Use of mental health services among disaster survivors.
OBJECTIVE
A sizable proportion of individuals following a disaster develop mental health problems. The consequences of these disorders can be long lasting. Only recently has research focused on mental health service delivery following disasters. This review examines the rates, predictors, and barriers to mental health service utilization following a disaster.


RESULTS
Most of the data on mental health service delivery come from three sources: a fireworks disaster in The Netherlands, the September 11, 2001, attack on New York City, and hurricane Katrina. Most survivors of disasters are reluctant to utilize mental health services and face barriers to accessing care. Even among disaster victims who are severely mentally ill, only a minority receive treatment. Among those who do receive assistance, more than half drop out shortly thereafter. Mental health service utilization following a disaster is influenced by a set of predisposing characteristics, enabling resources, and perceived need. The model for mental healthcare delivery following a disaster that has gained acceptance is Psychological First Aid.


CONCLUSIONS
Research is evolving on mental health service utilization. It is limited however to developed countries, although most disasters occur in developing countries. More research is needed, particularly among populations with scarce resources.
Mental Health, Substance Abuse and Rehabilitation, Technology and Health Services Delivery, Pan American Health Organization, Washington, DC 20037, USA. rodrigjo@paho.org
Jorge J
JJ
Rodriguez
Robert
R
Kohn
D004189:Disaster Planning; D004190:Disasters; D006297:Health Services Accessibility; D006801:Humans; D008603:Mental Health; D008605:Mental Health Services / Q000706:statistics & numerical data*; D009426:Netherlands; D010342:Patient Acceptance of Health Care; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000517:prevention & control; D014481:United States