title: Internet-based self-assessment after the Tsunami: lessons learned.
abstract: BACKGROUND
  In the aftermath of the Tsunami disaster in 2004, an online psychological self-assessment (ONSET) was developed and made available by the University of Zurich in order to provide an online screening instrument for Tsunami victims to test if they were traumatized and in need of mental health care. The objective of the study was to report the lessons learnt that were made using an Internet-based, self-screening instrument after a large-scale disaster and to discuss its outreach and usefulness.
  
  
  METHODS
  Users of the online self-assessment decided after finishing the procedure whether their dataset could be used for quality control and scientific evaluation Their answers were stored anonymously only if they consented (which was the case in 88% of the sample), stratified analyses according to level of exposure were conducted.
  
  
  RESULTS
  A total of 2,914 adult users gave their consent for analysis of the screenings. Almost three quarter of the sample filled out the ONSET questionnaire within the first four weeks. Forty-one percent of the users reported direct exposure to the Tsunami disaster. Users who were injured by the Tsunami and users who reported dead or injured family members showed the highest degree of PTSD symptoms.
  
  
  CONCLUSIONS
  ONSET was used by a large number of subjects who thought to be affected by the catastrophe in order to help them decide if they needed to see a mental health professional. Furthermore, men more frequently accessed the instrument than women, indicating that Internet-based testing facilitates reaching out to a different group of people than "ordinary" public mental health strategies.
authors.affiliation: Centre for Disaster and Military Psychiatry, University of Zurich, Militaerstrasse 8, Zurich, Switzerland. stefan.vetter@access.uzh.ch
authors.forename: Stefan
authors.initials: S
authors.lastname: Vetter
authors.forename: Astrid
authors.initials: A
authors.lastname: Rossegger
authors.forename: Thomas
authors.initials: T
authors.lastname: Elbert
authors.forename: Juliane
authors.initials: J
authors.lastname: Gerth
authors.forename: Frank
authors.initials: F
authors.lastname: Urbaniok
authors.forename: Arja
authors.initials: A
authors.lastname: Laubacher
authors.forename: Wulf
authors.initials: W
authors.lastname: Rossler
authors.forename: Jérôme
authors.initials: J
authors.lastname: Endrass
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D004190:Disasters; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000453:epidemiology; D015995:Prevalence; D011594:Psychometrics / Q000295:instrumentation*; D012647:Self-Assessment; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D057192:Tsunamis; D014947:Wounds and Injuries / Q000453:epidemiology; D055815:Young Adult