief Society of the Western United States.
authors.forename: A
authors.initials: A
authors.lastname: Goenjian
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D001136:Armenia / Q000453:epidemiology; D002648:Child; D003419:Crisis Intervention / Q000379:methods*; D004189:Disaster Planning; D004190:Disasters; D006266:Health Education; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D008605:Mental Health Services / Q000458:organization & administration*; D010560:Personnel Selection; D015995:Prevalence; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D000078329:Workforce