title: Social, psychological, and behavioral responses to a nuclear detonation in a US city: implications for health care planning and delivery.
abstract: A nuclear detonation in a US city would have profound psychological, social, and behavioral effects. This article reviews the scientific literature on human responses to radiation incidents and disasters in general, and examines potential behavioral health care provider (BHCP) contributions in the hours and days after a nuclear detonation. In the area directly affected by the blast, the immediate overarching goal of BHCP interventions is the support of lifesaving activities and the prevention of additional casualties from fallout. These interventions include 6 broad categories: promoting appropriate protective actions, discouraging dangerous behaviors, managing patient/survivor flow to facilitate the best use of scarce resources, supporting first responders, assisting with triage, and delivering palliative care when appropriate. At more distant sites, BHCP should work with medical providers to support hospitalized survivors of the detonation. Recommendations are also made on BHCP interventions later in the response phase and during recovery.
authors.affiliation: Office of the Assistant Secretary for Preparedness and Response, Department of Health and Human Services, USA. daniel.dodgen@hhs.gov
authors.forename: Daniel
authors.initials: D
authors.lastname: Dodgen
authors.forename: Ann E
authors.initials: AE
authors.lastname: Norwood
authors.forename: Steven M
authors.initials: SM
authors.lastname: Becker
authors.forename: Jon T
authors.initials: JT
authors.lastname: Perez
authors.forename: Cynthia K
authors.initials: CK
authors.lastname: Hansen
mesh_terms: D001524:Behavioral Medicine; D002947:Cities; D003695:Delivery of Health Care; D004190:Disasters; D005239:Fear; D006285:Health Planning; D006801:Humans; D008399:Mass Behavior; D054527:Mass Casualty Incidents; D008605:Mental Health Services / Q000458:organization & administration; D054043:Nuclear Weapons; D010166:Palliative Care; D024382:Professional Role; D011847:Radioactive Fallout; D018788:Radioactive Hazard Release / Q000523:psychology*; D012924:Social Conditions; D023481:Terrorism; D014218:Triage; D014481:United States
chemical_list: D011847:Radioactive Fallout