Mental health care for ethnic minority individuals and communities in the aftermath of disasters and mass violence.
Findings from research on psychiatric epidemiology, disaster effects, discrepancies in service use, and cross-cultural psychology are reviewed to generate guidelines for culturally responsive postdisaster interventions. Ethnicity and culture influence mental health care at various points: on need for help; on availability and accessibility of help; on help-seeking comfort (stigma, mistrust), and on the probability that help is provided appropriately. There are aspects of disaster mental health practice that may ameliorate many of barriers that contribute to ethnic disparities in service use. It is proposed that interventions should give greater attention to socially engaged emotions and functioning. To promote disaster recovery, practitioners are advised to: assess community needs early and often; provide easily accessible services; work collaboratively and proactively to reduce stigma and mistrust and engage minorities in care; validate and normalize distress and help-seeking; value interdependence as well as independence as an appropriate developmental goal; promote community action; and advocate for, facilitate, or conduct treatment and evaluation research. Notwithstanding the pain and stress they cause, disasters create opportunities to de-stigmatize mental health needs and build trust between providers and minority communities.
Norris
Fran H
FH
Department of Psychiatry, Dartmouth Medical School, Hanover, NH, USA.
Alegria
Margarita
M
D003156:Community Mental Health Services; D004190:Disasters; D005006:Ethnicity / Q000523:psychology*; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D008605:Mental Health Services; D008913:Minority Groups / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000208:ethnology* / Q000523:psychology / Q000628:therapy; D014481:United States; D014754:Violence / Q000208:ethnology* / Q000523:psychology